More Canadians underwent colorectal and breast cancer screening in 2024 compared with 2017, according to data Statistics Canada released Wednesday.

Nearly half (49%) of people in the provinces aged 50 to 74 had a fecal test in the past two years or a sigmoidoscopy in the last 10 years to screen for colorectal cancer, compared with 43% in 2017. The data did not include people who have had a colonoscopy and could be undercounting the proportion of Canadians who have undergone screening for colorectal cancer.

For women aged 50 to 74 in the provinces, 79% had a mammogram to look for breast cancer in the past three years, compared with 78% in 2017. Mammogram participation was highest in Alberta (84%) and Ontario (81%) and lowest in Nova Scotia and Prince Edward Island (both 67%).

However, only 69% of women aged 25 to 69 in the provinces had a Pap smear test for cervical cancer in the past three years, compared with 74% in 2017. The test was most common (75%) for those aged 35 to 49, followed by those aged 25 to 34 (70%) and women aged 50 to 69 (64%).

In recent years, two of the big three insurers have extended life insurance coverage to cancer survivors. They can apply to all lines of life insurance products with Manulife and Sun Life, and may receive standard ratings depending on factors such as cancer type and stability period.

While applications within the first five years of treatment completion are more likely to be rated, those premiums can come down over time. If an applicant is denied for applying too soon after treatment ended, the insurer could issue a lesser product in the meantime and ask the applicant to reapply for a mainstream product later.

In response to an email, a Canada Life spokesperson wrote, “we don’t have information to share.”

Advisors say planning for a family with a disabled child involves setting up the right life insurance for relatives, a Henson trust, registered accounts and taking advantage of provincial and federal programs. 

“You want to ensure that the special needs individual is properly cared for when the parents are no longer here,” said Joseph Trozzo, vice-president of national investment sales and MGA at Equitable Life in Toronto.

Trozzo has a son with autism, who has played soccer in the Special Olympics. 

Insurance 

Parents can buy a permanent, joint last-to-die life policy on themselves to fund a Henson trust and term insurance to protect income, said Ron Malis, a financial advisor with Reegan Financial in Toronto who serves clients living with disabilities. 

Another option is to explore buying life insurance on the grandparents’ lives. “It takes a village, especially when you have a special needs person in your life,” Trozzo said. 

Henson trust 

Assets held in a Henson trust for the benefit of a person living with a disability aren’t considered as belonging to them, and won’t put their eligibility for asset-tested government benefits at risk. 

Almost anything can go into the trust. For example, the parents can put a second property in to exempt it from capital gains tax when they die, Malis said. 

Advisors should talk to their clients about a Henson trust as soon as possible. It’s only allowed if the testator includes it in their will before they die, Malis said. They should also pick reliable trustees and connect them with professionals like advisors and accountants. 

Parents can name more than one trustee as well as backup trustees to a Henson trust, said Guerlane Noël, assistant vice-president of tax and estate planning at Mackenzie Investments in Montreal. For example, one trustee could have financial expertise, while the other could have a health-care background. 

Disability tax credit 

The disability tax credit (DTC) is a non-refundable tax credit for people with severe and prolonged disabilities that last at least 12 months. Applicants need a medical professional to complete a form, and qualification can be either temporary or permanent. 

Apart from the tax benefit, the DTC certificate is key to qualifying for several federal programs, such as the registered disability savings plan (RDSP) or the Canada Disability Benefit, which will begin distributing up to $200 a month to eligible beneficiaries in July 2025. 

Registered disability savings plan 

There is no annual limit on contributions to an RDSP, which has a lifetime limit of $200,000. An RDSP can also get matching grants every year. Families earning under the specified income threshold can get up to $70,000 in grants with $30,000 of contributions over 20 years.  

“An RDSP is almost always a no-brainer,” Malis said. 

If there is sufficient contribution room, families can transfer their grandparents’ registered retirement income fund (RRIF) into the RDSP, Noël said. This will defer taxes on the RRIF, so it’s only due at the time of withdrawal from the RDSP. 

Registered education savings plan 

Families with more than one child can set up a family registered education savings plan (RESP). If the special needs child doesn’t pursue post-secondary education, their siblings can use the funds, Trozzo said. 

