There is a common question many small business owners have about group benefits plans. If Canada offers provincial health plans why do they need extended health care benefits?
Extended health benefits are designed to supplement things that are not offered by the provincial health plan.
Offering benefits can help a business stay competitive in the market. Benefit plans can improve employee retention, increase candidates per job, and improve employee morale. 74% of employers say that budget is the most important part of a b benefits package and 63% say employee retention is next.
Group benefits packages offer the ability to be completely customizable. The problem is how do you choose the right mix of extended health options?
Extended Health Options
Every benefits package will vary. Many employee benefits packages allow you to choose the best coverage options for your employees.
Here are the six most common health care benefits and a breakdown of what they cover for your employees.
Prescription Drug Coverage
Canada’s Universal Healthcare system does not include prescription drugs. It is one of the only countries with a Universal Healthcare system that doesn’t include a drug plan.
A group benefits plan will cover any drugs that are:
- Prescribed by a medical professional
- Deemed medically necessary
- Have an associated DIN (Drug Identification Number)
Medically necessary drugs like insulin, blood pressure medication, and cholesterol medication have high costs. A group benefits plan that includes prescription drugs can help improve the lives of your employees.
More than 90% of employers provide full-time employees with extended health benefits.
There are commonly three different types of prescription drug coverage plans available.
- Prescription Only Drug Plan – Coverage for drugs with a written prescription.
- Prescribed Drug Plan – Covers all prescribed medications including over-the-counter drugs.
Paramedical Services
Paramedical services are services completed by a list of specific practitioners. These extended health benefits commonly have a maximum spend per year under a group benefits plan.
Some plans will allow you to customize which practitioners are available under your benefits plan. The coverage extends from visits to x-rays.
Here is a list of common practitioners covered under paramedical services:
- Acupuncturists
- Athletic Therapists
- Audiologists
- Chiropractors
- Clinical Dieticians
- Massage Therapists
- Registered Kinesiotherapists/Kinesiologists
- Naturopaths
- Osteopaths
- Physiotherapists
- Podiatrists/Chiropodists
- Psychologists/Social Workers/Registered Clinical Counsellors, Canadian Certified Counsellors/Psychotherapists
- Speech Therapists
Paramedical services are often services that help improve the stress and well-being of your employees. It is one of the best-extended health benefit options to use as leverage for hiring new employees.
Vision Care
Vision care is a benefit not covered under British Columbia’s provincial health system.
A group benefits plan will commonly cover the eye examination, eyeglasses, and contact lenses of the entire family. It is common to have a maximum spend on this benefit offering. Families commonly get around $200 per person every 24-month period depending on the plan.
Sunglasses and non-prescription eyewear are not included under most benefits plans.
Out-of-Province Emergency Coverage
Emergency coverage allows employees to be medically covered while travelling outside of the province. It is common for this coverage to extend to a maximum of 180 days of travel, depending on age. Coverage can include:
- Hospital room
- Hospital out-patient services
- Hospital supplies
- Diagnosis and treatment by a physician
- Ambulance
Some benefit plans will also include an emergency evacuation fund to help get employees back if they are travelling and get stuck in a natural disaster.
Dental Care
Dental coverage is one of the most commonly used benefits in Canada.
59% of employees say health and wellness benefits are important for increasing their loyalty to an employer.
There are three different categories of dental coverage.
- Basic Dental Coverage
- Restorative Dental Coverage
- Orthodontics
Most dental benefit plans will include preventative treatments like:
- Exams
- X-rays
- Cleanings
- Fluoride
- Fillings
- Scaling
- Extractions
Restorative care and orthodontics can be covered based on a percentage in many plans. Restorative services include dentures, crowns, and bridgework. Orthodontics can include braces, wires, space maintainers and other mechanical aids required to straighten teeth and correct defects.
Many group benefits plans will have a level of coverage for each category. There may be deductibles and yearly or lifetime limits depending on the benefits plan you choose.
Life insurance
Life insurance can be covered from a minimum of $25,000 to a multiple of your annual income. Many plans will have the ability to give employees access to purchase additional insurance for themselves and their families.
Short Term Disability
Short-term disability also known as weekly indemnity (WI) covers an employee in the event that they are unable to work due to a disability.
WI covers up to 66% of an employee’s weekly earnings. Benefits are also covered if the disability resumes within 14 days of an employee returning to work. This option covers up to a maximum of 26 weeks.
Long Term Disability
Long-term disability covers employees who are unable to work for extended periods because of a disability.
Benefits pay for a maximum of 5 years or up to the age of 65. Coverage is set between 50% to 75% of monthly earnings depending on the length of the disability claim.
Critical Illness
Employees diagnosed with a life-threatening illness are covered under critical illness insurance.
Illnesses covered under insurance include:
- Alzheimer’s Disease
- Aortic Surgery
- Aplastic Anemia
- Bacterial Meningitis
- Benign Brain Tumour
- Blindness
- Coma
- Coronary Artery Bypass Surgery
- Deafness
- Dilated Cardiomyopathy Fulminant Viral Hepatitis Heart Attack
- Heart Valve Replacement Kidney Failure
- Life Threatening Cancer
- Liver Failure of Advanced Stage
- Loss of Independent Existence
- Loss of Limbs
- Loss of Speech
- Major Organ Failure – Waiting List
- Major Organ Transplant Motor Neuron Disease Multiple Sclerosis Muscular Dystrophy Occupational HIV Paralysis
- Parkinson’s Disease Primary
- Pulmonary Hypertension
- Progressive Systemic Sclerosis
- Severe Burns
- Stroke
Dependants can also be covered for many life-threatening illnesses including:
- Blindness
- Cerebral Palsy
- Coma
- Congenital Heart Disease (requiring surgery)
- Cystic Fibrosis
- Deafness
- Diabetes Mellitus (Type 1)
- Down Syndrome
- Life Threatening Cancer
- Loss of speech
- Major Organ Transplant
- Mental Deficiency
- Muscular Dystrophy Paralysis
- Severe Burns
- Spina Bifida Cystica
Employee Assistance Services (EAP)
To improve the morale and productivity of employees your health benefits can offer employees the chance to speak to a therapist.
12 face-to-face hours are offered per year per family. The family can choose to see a therapist to support their family, mental health, and work-related stressors.
Choosing the Best Mix of Extended Health Benefits
The most important things to think about when choosing your extended health and group benefits plans are coverage type and budget.
There are different options that may be mandatory or common within your industry. Look at the options being offered by your competition and make sure you are meeting the industry minimums.
It is also best to talk to an insurance specialist. Each insurance company will offer different options and different coverage amounts. A specialist can help you build the best mix of benefits for your specific budget.
You can also ask your current employees what they care about most and put that into consideration when choosing benefit plans.
If you need help building your unique group benefits plan please give me a call at (604) 461-6164 or email me at info@ahopkinsinsurance.ca. I would be happy to help you out.
