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A Q&A on Alberta’s Bill 11 – What We Know Now, and What Plan Sponsors Can Do

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Sep 22, 2026 5:10 PM
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Blog Alberta september 2026 image

Last spring, the Alberta government passed Bill 11 – Health Statutes Amendment Act, 2025 (No. 2) which included key changes to the benefits landscape, especially for employers who have employees in this province. Since then, the government issued clarifications on how some provisions will be applied and their October 1, 2026 implementation date.

In this article, we answer some questions related to the bill’s provisions, including additional guidance to plan sponsors, complementing our original April article on the topic.

What are the key provisions of Bill 11?

Two key changes stem from Bill 11:

  • Provincial plans become payors of last resort for drug coverage, shifting the role of private plans to first payor.

  • Employers will no longer be allowed to terminate or reduce health benefit coverage for employees 65 years and older who are actively employed.

When will these new measures apply?

The effective date for the above changes has been set to October 1, 2026.

What are the implications for employer-sponsored coverage past age 65 for Alberta residents?

Employers cannot terminate or reduce Extended Health Care (EHC) coverage for employees aged 65 and over who are actively employed. Plans must reinstate currently active 65+ employees in Alberta who have been previously terminated for age restrictions. For employees who have left an organization, and for reinstated employees, no retroactivity is required.

While Bill 11 applies to EHC benefits, what is excluded?

The Bill does not apply to Health Care Spending Accounts (HCSAs), travel insurance benefits or post-retirement plans.

What is the expected impact on drug costs for affected private plans?

Drug costs are expected to increase for plans covering employees over age 65 in Alberta. Alberta Blue Cross estimates on average* a 2% to 5% increase to drug claims and up to a 0.4% increase to overall EHC cost. Cost variability may be greater for experience-rated smaller groups, with expected impact to both pooling and renewals.

What are the other changes?

Modifications to rules outlining how physicians participate in Alberta’s publicly funded Alberta Health Care Insurance Plan will give physicians more practice flexibility between the public and private plans.

What should plan sponsors do?

  • Review plan designs, administrative processes, and member-facing materials for compliance; remove age restrictions on EHC plans and reinstate active employees who have been terminated due to age.

  • Review carriers’ amendments and bulletins; each will have its own processes for drug plan management such as formularies, prior authorizations, etc.

  • Decide if EHC coverage (and other coverage) should also be expanded in other provinces past age 65 for consistency, and how to address dependent coverage.

  • Determine whether plan has significant exposure and whether cost containment measures should be implemented.

  • Review contracts to determine whether EHC plans provide unintended private physician coverage.

As a reminder and for additional context, you can read our April article about Bill 11.

The team at AGA Benefit Solutions is actively involved in supporting plan sponsors with Alberta employees navigating through these changes–including legal compliance, sound financial management of plans, and efficient administration.

 

*Source: Alberta Blue Cross Advisor Bulletin, 2025–2026
Barry Hutchins, Senior Group Insurance Consultant
With over 30 years of experience in Group Benefits, Barry has provided strategic consulting services to employers of various sizes. He is focused on developing and maintaining strong client relationships through the delivery and implementation of strategies designed to achieve the objectives of each client’s specific plan purpose. Barry holds a Bachelors degree from Dalhousie University
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A Q&A on Alberta’s Bill 11 – What We Know Now, and What Plan Sponsors Can Do

Blog Alberta september 2026 image

Last spring, the Alberta government passed Bill 11 – Health Statutes Amendment Act, 2025 (No. 2) which included key changes to the benefits landscape, especially for employers who have employees in this province. Since then, the government issued clarifications on how some provisions will be applied and their October 1, 2026 implementation date.

In this article, we answer some questions related to the bill’s provisions, including additional guidance to plan sponsors, complementing our original April article on the topic.

What are the key provisions of Bill 11?

Two key changes stem from Bill 11:

  • Provincial plans become payors of last resort for drug coverage, shifting the role of private plans to first payor.

  • Employers will no longer be allowed to terminate or reduce health benefit coverage for employees 65 years and older who are actively employed.

When will these new measures apply?

The effective date for the above changes has been set to October 1, 2026.

What are the implications for employer-sponsored coverage past age 65 for Alberta residents?

Employers cannot terminate or reduce Extended Health Care (EHC) coverage for employees aged 65 and over who are actively employed. Plans must reinstate currently active 65+ employees in Alberta who have been previously terminated for age restrictions. For employees who have left an organization, and for reinstated employees, no retroactivity is required.

While Bill 11 applies to EHC benefits, what is excluded?

The Bill does not apply to Health Care Spending Accounts (HCSAs), travel insurance benefits or post-retirement plans.

What is the expected impact on drug costs for affected private plans?

Drug costs are expected to increase for plans covering employees over age 65 in Alberta. Alberta Blue Cross estimates on average* a 2% to 5% increase to drug claims and up to a 0.4% increase to overall EHC cost. Cost variability may be greater for experience-rated smaller groups, with expected impact to both pooling and renewals.

What are the other changes?

Modifications to rules outlining how physicians participate in Alberta’s publicly funded Alberta Health Care Insurance Plan will give physicians more practice flexibility between the public and private plans.

What should plan sponsors do?

  • Review plan designs, administrative processes, and member-facing materials for compliance; remove age restrictions on EHC plans and reinstate active employees who have been terminated due to age.

  • Review carriers’ amendments and bulletins; each will have its own processes for drug plan management such as formularies, prior authorizations, etc.

  • Decide if EHC coverage (and other coverage) should also be expanded in other provinces past age 65 for consistency, and how to address dependent coverage.

  • Determine whether plan has significant exposure and whether cost containment measures should be implemented.

  • Review contracts to determine whether EHC plans provide unintended private physician coverage.

As a reminder and for additional context, you can read our April article about Bill 11.

The team at AGA Benefit Solutions is actively involved in supporting plan sponsors with Alberta employees navigating through these changes–including legal compliance, sound financial management of plans, and efficient administration.

 

*Source: Alberta Blue Cross Advisor Bulletin, 2025–2026