How Canadian employers offer mental health support

So, what does mental health support look like in employee benefits packages? Here are some of the benefits that employers in Canada offer to their employees:

Why support mental health in the workplace? 

Supporting mental health in the workplace is essential for several reasons:

• Enhances employee well-being
• Boosts productivity
• Reduces absenteeism
• Lowers mere presenteeism
• Increases employee engagement
• Improves employee retention
• Promotes a positive work culture

Want to choose the best group health plan with mental health benefits? Speak to our experts!

At PolicyAdvisor, our licensed experts will give you honest, unbiased advice that puts your needs first. So, if you’re looking for an insurer that will prioritize your employees’ mental health and give you a sustainable group health plan, speak to us today! 

Life is unpredictable. One moment, you’re walking down the same stairs which you use everyday. And the very next, you’ve missed a step and ended with a fractured knee.

Sounds painful? It certainly is. And the additional expenses that come with an accident don’t help ease the pain at all. A group accident insurance plan helps employees deal with the unexpected twists (sometimes quite literally) that life throws at them. 

One of the many additions to an employee benefits plan is a group accident insurance policy. Just like group disability and group critical illness benefits, an employee accidental insurance policy can help employees during a difficult time. But what exactly is it and what does it cover? Let’s find out. 

What is group accident insurance?

A group accident insurance policy pays a lump sum amount to an employee in the event of an accident. This benefit can ease the financial burden of a medical intervention that may be required for an employee to recover. A group accident insurance policy will usually have Accidental Death and Dismemberment (AD&D) benefits—more on this later. 

Apart from the physical strain that an accident puts an employee through, it also causes immense financial stress that they may not be prepared for. A group accident insurance policy can help them and their families with the costs incurred during

• Recovery period
• Hospitalization
• Medication
• Rehabilitation
• Therapies and mental health wellness programs

Employee accident insurance plans extend beyond work-related injuries. Any employee covered under this policy will get the benefit regardless of how or where an accident occurs. 

What do employee accident benefits cover?

Different insurers offer different kinds of coverage under a group accident insurance plan. But most policies cover a range of accidental injuries including:

Group accident insurance policies cover the medical expenses associated with an accidental injury. These include:

Group Accidental Death and Dismemberment (AD&D) benefits

AD&D benefits provide coverage for an employee if they meet with an accident regardless of where they are in the world and whether they’re on or off the job. If an employee suffers any of the losses listed in their policy document, they will get AD&D benefits. An AD&D policy usually has a defined meaning of “accident”. Most insurers define it as a sudden and unexpected event that causes unexpected injuries or bodily harm. 

Group AD&D plans are customizable and employers can build a plan according to their unique needs. These customization options include:

How do group accident benefits work?

Typically, the premiums for a group accident insurance policy are paid by the insured employee through payroll deductions. Employees have the option to add their family members to the policy and pay any additional premium to cover the dependents.

Employee accident insurance plans are also often portable so an employee can continue to be covered under this policy, even if they leave their organization. Group accident insurance is a pretty straightforward policy. An insured employee will get a lump sum payout if they meet with an accident and they can choose to use this benefit in any way they want to. Apart from the medical costs, they can also use it to:

✅ Hire child care if required 

✅ Substitute income from missing work 

✅ Home healthcare requirements 

✅And more

Key features of principal group accident insurance

Principal group personal accident insurance offers comprehensive coverage and several benefits to protect employees in case of accidental injuries or death. Key features of principal group accident insurance typically include:

• Accidental hospitalization benefit: Covers the cost of hospitalization in case an insured individual has met with an accident and requires immediate medical attention
• Accidental death benefit: Provides a lump-sum payment to beneficiaries if the insured dies as a result of an accident
• Accidental dismemberment benefit: Pays a specified amount for the loss of limbs, sight, speech, or hearing due to an accident
• Instant policy issuance: Group personal accident insurances are issued immediately without the need for any waiting period
• Disability benefits: Provides income replacement if an employee is unable to work due to an accident
• Emergency evacuation: Covers costs associated with emergency transportation to a medical facility
• Repatriation of remains: Pays for the transportation of remains if the insured dies in an accident while away from home
• Family benefits: Some insurers may include coverage for family members, such as childcare benefits or education benefits for children

Find out more about group health insurance as an employee benefit through our detailed blog

Who pays the insurance premium?

