Introduction

This page provides 2025/2026 budget guidance for employer‑paid group benefits in Canada, excluding Quebec. Use these per‑employee‑per‑month (PEPM) benchmarks and headcount totals to set an initial budget, then request a tailored quote. All figures are CAD and illustrative, not a binding offer.

What the PEPM range typically includes

• Core health: prescription drugs, extended health (paramedicals), vision, out‑of‑country/travel emergency

• Dental: basic, endodontics/periodontics, and (optionally) major/restorative/orthodontics

• Income protection: life, AD&D, LTD, and (optionally) STD

• Wellbeing: EAP/EFAP and (optionally) virtual care/mental health add‑ons

• Administration: pooled/insured small‑group pricing with carrier admin fees embedded

Note: Optional wellness stipends, HSAs/LSAs, flex credits, and employer payroll taxes/surcharges are outside the PEPM figures.

2025/2026 national (ex‑Quebec) cost benchmarks

The table below consolidates PEPM benchmarks and the corresponding monthly employer totals for common team sizes. Use “Lean/Standard/Enhanced” as starting tiers; final pricing varies by industry, age mix, province, plan design, and claims experience.

How to annualize: multiply the monthly total by 12. These benchmarks exclude Quebec (different provincial rules and RAMQ integration), exclude taxable benefit considerations, and exclude employer payroll levies that may apply by province.

How to get your exact number (fast)

1) Start the benefits intake: provide headcount, ages, provinces, union status, and current plan (if any). 2) Pick a target tier (Lean/Standard/Enhanced) and any add‑ons (STD, major dental, orthodontics, wellness, virtual care). 3) Receive carrier quotes and plan design options tailored to your objectives and budget.

Call to action:

• Start the intake now: Contact Summit

• Learn about our compensation transparency: How We Get Paid

What drives your quote up or down

• Demographics: average age, family mix (single/couple/family), and high‑cost drug exposure

• Geography (ex‑Quebec): provincial fee guides (dental), dispensing fees, out‑of‑country travel needs

• Funding method: fully insured pooled plans vs. ASO for larger/claims‑mature groups

• Plan richness: coinsurance, deductibles, maximums, and inclusion of LTD/STD/major dental/orthodontics/vision

• Claims experience: credibility weighting, pooling thresholds, and renewal trend assumptions

• Participation and eligibility: waiting periods, minimum hours, probation, and class design

Assumptions and caveats

• PEPM range ($80–$350) reflects typical small‑to‑mid market pooled insured pricing observed in 2025 marketing exercises across major Canadian provinces outside Quebec.

• “Lean/Standard/Enhanced” are planning anchors; they are not standardized market labels and can be re‑configured to meet budget/coverage goals.

• Totals shown are employer cost before any employee contribution and before provincial payroll levies; tax‑treatment of benefits varies by benefit type and province.

• Final pricing depends on underwriter review of census data, plan design, prior claims (if applicable), and carrier underwriting rules.

Next step

Use the benchmarks to set a draft budget, then complete the intake for a custom quote and side‑by‑side plan designs within typical market timelines. Contact Summit.