“You don’t want to put limitations on [the special needs child], but they’re going to be challenged to go to post-secondary education,” he added. 

Any unused individual RESP funds can be transferred into an RDSP, but any government contributions to the RESP must be returned first, Malis said. 

Ontario Disability Support Program

In addition to federal schemes, provincial disability support programs can also help. For example, the Ontario Disability Support Program (ODSP) pays up to $1,368 per month for a single person. 

Although benefits could be paused or clawed back if the recipients exceeds prescribed asset or income limits, there are exemptions. For the ODSP, anything held in a Henson trust and up to $100,000 of life insurance products are exempt as chargeable assets, and payments from an RDSP account aren’t considered chargeable income, Malis said. 

If a special needs child is due to receive an inheritance that could make them ineligible for ODSP, the assets could be deposited into an RDSP or funnelled into a segregated fund, Malis said. Segregated fund withdrawals are chargeable income, however. 

The financial handover 

A special needs child can outlive their parents, so parents should involve the next generation of caretakers early in the process. For example, they could be Henson trust trustees or the child’s siblings, Trozzo said. 

They should pass on information such as medical care instructions, the doctor’s name and specific details from the last will and testament to ensure the handover is as seamless as possible.

Trozzo’s son has a grilled cheese sandwich daily but won’t eat it unless it’s cut a specific way. “If that information is not captured … you’re going to be scratching your head thinking, ‘why isn’t he eating his grilled cheese anymore?’” he said. 

The new caretakers should also participate in financial planning sessions with the financial advisor to fully understand the strategy behind using the different registered accounts and government programs, Trozzo said.  

Proper financial planning can help ease parents’ anxiety, Trozzo said. “God forbid if you’re not here or your spouse isn’t here, you have a plan in place. … When you go to bed at night, you can put your head on the pillow and say, ‘I know [that] financially, my special needs child is going to be OK.’” 

As family responsibilities grow, one partner may decide to reduce work hours or leave the workforce altogether to care for children or aging parents, or to take on other duties or meaningful projects. Financial advisors play a key role helping families consider how they can afford to live on a reduced income and how insurance needs will change.

It’s a good start if clients are asking about reducing income ahead of time, because it means they’re putting thought into it, said Maya Patrie, senior investment counsellor and portfolio manager with BMO Private Wealth in Edmonton.

Advisors should ensure that both partners are present for the conversation, Patrie said. “Sometimes, I will find only one partner comes to meetings. And if it’s a family decision, you need both parties present.”

Because advisors tend to focus on the numbers, taking time to understand the soft side of why a client wants to leave work is a great way for an advisor to add value, said Scott Sather, founder and president of Awaken Wealth Management in Regina. Advisors will get to know their clients better and deepen their relationships, he said.

Sather and his wife wanted one parent at home during their children’s teen years, he said. While a lot of people think teenagers are self-sufficient, “they are not,” he said. “They’re emotional messes.” His wife worked part time so she was present to help the kids debrief their day when they arrived home after school; they wouldn’t have wanted to talk by suppertime, Sather said.

When an advisor works with a family to assess whether they can afford to live on one income, the advisor should build a net worth statement by establishing an inventory of assets and liabilities, Patrie said.

Advisors should also help clients create a cash flow statement, Sather said. Clients should know how much they’re paying for basic expenses such as their mortgage and utilities.

“Here’s the income that’s going to come in, [and] here’s the bills that we have to pay,” he said. “And then deciding is that enough? Are we still able to do the saving? Are we still able to do the lifestyle side of things?”

While families can make lifestyle changes, such as buying generic brands, they may also want to consider there are things money can’t buy.

“How’s it going to feel when you both have to work knowing that you can’t get off to be able to see the [kid’s] recital or the big game?” Sather said. “Maybe we’re not buying the best quality of things, but we’re able to have those experiences instead.”

Sather also noted that, even if the working partner’s income rises to cover the other partner’s prior contribution, the investment plan needs to be updated from a know-your-client perspective. For example, long-term risk tolerance may not change, but the clients may want to switch some investments to shorter-term ones as the family may want more liquidity.

Reassessing insurance needs

“One of the common misconceptions is that only the breadwinner needs to be insured because they’re the one with the income,” said Kate Norris, a financial planner with Sun Life in Airdrie, Alta. But if, for example, the at-home partner gets sick, the income earner may have to take time off work. Additional expenses may include child care, home cleaning and meal preparation.

