Introduction

Updated: December 4, 2025. This guide is for Canadian startups under 50 employees operating outside Quebec. It provides two ready-to-launch plan templates and 2026 budgeting scenarios sized for teams of 10, 20, and 30.

Who this helps and what you get

• Seed to Series A startups and SMEs with 10–50 employees (outside Quebec).

• Two plug‑and‑play plan templates (Core and Enhanced) you can issue as-is or use as scaffolding for underwriting.

• A single 2026 budget table with totals for 10/20/30 employees in CAD.

• Canada‑specific tax/funding notes and source links.

• Links to Summit pages for service level/support, carrier panel context, and cost transparency.

2026 plan design assumptions (Canada, ex‑Quebec)

• Medical/dental trend: most Canadian employers should assume high‑single‑digit medical trend into 2026 after a 7.4% 2025 projection, driven by drugs (including GLP‑1s) and utilization. See Aon’s Canada trend (2025: 7.4%) and North America 2026 projection (9.3%). Benefits Canada summary, Aon 2026 outlook.

• Dental inflation continues to outpace wages; many employers are moderating paramedical coinsurance (e.g., moving from 100% to 80%). HRD Canada (Gallagher) 2025.

• Small‑group (1–50) baseline cost (health+dental) in 2025 commonly sat in the $250–$350 per‑employee‑per‑month range before plan design adjustments; budgets below reflect a prudent 2026 trend uplift. PolicyAdvisor 2025 small‑group ranges.

Template 1 — Core (cost‑controlled, startup‑friendly)

• Drugs: managed formulary; prior authorization for specialty; coinsurance 80%.

• Extended Health: paramedicals combined max (typ. $300–$500/yr); coinsurance 80%–90%.

• Vision: $150–$200/24 months.

• Dental: basic 80%, major 50% (optional), combined annual max $1,500.

• Life/AD&D: $25,000 flat (pooled).

• Disability: LTD 66.7% to $3,000/month; employee‑paid premium recommended for tax efficiency (see tax notes).

• Virtual care/EAP: basic telemedicine and short‑term counselling.

Template 2 — Enhanced (recruitment‑ready)

• Drugs: open or expanded formulary with specialty case‑management; coinsurance 90%.

• Extended Health: paramedicals combined max $750–$1,000/yr.

• Vision: $250/24 months; laser surgery allowance optional.

• Dental: basic 90%, major 60%, ortho optional for dependants; combined annual max $2,000.

• Life/AD&D: $50,000 flat (pooled).

• Disability: LTD 66.7% to $7,500/month; employee‑paid premium recommended.

• EAP + virtual care bundle; optional $500 Health Spending Account (HSA) per employee (adds ~$500/employee/year when included).

2026 budget scenarios (CAD)

The ranges below reflect typical 2026 small‑group pricing (outside Quebec) when averaged across tech/knowledge‑sector demographics and assuming LTD is employee‑paid (so not in employer cost). For HSA, add ~$500 per employee per year if selected.

Notes

• Source baselines: 2025 small‑group averages of $250–$350 per employee per month, trended for 2026 using high‑single‑digit assumptions. PolicyAdvisor, Aon trend, Benefits Canada coverage of Aon.

• All figures exclude Quebec and assume standard pooling charges, typical ages (late‑20s to late‑30s), and a majority single coverage tier mix common in startups.

Tax and funding notes (outside Quebec)

• Health and dental premiums paid by employers are generally non‑taxable benefits to employees outside Quebec.

• For disability: if any portion of LTD premium is employer‑paid, LTD benefits are taxable on claim; many startups have employees pay 100% of LTD to keep benefits non‑taxable. CRA guidance, Group benefits tax summary.

• Life/AD&D employer premiums are typically a taxable benefit to employees; benefits paid are generally non‑taxable.

How Summit implements this for startups

• Independent Canadian brokerage that shops multiple carriers for value and fit, and pairs you with a dedicated account manager. About Us — carrier panel context.

• Cost transparency, including commissions/fees, before binding coverage. How We Get Paid.

• Fast onboarding and support with clear escalation paths, including after‑hours claims assistance. Claim Services (service level and support) and Contact Us.

Implementation checklist (typical 2–4 weeks)

• Select Core or Enhanced as a starting point, confirm coinsurance and annual maximums.

• Decide LTD funding (employee‑paid recommended for tax efficiency outside Quebec).

• Choose optional HSA amount (e.g., $500/employee/year) and EAP/virtual care bundle.

• Provide census (age, province, family status), latest invoice/claims (if any), and target effective date.

• Summit markets to carriers, compares proposals, and finalizes contracts and onboarding.

Reference links (internal)

• Service level/support: Summit Claim Services

• Carrier panel (insurer partnerships noted): About Us

• Cost transparency: How We Get Paid

Attribution (external benchmarks)

• Canada 2025 medical trend 7.4%: Benefits Canada (Aon report)

• 2026 North America medical trend outlook 9.3%: Aon 2026 outlook

• Small‑group (1–50) cost ranges (baseline): PolicyAdvisor 2025

• Dental/coinsurance trends: HRD Canada (Gallagher) 2025

• Tax treatment summaries: CRA