GROUP BENEFITS

Group benefits plans help increase morale and long-term loyalty in a company. When employees feel like they are more than just a number and feel that their employer appreciates them and is looking out for their best interests, they are more loyal to their company and its long-term goals.

Traditional insured group plans provide a tax efficient way to transfer risk for health and dental claims processing. Stable employer sponsored plans are structured to clients' needs along with fixed premiums allow for longevity of benefit plans.

Life and AD&D

Life and Accidental Death and Dismemberment insurance provides financial protection to individuals  through Life insurance, which offers coverage in the event of the policyholder's death, providing a lump sum payment to the beneficiary, and AD&D insurance provides additional coverage specifically for accidental death or severe injuries resulting in dismemberment or loss of function, offering a separate benefit in addition to life insurance.

Dependent Life

Exclusive to employees' spouses and dependent children, our Dependent Life plans offer comprehensive coverage in fixed amounts. The coverage amount for spouses is typically higher compared to that for children. For children, coverage usually starts 14 days after birth and remains in effect until they reach 21 years of age (or 25 years if they are enrolled as full-time students in a school or university).

Employers have the flexibility to share the premium costs with employees or choose to have employees bear the entire premium. In the unfortunate event of the dependent's passing, the benefit is disbursed to the designated plan member.

Short Term Disability

Our Short-Term Disability benefit aims to financially support employees during temporary leaves caused by accidents or illnesses, compensating for lost income. Companies offering a Short-Term Disability plan have the option to waive the Employment Insurance Sickness Benefit, leading to a lower E.I. premium rate. To qualify for this opt-out, the STD plan must provide coverage that is equal to or exceeds the benefits provided by the E.I. plan.

Long Term Disability

When faced with an extended illness or injury, the resulting financial burden can be overwhelming. While employees may prioritize more apparent benefits, it is crucial to recognize the paramount importance of a Long-term Disability benefit in safeguarding employees' financial stability. The need for eyeglasses or dental work is unlikely to force employees into selling their homes. However, the loss of income can have far-reaching and severe consequences.

Extended Health Care

Extended Health Care benefits serve as a valuable complement to existing provincial hospital and medical insurance plans. These benefits are designed to cover expenses and services that may not be included in government plans.

Extended Health Care benefits encompass various categories, including:

1. Hospital coverage
2. Drug Coverage
3. Medical Supplies and Equipment
4. Paramedical Services
5. Out-of-Province Coverage
6. Other Health Care Benefits

The plan may incorporate a deductible, such as $25 for employees with single coverage or $50 for employees with family coverage, or a nominal amount per prescription drug, typically $5. Additionally, there may be a coinsurance factor that determines the reimbursement percentage, such as 80% for prescription drugs. Maximum limits may also apply, for example, $500 per calendar year for physiotherapy. It is common to have different coinsurance factors for each benefit category. For instance, hospital and out-of-province coverage often receive 100% reimbursement, as claims in these areas can be substantial and pose a significant financial burden to employees. However, other Extended Health Care Benefits may be reimbursed at a lower level.

Dental

Dental care benefits offer extensive coverage for dental services and supplies, benefiting both plan members and their eligible dependents. Dental plans typically encompass a range of services, classified into three primary categories:

1. Basic dental services: This category includes routine dental procedures such as cleanings, exams, X-rays, fillings, endodontal, periodontal and simple extractions.
2. Major restorative dental services: These services cover more significant dental treatments, including crowns, bridges, and dentures.
3. Orthodontics: Orthodontic coverage addresses the specialized area of braces, aligners, and other corrective treatments to enhance dental alignment and bite correction. Plan sponsors have the option of adding more comprehensive services including:
   • Endodontics,
   • Periodontics,
   • Dentures,
   • Crowns,
   • Bridges, and
   • Orthodontics

Dental care benefits aim to ensure that plan members receive comprehensive coverage for their oral health needs, providing them with the peace of mind and quality care they deserve.

Critical Illness

Critical Illness Insurance offers a tax-free lump sum benefit in the event of a critical illness diagnosis. Critical Illness Insurance helps manage the additional expenses associated with the illness, allowing the insured to rebuild or maintain a lifestyle after facing such a challenge. The benefit can be utilized in various ways to support  healthcare needs and provide financial stability during the recovery and adjustment period. Some examples of how the Critical Illness benefit can be used include:

1. Accessing healthcare outside the country.
2. Avoiding long hospital waiting lists.
3. Covering non-insured healthcare expenses.
4. Offsetting lost income.
5. Making necessary home renovations for improved accessibility.
6. Eliminating debt burdens.
7. Securing long-term care options.
8. Supplementing monthly income.

Critical Illness Insurance offers coverage for a wide range of illnesses, including but not limited to:

• Heart Attack
• Lou Gehrig's Disease
• Stroke
• Parkinson's Disease
• Life-Threatening Cancer
• Paralysis
• Major Organ Transplant
• Renal Failure
• Coma
• Major Burns
• Coronary Artery Bypass Surgery
• Loss of Speech
• Multiple Sclerosis
• Blindness
• Alzheimer's Disease
• Deafness

Administrative Services Only:

An Administrative Services Only (ASO) agreement is used by employers to fund their employee benefit plan but hire an outside vendor to administer it. For instance, an insurance company may be used to process claims under part of their plan, while the company still maintains the responsibility of paying the claims. This differs from a company that purchases health insurance for its employees from an external provider.

Cost Plus:

Cost Plus is an arrangement that provides a facility for payment of legitimate expenses that are not covered by the insured benefit program. Claims that qualify as a medical or dental claim under the Income Tax Act are eligible.