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Employee Benefits with Group Life, Health and Dental Insurance

 

Employer sponsored Health and Dental Insurance Plans are referred to as Empoyee Benefits by just about everyone. These plans are truly Win Win situations where both the Employer and Employee derive benefits. Employees value these benefits because they are paying only a portion of the expenses whether they be for prescription drugs or dental and in some cases would be the deciding factor in having dental work done or not done. Employers benefit from attracting and retaining quality employees in addition to the ability to write off the costs of the Benefits plan as a business expense.

 

 

Individual Health Insurance and Dental Insurance Plans are availabe. For details  click selfinsure.

 

Typical types of coverage available with Employee / Group Benefits Plan briefly outlined below are: Group Life Insurance, Accidental Death & Dismemberment, Weekly Indemnity, Long Term Disability, Prescription Drugs, Extended Health Care, Dental and Travel Insurance. A Benefit Plan can be tailored to a high degree to suit the situation.

 

Group Life Insurance

 

Life insurance is usually provided as a flat amount or a multiple of one or two times an employee's salary, a flat amount for spouse and dependent children. There is usually a non-evidence limit and when optional life is offered it is always subject to medical evidence for coverages over and above the non-evidence limit. The life insurance element is one of the mandatory coverages and is usually inexpensive. Rates are based on gender  and age banding with chages every five years. Often times the life rates are a blend of smoker and no-smoker rates but this is entirely up to the insurance company providing the coverages.

 

Accidental Death & Dismemberment (AD&D)

 

Accidental Death usually matches the basic group life insurance amount and the dismemberment amount of coverage is set out in a schedule of coverages depending on the severity of the loss. Again this element like group life insurance is mandatory but is even less expensive than the group life insurance cost.

 

Weekly Indemnity

 

Weekly Indemnity or Short Term Disability is an optional element of a group employee benefits plan and is often not included because employees are entitled to a sickness benefit under the Employment Insurance program after an initiall two week waiting period and is payable for up to seventeen weeks.

 

Long Term Disability (LTD)

 

Long Term Disability is designed to provide continuation of income in circumstances where an extended  illness prevents an employee from working. This covearage is based on 66.666% of the employees Gross Income and the waiting period usually 119 days matching the end of the Weekly Indemnity or EI benefit period. Premiums for the LTD component should always be paid by the employee to make sure the benefits payable are tax free when an employee has to make a claim. LTD premiums paid by an employer make any benefits claimed by an employee taxable, unless the employer reports the LTD premiums paid , as a taxable benefit. 

 

Extended Health Care

 

This is the component that reimburses for Accidental Dental expenses, the difference in Hospital Accomodation cost between Private or Semi-Private Room and standard ward, Ambulance transportation, Paramedical Services, Private Duty Nursing, Prosthetic Appliances and Medical Equipment. There are maximum payouts associated with this category of services.

 

Prescription Drugs

 

This category would probably be the most frequently used component and usually has a small annual deuctible and less than 100% reimbursement. Drug cards are are available as an option for this coverage eliminating the inconvenience of an employee having to payout their personal funds then claim and wait for reimbursement.

 

Dental

 

This category is very similar in nature to prescription drugs, usually has a deductible, less than 100% reimbursement and employee required to payout personal funds then claim and wait for reimbursement.  Basic sevices of cleaning, extractions and fillings are always covered but more complex procedures often either covered at a lower reimbursement rate or not covered at all.

 

Travel or Out of Province / Country Coverage

 

Most group plan coverages include reimbursement of medical expenses, incurred while away from your home Province, that exceeds the amount payable by the Ontario Hospital Insurance Plan (OHIP). However this is not mandatory and should not be taken for granted.


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