The at-home partner typically won’t qualify for disability insurance without earned income, but they can buy critical illness insurance.

“You only die once, but disability, critical illness — those can happen multiple times, at any point,” Sather said.

On the flip side, the family will need income replacement if the breadwinner becomes disabled, critically ill or dies.

Clients should understand what their employee benefits cover, and identify gaps. For example, a client might think they’re covered with group life insurance, when it covers only accidental death at work, Norris said. And group disability insurance might cover only base salary, not bonuses. A client can usually increase their group coverage at their own cost if they undergo medical underwriting, Norris said, which would typically be less expensive than taking out an individual policy for comparable protection.

“We want to make sure we’re maxing out what’s available through the group,” she said.

The cost of disability, critical illness and life insurance, as well as health and dental insurance, can add up. Some employers may allow an employee to keep their benefits if they work a minimum number of part-time hours, Sather suggested.

Mortgages may be best covered with a term policy. Unlike with mortgage insurance when the bank is the beneficiary, Sather noted that as the beneficiary of term insurance, a client can choose how to use the money — for example, the mortgage could be paid off or renegotiated. And, while mortgage insurance ends after the mortgage has been paid, the client could choose to renew a term policy or convert it into permanent life insurance.

For life insurance, each spouse should ideally have their own policy, Norris said, rather than a joint first-to-die policy: If one spouse dies, a surviving partner with children would need their own life insurance policy as they’ll need coverage if they die, too. A joint policy is typically used for estate planning and to leave a legacy, she added.

Employees have made more claims for anti-obesity drugs and substance use disorder in recent years, finds a study of group benefits data by Manulife Financial Corp.

Drug claims for anti-obesity medication in Canada increased by 42.3% from 2022 to 2023, and substance use disorder claimants increased by 17.2% in the same period, according to Manulife’s first Employee Health Report released Friday.

The report used aggregate claims data across Manulife’s Canadian group benefits business.

Across the 2020–2023 period, the increase in claims for anti-obesity drugs was steeper, rising by 91.9%. Global media coverage on off-label use of drugs like Ozempic may have contributed to the trend, the insurer said in a release.

Women account for 78.8% of all anti-obesity drug claimants, ranging from 77.1% in British Columbia to 81.3% in Atlantic Canada.

“The higher use amongst women could be related to social pressures and body image concerns that are sometimes experienced by women,” the report said.

The number of claimants who sought help with substance use disorder, including alcohol and opioid use, rose by 52% from 2020 to 2023.

Substance use disorder contributes to workplace absence and disability, Manulife said in the report: “It’s common for people with mental health issues to struggle with substance use disorder and vice versa.”

According to Manulife’s data, mental illness was the leading cause of short- and long-term disability diagnoses in 2023, followed by musculoskeletal conditions. The average age of long-term disability claimants was 48 and 55% were women, the report found.

Immune disorders followed by diabetes were the top two conditions for drug reimbursements.

The insurer said it provides health benefits to more than 5 million people across 27,000 Canadian employers.

Manulife Financial Corp. has signed a reinsurance deal with Global Atlantic that it says will free up $1.2 billion in capital that it plans to use to buy back shares.

The Toronto-based insurer said Monday it is reinsuring $13 billion of reserves to Global Atlantic and its partners, including $6 billion in long-term care reserves.

By having Global Atlantic agree to insure its exposure to the portfolios, Manulife said the deal is expected to release $1.2 billion of capital that it plans return to shareholders via share buybacks.

The deal on long-term care (LTC) reserves was especially notable, as it’s a riskier area of insurance that Manulife has been working on deals for some time.

“With this largest-ever LTC reinsurance deal, we believe it marks an important step in establishing an active LTC reinsurance market,” Manulife chief executive Roy Gori told a conference call with investment analysts.

Manulife said it ceeded $270 million on the LTC reserves, while the rest of the reserves were done at full value.

Gori called the agreement a major milestone for the company as it reshapes its portfolio, reduces risk and delivers value to shareholders.

Scotiabank analyst Meny Grauman said in a note that the deal marked a “giant leap” for sentiment around LTC transactions by establishing a good valuation baseline for such deals.

