The National Pulse - September 2026
GLP-1 Update - Generics Have Arrived, but savings aren’t happening on their own
Ozempic is still the top GLP-1 drug for diabetes by spend. But carrier data shows things are shifting.
Generic Ozempic is now available at about one-third the cost of the brand. Nevertheless, uptake of the generic medication has been slow. We encourage plan sponsors to consider mandatory generic pricing to avoid paying more than you need to.
For organizations who want to support plan members who may be using Ozempic for weight loss (and not covered by their plan) or who may not want to switch to the generic product, Novo Nordisk Canada has expanded its Ozempic Savings Card to members with private drug plans.
Eligible members can now buy brand-name Ozempic at a price in line with the generic. The discount applies at pharmacies across Canada, plus Novo Nordisk Care Rx (operated by Rexall) and select online partners. Along with InnoviCares, it's another helpful option if members push back on switching. Members can learn more at ozempic.ca.
Generic Ozempic may not solve all cost drivers associated with GLP-1 medications. Ozempic spend dipped even before generics arrived, but this may be because plan members are moving to Mounjaro, which more than doubled in 2026 compared to the same period last year.
Note: The Ozempic Savings Card is not available in Quebec.
Quebec
Effective January 1, 2027, the government of Quebec will increase the insurance premium tax rate from 9% to 9.975% to align it with the general rate of the Quebec Sales Tax (QST).
For group plans with employees or covered plan members residing in Québec, the insurance premiums tax rate increase will impact:
upcoming renewals;
installment payments;
premium adjustments;
retroactive audits and corrections;
benefit or coverage changes;
or any other insurance transactions that may be processed in 2027.
What you can do: make sure you have cleared any ASO deficit amounts prior to January 1st to avoid having increased taxes applied.
Alberta
Alberta’s Bill 11 has been touted as one of the most consequential pieces of legislation in a generation to affect healthcare and group benefits in the province. It is taking effect 1 October 2026 and applies to active employees. It impacts health and drug coverages only.
Not sure how this affects your specific plan? Please reach out to schedule a 20-minute call.
There are two central themes that impact employer benefits:
The payor of the last resort will change from private plans to government, and
Employers must continue unreduced coverage for active employees aged 65 and older
1 - Payor of last resort: For employees under the age of 65 who are covered by both your group plan and the Alberta Blue Cross Non-Group Plan, or for employees over the age of 65 covered by the Alberta Senior’s Plan, the government plan is now the payor of last resort.
For low-cost claims, the plan member is unlikely to be impacted, but the employer’s cost for the claim will increase.
For high-cost claims, which impact approximately 1 – 3% of Albertans with drug costs over $10,000, employers could face significant differences in how much medication cost lands on their drug plan experience. Similarly, employees will see increased out-of-pocket costs.
For members under the age of 65 and who have opted into the Alberta Blue Cross Non-Group plan, the provincial plan will pay claims only after all private coverage is applied for:
prescription drugs
land (not air) ambulance services
clinical psychologist services
home nursing care
prosthetic and orthotic benefits
mastectomy prosthesis
hospital accommodation
This change applies to the following benefits for employees aged 65+:
prescription drugs
land (not air) ambulance services
clinical psychologist services
home nursing care
chiropractic
2 - You can no longer decrease or discontinue benefits based on age: employers must continue drug and healthcare coverage without reduction for active employees aged 65 or older. This change does not apply to Life, Disability, Dental, Travel Insurance, Health Spending Accounts or Wellness Accounts.
Next Steps
If you have employees who have been terminated from your Extended Health benefits due to age, please notify your insurance carrier as these individuals will need to be re-added to your plan by 30 October 2026.
Watch for an amendment to your benefits plan that may shift coverage termination dates of 75, 80, or 85 to “retirement” if applicable.
Determine whether you want to apply the new termination clause to dental benefits as well; you should also decide whether the revised termination clause for extended health benefits should apply to employees in other provinces.
Plan for larger-than-usual healthcare premium increases in your 2027-28 renewals. The financial impacts to your benefits plan will vary based on factors such as plan design, claiming patterns, and the demographics of your team.
If you don’t have one already, consider a health spending account as this can help mitigate out-of-pocket expenses for employees.
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