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 [email protected]. I would be happy to help you out.