Employers often offer group insurance as part of their benefits package. Group insurance is insurance offered to all eligible employees of the company. Normally, members of the group insurance plan receive insurance at a reduced cost because the insurer’s risk is spread across a group of policyholders.
Do all employees participate in the group health insurance plan?
Enrolment to the group health insurance plan is generally mandatory for all eligible employees. In return, no health questionnaire is required and acceptance is guaranteed regardless of the health of the employee and his dependents.
The employer determines which categories of employees are eligible for the plan. Generally, these are all permanent full-time employees. However eligibility can also be based on role, e.g. clerical, factory, sales. In some cases, seasonal and contract employees are also eligible.
The families of eligible employees are also covered by the plan:
- Spouses (married or common-law)
- Children under the age of 21
- Children under the age of 26 who are full-time students
Employees who are already covered by their spouse’s plan can opt out of health and dental care.
What are the main types of group insurance benefits included in a group insurance plan?
Group insurance plans usually include a basic amount of life insurance. The employee can designate the beneficiary of his choice. This life insurance generally ends if the employee changes jobs or upon retirement.
Dependent Life Insurance
Dependent life insurance pays a benefit on the death of the employee’s spouse or child. This coverage generally applies to all employees with dependents.
Disability Insurance (short and/or long)
Worker’s compensation takes care of an employee who is the victim of a work-related accident or illness; but what about other conditions that would prevent your employee from working? Disability insurance can compensate for the loss of his salary.
Short-term disability insurance is paid weekly. As the name suggests, these benefits are paid for a short period, usually 3 to 6 months.
When the employee is no longer entitled to benefits from short-term disability insurance or employment insurance, long-term disability insurance comes into effect. The benefit is paid on a monthly basis for a period of 2 years, 5 years or until the age of 65.
Health insurance helps pay for medical expenses including medications, paramedical care (physiotherapists, chiropractors, acupuncturists, massage therapists, osteopaths, etc.), ambulance transportation, eye exams, medical devices and more.
Dental insurance helps pay for dental costs including cleanings, dental exams, fillings and root canals. Major restoration (bridge, crown, dentures) and orthodontics are sometimes also covered.
Traveling without travel insurance can have serious financial consequences for your employees. Travel insurance is therefore necessary to reduce its risks when traveling outside the country either for work or for vacation.
Risks covered by travel insurance may include the following:
- Emergency medical care insurance;
- Trip cancellation and interruption insurance;
EAP and Telemedecine
Employee Assistance Program (EAP)
The Employee Assistance Program (EAP) offers several services to employees to help them with personal or family problems and even physical or psychological health problems. The program may include the following services:
- Telephone consultations for financial or legal assistance
- In-office or secure Internet consultations with a mental health professional
- Assistance to improve your lifestyle
Virtual health is easily accessible from a computer or mobile device, either a tablet or a smartphone, equipped with web access. The employee can be securely connected directly with healthcare professionals to have a text or video chat anytime, anywhere.
A remote appointment with a doctor can be used to:
- Diagnose and treat many medical problems;
- Prescribe medication;
- Provide laboratory requests;
- Provide specialist references;
Virtual health can reduce employee absences because it eliminates travel time and wasted time sitting in waiting rooms.
How much does a group health insurance plan cost?
Many criteria affect the cost of group insurance:
- The industry
- Group size
- The average age of the group
- Employee salaries
- The number of employees with family coverage
- The type of coverage included in the plan
In order to obtain the pricing for your group, an advisor can submit a request for quotes to several insurers.
Does the company pay for the group insurance premiums?
In the majority of cases, the employer pays 100% of the premiums. However, the employer is not required to pay all the premiums. In situations where they do not pay 100% of the premiums, the balance is paid by the employees through payroll deductions. The province of Quebec is a little different than the rest of Canada where it is common that the employer and employees each pay 50% of the premium.
For residents of Quebec: Note that introducing a group insurance plan allows your employees and their dependents to opt out of the RAMQ universal drug plan. Employees therefore save $710 per adult per year in their tax return (the amount of the contribution is adjusted annually by the RAMQ on July 1) and benefit from more generous coverage.
For residents of Ontario: Ontario does not have a universal drug plan. Since prescription medication is the largest out-of-pocket health expense, offering a group insurance plan with robust health coverage is an important employee benefit. In addition, health insurance premiums paid by the employer have a significant fiscal advantage over additional salary since they do not generate any taxable benefit.