The premium for a group accident insurance cover is typically paid by the insured employee. This policy is usually offered by employers as an optional supplemental cover in addition to other benefits. Depending on the insurer and the plan they offer, the premium can vary. 

How is the premium for employee accident benefits calculated?

Different insurance companies have different methods to calculate the premium for an employee accident premium policy. Generally, there are five key factors that can determine employee accident insurance premium rates:

The bad news is that critical illness is on the rise in Canada. The good news is that survival rates are also increasing. Canadians who have a heart attack are more likely to survive it with the right kind of medical intervention. In fact, the survival rate for cancers is also on the rise—again, due to medical advances and interventions. And that’s where a group critical illness insurance comes in. It gives employees the opportunity to get the right kind of medical help when they truly need it. 

We know that employees’ health can have a major impact on their work. We also know that with advancement in medicine, treating critical illnesses has become easier than ever before. Both these factors make group critical illness insurance an integral part of an employee benefits plan. Let’s find out more about it. 

What is group critical illness insurance?

Group critical illness insurance is a lump sum benefit paid to an employee who has been medically diagnosed with a qualifying critical illness. Insurers will typically list the illnesses covered under a group critical illness insurance plan in the policy document. 

As mentioned above, critical illnesses are on the rise. But so are survival rates. This means that there is a growing need for help in covering the costs associated with a critical illness recovery process. And this is precisely what employee critical illness insurance does.

How does group critical illness insurance work?

With group critical illness insurance, an employee will get a one-time lump sum payment if they receive a medical diagnosis for a critical illness after the policy comes into effect. Most employers offer group critical illness insurance to all their employees who have successfully completed a waiting period that can vary between 30-45 days. 

Unlike life insurance, the payout for critical illness doesn’t happen after an insured employee’s death. It’s a benefit that is given to them to help with the immediate financial burdens of a critical illness. Most insurers will offer plans that cover serious illnesses such as cancer, heart attack, stroke, paralysis, kidney failure, and more. 

What does group critical illness insurance cover?

Every insurer has a fixed list of serious ailments that an employee critical illness insurance covers. Employees can either get basic coverage with 3-4 illnesses covered or enhanced coverage with 25+ conditions. 

Basic group critical illness coverage includes:

Enhanced employee critical illness insurance coverage includes:

Learn more about critical illness insurance cover

Who is covered?

Group critical illness health insurance plans in Canada typically cover the following people from any unprecedented critical health condition:

• Employees or members of an association: The primary individuals covered under the plan are the employees of an organization or members of an association. This coverage is part of an employee benefits package, and part-time freelancers or contractual employees cannot avail the benefits of a critical care plan, unless otherwise specified in the policy documents

• Dependents: Many group plans also extend coverage to the dependents of employees, which can include spouses and children. The specifics can vary based on the employer’s policy and the insurance provider’s terms

Find out the difference between critical illness rider and insurance here

Eligibility requirements for group critical health insurance

Although the eligibility requirements for group critical care plans can vary, here are some common eligibility criteria:

• Active work requirement: You usually need to be actively at work when the coverage begins. If you are not working due to illness or disability, you may need to return to work and enroll in your organization’s group benefits plan
• Minimum service period: Some insurance companies or organizations may require an employee to complete a certain period of service before availing critical care benefits. The period may range from a few weeks to several months

• Relationship with dependents: If the policy covers dependents, they must be the legal spouse or children (biological, adopted, or stepchildren) of the employee. Age limits for children might apply in the case of certain companies
• Age restrictions: Some plans have minimum and maximum age limits for coverage, and eligibility might be restricted to individuals with a certain age range
• Health requirements: While group plans are generally more lenient than individual plans, some insurers may require health questionnaires or medical exams, especially for higher coverage amounts

Policy details

Policy details contain comprehensive information on the insurer’s policy, some of which are:

1. Benefit amount

Policy details may contain the benefit or coverage amount that the insured can expect to receive for a critical illness diagnosis and treatment. Having knowledge about the coverage can help an individual plan their finances accordingly.

