Extended Health Benefits Summarized

Health benefits and Insurance Programs are critical components of an employee benefits package. Here is a synopsis of the common programs that can be provided through a benefit carrier.
Most companies provide a company-paid benefit program to employees after they have successfully completed their probationary period. Eligible employees include those who are employed on a permanent basis, either in a full time capacity, or on a regular part-time basis of perhaps 24 hours/week or more. Benefit programs normally cover a spouse and dependent children. (The definition of a dependent and the eligibility requirements for part time employees would be defined within the program.)

The Extended Health and Dental program is the most commonly utilized benefit and companies may set this up to require a deductible or a partial payment from the employee. Many benefit companies have robust program platforms where you can submit claims through a mobile app, check balances and provide a “pay direct” card for prescriptions. These platforms assist with accessibility of the benefit program for your staff and can provide useful information for reference purposes.

The Extended Health program covers prescription medication and medical services, such as semi-private hospital rooms. Paramedical coverage is often included up to a certain dollar amount per practitioner and can include physiotherapy, chiropractor, massage, psychiatrists, etc. Vision care is another option under this program and can provide an eye exam every one to two years and partial coverage for glasses, contacts or eye surgery. Out of country medical insurance is a welcome addition to an extended health program, relieving your employees of the need to purchase additional coverage for a quick trip across the border or for their vacation abroad.

Dental coverage is usually broken down between basic dental (cleanings, fillings and checkups) and the major dental work like bridges and oral surgery. Different coverage is often applied (ie. 80% for basic and 50% for major) and there may be an annual cap. Many dentists will bill the insurance company directly and request pre-approval for work done. However, it is important that your staff know the details of their program so they can plan accordingly.

An Employee Assistance Program helps support the mental well-being of your staff. This is a confidential service which provides access to professional assistance with issues of addictions, finances, legal, child or elder care and a variety of more personal circumstances.

Insurance Programs are another popular benefit and may be provided by the same carrier as the Health and Dental Program. There are a number of different programs that a company can choose to offer their staff.

For some programs, if a company pays for it, the benefit could be taxable to the recipient. If the employee pays for it – then the benefit could be tax-free. This is something that you would want to discuss with your benefits broker.

Life Insurance is usually offered at either one time or two times annual salary, or alternatively a company may choose to provide a set dollar amount of coverage. Costs for this insurance are generally cheaper than the employee could get on their own, and some companies provide the opportunity for the employee to purchase additional supplementary insurance at their own cost.

Accidental Death and Dismemberment is an insurance which provides payment if there is an accidental death or if there is a loss of a bodily part or the ability to hear, see or speak. This insurance is often provided in the same denomination as life insurance.

Dependent Life coverage recognizes the impact on your employees of the death of a spouse or a child. This is often a dollar amount that could be utilized to cover immediate financial obligations, such as funeral expenses.

Critical Illness Insurance provides a lump sum payment to the employee to cover costs associated with a life-altering illness. The list of “eligible” illnesses is established in advance and could include cancer, brain injury, stroke and heart attack, for example.

Short-Term Disability is funded through an insurance company and provides extended coverage to an employee for an approved illness. Short-term disability benefits would be utilized before long term disability starts. Alternatively, some companies choose to provide company-funded sick days and employees would need to rely on the sick benefit provided through the Employment Insurance program for a prolonged illness.

Long-term Disability will cover a portion of earnings after a qualifying period of (usually) seventeen weeks. (This is the time period covered by Employment Insurance). Long term Disability payments are a percentage of your earnings up to a maximum amount and can continue until you reach 65 years of age. The insurance company will provide follow up and support to help you get back to work, if possible.

Provincial Health Care: The province of BC is the last province in Canada which requires a payment from residents for their doctor and hospital visits, but this will only continue through 2019. Starting in 2020, coverage for BC Medical will be provided to all residents free of charge. (The costs associated with this program are collected through other means vs. a personal payment.) Some employers do provide coverage, or partial coverage, for their employees and this is a taxable benefit for the employee.

In Summary - You should ensure that you understand all programs available and try to provide those that would be most valued by your team. Whatever programs you choose to offer, it is important to properly promote the benefit package so that both you and your team can have some “peace of mind”.

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