Manulife said it has received approval from the Office of the Superintendent of Financial Institutions to buy back up to about 2.8% of its outstanding common shares starting in February.

Clients approaching retirement are increasingly interested in directing at least part of their savings to purchasing an annuity, says a financial advisor.

“I have had more questions about annuities in the last six months, I would say, than probably [over] my career,” said Jason Heath, managing director of Objective Financial Partners Inc. in Markham, Ont.

However, some clients get cold feet when they realize that buying an annuity means handing over a significant sum in return for the guarantee of periodic lifetime payments, Heath said.

Yet “the same people who might be jealous of retiree with a pension would never think of giving their money away to an insurance company to buy what is effectively a pension of their own,” he said.

Over the previous three decades of low interest rates, clients largely spurned annuities, which offered relatively meagre payouts. However, as the Bank of Canada, as well as other central banks globally, began hiking rates in the spring of 2022 in response to rising inflation, client interest in annuities began to increase.

As of February 2023, the monthly payout on a single-life annuity with a premium of $100,000 and a 10-year guarantee were up more than 20% compared to a year before.

Heath said he’s met with clients who see annuities as an attractive alternative to determining the appropriate amount to draw down from retirement savings for expenses, or to managing their own retirement investments.

“With Canadian bonds down double digits [last year], conservative investors who lost double digits on their bond portfolio are maybe thinking more about annuities as a true guarantee of fixed income as opposed to bonds, which do have some interest-rate risk,” Heath said.

Clients interested in annuities typically only direct a portion of their retirement assets to the purchase of a regular payout, Heath said.

To address client concerns about dying before reaping the benefits of the annuity, insurance companies offer guarantee periods, such as five or 10 years. They also may offer joint annuities rather than single-life annuities, where the life expectancies of both spouses factor into the payout.

However, the key benefit of “buying an annuity is not so much about protecting against the risk of dying young, it’s protecting against the risk of living a long life. [It’s] longevity insurance,” Heath said.

Canada should consider publicly funded long-term care (LTC) insurance to address the economic realities of the country’s aging population, suggests a new report from Toronto Metropolitan University’s National Institute on Ageing (NIA).

The report, released on Thursday, outlined how the aging population is leading to mounting LTC costs, requiring a viable solution.

Based on Statistics Canada data, Canadians aged 65 years and older will account for nearly 27% of the country’s total population by 2048, and the number of Canadians aged 85 and older is expected to triple in the same period — to as many as 2.8 million people.

In 2019, Canadian households spent $9.4 billion out of their own pockets to access additional LTC services beyond those that are publicly funded, according to the Organization for Economic Co-operation and Development, cited in the report.

Private insurers struggle to offer affordable LTC insurance premiums because of the small selection pool and high probability that the insured will require services, the report said.

“Establishing a national LTC insurance program in Canada could present a unique opportunity to re-imagine Canada’s social contract and better align its provision of LTC services to the needs and preferences of older Canadians,” it said.

Such a program could also help standardize care.

“A national LTC insurance program could present a chance to establish a national definition of LTC services, creating common standards for eligibility, benefits and the quality of care that Canada wants to commit to providing,” the report said.

The NIA examined LTC insurance programs currently offered by five countries and one U.S. state: Japan, Germany, South Korea, Taiwan, the Netherlands and Washington.

Each program varies in eligibility, benefits and user choice, and programs were financed through varying combinations of taxation, social contributions and out-of-pocket spending. The NIA applied its findings to the consideration of a national LTC insurance program in Canada.

For example, the potential program could support seniors to age in place by allocating LTC funding to more home and community care, instead of institutional care.

The program could also leverage Canada’s established network of public and private LTC home and community care providers, the NIA said. Establishing employees who work at a local level as care plan managers could help ensure that seniors receive appropriate, timely care based on their needs, the report suggested.

It also suggested using social insurance contributions as the program’s primary funding mechanism, supplemented by general taxation revenues. This would subsidize and redistribute costs across the entire Canadian population, which could lead to a more “equitable and sustainable” national program, the report said.

A national LTC program represents an opportunity to “reduce fragmentation, guarantee all Canadians a basic level of service and financial coverage for LTC services, and create a more consistent and sustainable level of funding for LTC for future older Canadians,” it said.