2. Survival period requirements

Policy details may also contain information on specific survival period requirements. Most critical illness policies require the insured to survive a certain period after the diagnosis of a covered illness to be eligible for the benefit. This period is typically 30 days but can vary from one policy to another.

3. Exclusions

Policy details can also help the insured understand the limitations of their policy. Some policies do not cover specific pre-existing diseases, lifestyle-related critical disease care, the payout for individuals above 65 years of age, etc. Being aware of a policy’s limitations may help the individual come up with suitable treatment alternatives.                            

Are employee critical illness insurance plans a taxable benefit?

Any premium for group critical illness coverage that is paid by the employer will be a taxable benefit for the employee. Since the employer is paying the premium, it will be considered to be additional income for the employee. This means that the employee will have to report it on their tax return. 

However, if an employee is diagnosed with a critical illness, the benefit that they will receive will be tax-free. The tax liability is only on the premium amount. 

Importance of group critical illness insurance for employees

Canada has a well-defined and regulated healthcare system. But provincial healthcare plans are not comprehensive and might not cover some of the costs associated with an illness. That is where a group critical illness insurance plan plays an important role. 

Apart from being relatively inexpensive when compared with individual critical illness insurance plans, employee critical illness insurance also doesn’t require a medical examination. Employee critical illness insurance benefits can help with: 

Is group critical illness insurance worth it?

Employees are arguably the most important factor to an organization’s success. Employers who value their workers should absolutely offer group critical illness insurance as part of employee benefits. Employee critical illness insurance will add to an organization’s hiring and retention strategy and will help them stand out as an employer of choice for top talent. 

Most people who are diagnosed with cancer might have to stay home or in a hospital leading to wage losses. Keeping this in mind, offering employee critical illness insurance is the right step for any empathetic employer. 

Integrating group critical illness insurance in an employee benefits plan

A critical illness can be a mentally and emotionally difficult time for an employee and their family. Navigating the process to recovery—from hospital visits, to medication, and recovery—can take a toll on the employee and their loved ones. At such a time, offering a group critical illness insurance cover can make all the difference. 

Our licensed and expert advisors will help you understand how to integrate a group critical illness insurance plan to your employee benefits package. Speak to us today to get started. 

Choosing the right policy for your organization

Employers need to take a lot of things into consideration while choosing the best group critical illness plan for their workforce. Here are a few common factors to look at:

• Accessing the needs of employees through a detailed questionnaire
• Comparing different insurance plans of various companies and understanding their offerings thoroughly
• Deciding upon the coverage amount and coming up with the right premium payment plan
• Understanding if the chosen insurance plan offers flexibility and customization options
• Checking out the compliance and regulatory requirements before making the purchase
• Choosing specific add-ons such as dependent coverage, disability rider and more

Check out the different types of group health insurance plans in Canada through our detailed blog

Getting a quote and setting up the policy

If you’re looking for the most affordable group health insurance quotes but don’t know where to begin, it’s best to seek help from industry experts. Speak to a licensed insurance expert such as our advisors at PolicyAdvisor to understand the features of each plan and get the best quotes.

Once you’ve finalized a policy, go ahead and set it up with the help of insurance agents. This includes the underwriting of the policy, any additional rider inclusion, setting up the requirements for the policy and more. 

Communicating the benefit to employees

Once the plan has been set up, employers can communicate about the insurance policy with their employees. A thorough orientation meeting wherein the employers provide a walkthrough about the insurance policy, its features and benefits to the employees can be beneficial. 

Employers can also answer common doubts and queries and help the employees understand their policies better and figure out how to make the claims. This can streamline the process for both parties in the future.

Additional support services

Apart from providing group critical care insurance, employers can extend their employee benefit package to include a plethora of additional perks, such as:

• Mental health and wellness packages
• Access to dental care subscriptions and applications
• Out-patient consultation claim support
• Second-opinion reimbursement support
• Disability benefits and rider add-ons

In the fast-paced and high pressure business world, companies use employee benefits to nurture their employees and  ensure their well-being. 

This guide covers all you need to know about employee benefits (also known as group benefits and group health insurance). We’ve explained what they are, their types, structures and compliances, and how to build an employee benefits package. 

What are employee benefits?

Employee benefits are services and perks offered to employees over and above their salaries and wages. Employee benefits plans typically include a suite of benefits such as paid time off (PTO), health and dental insurance, disability and critical illness insurance, retirement benefits, and more.

Certain benefits such as pension plans and employment insurance are mandatory by law to ensure a basic level of financial security and protection for employees. Other benefits are voluntary and are offered at  the employer’s discretion to attract and retain talent, boost morale and differentiate themselves in the competitive job market. 

Know more about employee benefits plans in Canada

Why are employee benefits important?

Employee benefits help boost employee well-being and morale, and can increase job satisfaction and build loyalty. Here’s why employee benefits are important:

What does an employee benefits plan look like?

In Canada, employee benefits are provided by most companies and small businesses. Here is a detailed sample of what an employee benefits plan looks like in Canada:

Find out more about how group health insurance plans can be used by small businesses

Who is entitled to benefits in Canada?

Any full-time employee in Canada is entitled to receive employee benefits and perks from their company. Although the benefits may vary from one company to another, companies are legally required to offer government-mandated benefits such as CPP, sick days, PTO, etc. Most companies also offer health and dental, AD&D, etc., to their employees.

Even small businesses are expected to provide their workforce with some employee benefits and perks within their budget.

Do employers have to provide employee benefits in Canada?

There are certain mandatory employee benefits that all employers are required to provide by law. These are:

Apart from the mandatory benefits, many employers offer supplemental benefits like health and dental plans, life insurance, disability insurance, etc. These are optional benefits that are part of an employee benefits package and are offered at the sole discretion of the employer. 

Types of employee benefits

Mandatory employee benefits in Canada can be categorized into two types:

1. Benefits mandated by law
2. Benefits offered on an optional basis

Employment Insurance (EI)

Employment Insurance (EI), run by the Federal Government, is a program that offers temporary financial support to employees who are unable to work due to one of the following reasons:

Unemployed workers can receive up to 55% of their average weekly earnings as EI. As of January 1, 2024, the maximum yearly insurable earnings in Quebec and the rest of Canada is $63,200 which means an unemployed worker can get $668 per week. 

Here are the key features of employment insurance:

The program is administered by Service Canada, a government agency, and individuals typically apply for benefits online or by phone. They must continue to meet eligibility requirements while receiving benefits, such as actively seeking employment and reporting any income earned during the benefit period.

Pension plan 

The Canada Pension Plan (CPP) is a retirement savings plan that provides a stable income during retirement for individuals and their families.In addition to retirement benefits, the CPP also offers disability and survivor benefits. 

The CPP makes pension contributions mandatory for most employees. The pension contributions are typically split equally between the employer and the employee. Employees can opt to receive  a reduced pension amount as early as the age of 60, although the full benefits start to pay out, once they reach the age of 65 years. Any employee earning less than $3,500 per year is exempt from this contribution along with their employer. Similarly a self-employed individual may voluntarily opt-in to the program.

Under the CPP, employers and employees pay 5.95% of a worker’s salary in annual contributions which is capped at $3,867 per year. 

While all of Canada follows the CPP, Quebec has its own pension plan called the Quebec Pension Plan (QPP), applicable only to the province of Quebec. It requires employers and employees to contribute 5.4% of a worker’s salary and caps it at $3,867 per year. 

Holidays

Holidays are mandatory for any individual to sustain a healthy work-life balance. The Canadian government strictly asks companies to provide abundant holidays for the overall well-being of the employees. This allows employees to rejuvenate and spend quality time with their families while still being paid what they deserve.

Here is a list of the most prominent holidays celebrated across Canada:

1. New Year’s Day
2. Good Friday
3. Victoria Day
4. Canada Day
5. Labour Day
6. National Day for Truth and Reconciliation
7. Thanksgiving Day
8. Remembrance Day
9. Christmas Day
10. Boxing Day
11. Civic Day
12. Easter Sunday

Check out the cheapest travel insurance in Canada

Workers’ compensation insurance

Workers compensation is a form of social insurance that provides financial and support services to employees who experience work-related injuries or illnesses. Every province has a Workers’ Compensation Board (WCB) that manages and regulates the compensation  offered to employees. The WCBs also decide the premiums that employers need to pay. 