Hundreds of thousands of Canadians could be in the market for individual disability insurance because they depend on gig-economy work, but placing coverage is not easy, advisors suggest.

Individual disability insurers have traditionally favoured white-collar professionals like dentists and doctors, said Geoff Cook, certified financial planner with Infinite Financial in Barrie, Ont.

“You can’t really buy disability without [working] 30 hours [a week], at least,” he said. “And then you’ve got to supply a T4, and if you don’t supply a T4, you might not actually be getting a decent product.”

“Many in the gig economy are self-employed and they are concerned about reporting their income to justify the benefit amount,” said Jean Salvadore, senior director of life and living benefits with RBC Insurance. She explained that underwriters can work with business owners and contract workers to evaluate business and personal income so that all income is counted.

Placing individual disability for gig workers can also be complicated because workers could potentially have multiple jobs, said Toronto-based advisor Brian Shumak.

As such, advisors should manage gig workers’ expectations on coverage availability. For example, if a gig worker can get individual disability coverage, it will probably be in the guaranteed renewable category rather than non-cancellable category, Shumak said.

In a non-cancellable policy, premiums cannot be increased, benefits cannot be reduced and the insurer cannot unilaterally cancel the contract. With a guaranteed renewable disability policy, the insurer can raise the premiums for everyone in a certain class or category but cannot raise individual premiums.

“The ability to qualify for a non-cancellable product is diminishing and as a result of the historic claims experience, you’re going to see a lower desire for the remaining companies to maintain the non-cancellable product,” Shumak said, alluding to Manulife Financial Corp.’s decision in 2022 to stop selling its non-cancellable products.

Another area in which to manage expectations is the scope of disability coverage. In the event of a claim, a dispute could arise between the claimant and insurer over whether or not the claimant can do their job, Cook said, suggesting that an advisor should explain the definition of “disability” in a policy to clients.

The ideal policy would pay income replacement if the policyholder cannot do the duties of the job they are trained to do, Cook said. “[But] there’s another definition of disability called ‘any occupation,’ which means, for lack of better terms, that if you can work anywhere, we won’t pay you. If you can’t pound nails as a carpenter but you could be a greeter at Wal-Mart, we won’t pay you.”

“Any occupation” coverage is generally less expensive.

The share of Canadians in gig-economy jobs (including drivers, artists and freelancers) nearly doubled to 10% in 2020 from 5.5% in 2005, Employment and Social Development Canada said in a report released in March. This works out to roughly two million Canadian gig workers. A separate 2019 Statistics Canada survey found 48.6% of gig workers had no wage-earning job and relied solely on gigs.

Manulife Financial Corp. has named Cleveland Clinic Canada as its new medical director for group benefits, the insurer said in a release on Thursday.

The collaboration allows Manulife to leverage the academic medical centre’s experts and research.

“Working with Cleveland Clinic Canada will assist Manulife in achieving its goal of helping Canadians prevent, treat and recover from physical and mental health complications,” the release said.

Mental health claims, in particular, have soared since the pandemic. In 2021, Canada’s insurers paid $580 million for mental health claims — up by 75% from 2019, the Canadian Life and Health Insurance Association said in the 2022 edition of its annual update on the industry. For comparison, physiotherapy and chiropractic claims are about $700 million each.

Manulife has about five million group benefits customers, the release said.

Vancouver-based independent wealth management firm Nicola Wealth has acquired Levine Financial Group, a Toronto-based provider of insurance products and services to doctors in Ontario, the firm announced Monday.

The move aligns with Nicola Wealth’s strategy to grow across the country and allows it to bring its “integrated approach to wealth planning alongside its diversified investment platform to medical professionals across Ontario,” the firm indicated in a release.

With offices in B.C. and Ontario, Nicola Wealth manages $12.7 billion in assets for high-net-worth families and entrepreneurs.

Levine Financial’s clients will “benefit from our financial planning and diversified investment platform,” said Vanessa Flockton, senior vice-president of advisory services at Nicola Wealth, in the release. “Together, we can offer medical practitioners the comprehensive plans they need as they consider the complexities of their financial future.”

According to the release, Nicola Wealth and Levine Financial will continue independent operations while looking for “opportunities to optimize and collaborate on shared initiatives.”