While most organizations need to register with their provincial WCBs, there are certain categories that are exempt from paying workers’ compensation insurance. The province-based exemptions are listed below: 

Vacation benefits 

Based on where an individual is working in Canada, their vacation entitlement will vary. They can be accrued in one go or prorated for an employee. The following table gives an overview of the provincial vacation entitlement in Canada:

Maternity and parental leave

Employees are entitled to 17 weeks of maternity leave that can be taken up to 13 weeks before the expected date of delivery. Employees who adopt a child are entitled to 63 weeks of parental leave. The leave can be taken by one parent or shared between both parents. 

Sick leave

Different provinces have varying rules when it comes to sick leave. Some of the key features of sick leave as an employee benefit are:

• Sick leave is not pro-rated. A set number of sick leave days are given to the employees at the beginning of each year 
• Employees who join in the middle of a year are entitled to the entire number of sick leave for that whole year 
• Sick leave cannot be cashed out and is not carried over to the next year

The following table has the sick leave entitlement for each province in Canada:

Group health benefits 

Canada has provincial health insurance that is offered to every citizen. So the question is—why should an employer offer health insurance at all? It’s because provincial health insurance only covers some essential medical services while group health benefits are more comprehensive in nature. 

Group health benefits are cheaper than individual health insurance. They’re purchased by an employer and offered to all full-time and/or contractual workers.

Group health benefits typically include:

Learn more about why group health insurance matters

Group Registered Retirement Savings Plans (RRSP)

Group Registered Retirement Savings Plans (GRRSPs) are offered in addition to the mandatory pension plan that most employees are entitled to. RRSPs help employees build additional wealth for when they retire and also give immediate tax benefits to the contributor. 

RRSPs are regulated by the Canada Revenue Agency and the contributions yield returns since they can invested in one of the following options:

Healthcare Spending Accounts (HSAs)

HSAs are a special kind of medical account that offers a mutually beneficial way for both employers and employees to provide and receive medical insurance benefits. 

Employers create an HSA account for their employees with a maximum spend limit. Employees can utilize the money from this account to pay for any medical requirements. HSAs allow both parties to receive tax benefits. Additionally, it also provides individuals a streamlined access to medical facilities without the burden of extra paperwork.

Some of the key features of HSA are as follows:

• Funds roll over year-to-year, and there is no “use it or lose it” rule
• Accounts are portable – you can keep the HSA if you change jobs or health plans
• Can invest HSA funds for potential growth, similar to an IRA

Disability Insurance (DI)

There are two types of disability insurance that an employer can choose to offer: short-term disability insurance and long-term disability insurance. Short-term disability insurance typically covers a shorter duration, from a few weeks up to six months. Long-term disability insurance is for employees who are unable to work for longer periods and usually begins after the expiration of short-term disability benefits or after a waiting period. 

Disability insurance covers any medical condition that prevents the employee from working such as mental health issues, fractures, back injuries, carpal tunnel, seizures, and hearing or vision loss. Short term disability benefits can be paid out as weekly benefits while long term disability benefits are typically paid out on a monthly basis to an eligible employee. 

Critical illness coverage 

An employee benefits package can also include critical illness coverage that is offered to workers who suffer a heart attack, cancer, stroke, kidney failure, Parkinson’s disease, aplastic anemia, and 26+ common conditions as listed by the Canadian Life and Health Insurance Association (CLHIA).

It is easy to confuse critical illness with a disability. For instance, blindness and paralysis are critical illnesses and disabilities. 

Learn more about the differences between critical illness and disability insurance 

Life Insurance

Life insurance provides financial support to family members in the event of the individual’s passing away. Life insurance as an employee benefit is important to help manage the financial impact from an earning member’s demise. It can be used to: 

• Pay for funeral expenses
• Pay off debts 
• Replace lost income 
• Make charitable donations 

Employers can pay the entire premium or split the cost with the employees for life insurance benefits. 

Additional paid days off

In Canada, some companies provide additional paid days off beyond statutory holidays and vacation entitlements. These extra days provide employees with more time for personal pursuits, family commitments, or rest. 

Employers offering this benefit often see increased productivity, reduced burnout, and higher job satisfaction. 

Wellness programs

Wellness programs, including health coaching and virtual care, promote overall employee well-being. 

Health coaching offers personalized guidance on nutrition, fitness, and mental health, helping employees achieve their health goals. Virtual care provides convenient access to healthcare professionals via digital platforms, reducing the need for in-person visits. 

These programs enhance employee health, leading to reduced absenteeism, increased productivity, and lower healthcare costs for employers. 

Transportation allowance

Transportation allowances are a valuable employee benefit that can significantly ease commuting stress and expenses. These allowances, provided as a monthly stipend or reimbursement, help cover costs related to public transit, fuel, parking, or even car maintenance. 

Cash bonuses

Cash bonuses are awarded for meeting specific targets or exceptional performance. They provide immediate financial rewards and recognition, fostering a culture of excellence and achievement and driving employees to exceed their goals.

Other supplemental group benefits

Supplemental benefits are a range of comprehensive add-ons that employers may choose to offer their employees. Some companies provide bonuses and stock options as an added perk to their employees. 

Others may provide travel benefits, including all-expense-paid trips for the employee and their families. Supplemental benefits promote loyalty and a sense of belonging among employees. Other examples of supplemental group benefits include:

• Retirement savings programs
• Employee training, education, and development programs
• Flexible work schedules and remote work
• Compassionate care leave
• Aboriginal employee leave
• Childcare benefits

Understanding Employee Assistance Programs (EAPs)

Employee Assistance Programs (EAPs) are critical benefits that offer confidential support for employees dealing with personal or work-related challenges. These programs help employees manage stress, anxiety, and other issues that might affect their performance and well-being. 

Some of the most prominent EAPs offered by Canadian companies are:

• Counseling services: Access to professional counselors for issues like stress, anxiety, depression, and relationship problems
• Legal assistance: Guidance and advice on legal matters, including family law, wills, and housing issues
• Financial planning: Support with budgeting, debt management, and financial planning
• Work-life balance support: Resources to help manage personal and professional responsibilities
• Substance abuse programs: Help for employees dealing with addiction or substance abuse issues

By offering EAPs, employers demonstrate a commitment to their workforce’s holistic health, fostering a supportive and productive work environment.

An average employee in Canada works for 40 hours a week. That is 40 hours of their time dedicated to working for an organization and helping it grow and achieve its goals. In return they expect their employer to care of their wellbeing. One of the easiest and most effective ways for an organization to do this is by offering them an employee benefits plan. 

Employee benefits plans, also known as group benefits, employee insurance plans, or employer-sponsored plans, are offered by an organization to its full-time or part-time workers. In Canada, these plans are available in various forms, customized to meet the unique and diverse needs of an organization and its employees. 

In this blog, we’ve explained the different types of group insurance plans that are available. If you’re an employer, looking to attract and retain talent, or an employee who wants to understand group health coverage, this blog is for you!

How is a group health plan different from an individual health insurance plan? 

The main difference between a group health plan and an individual health plan is reflected in their respective names—the former covers a “group” of employees in an organization while the latter is purchased by an individual for personal health coverage.

Types of group health benefits plans 

In Canada, group health benefit plans typically fall into three main categories: employer-sponsored plans, benefits provided through professional associations, and government-sponsored benefits.

Employer-sponsored benefits

Employer-sponsored benefits are offered by an employer to the employees of an organization, forming a key part of an organization’s compensation package. Employers work with licensed experts, such as the ones at PolicyAdvisor, to obtain a group health plan that is tailored to meet the needs of the employee pool at the organization. 

Employer-sponsored benefits are typically part of an employee’s compensation package and are offered as a perk. This means that the employer pays most or all of the premium for the group health benefits being offered to their employees. Since these benefits are offered to a group of people, the premiums are lower as compared to individual plans since the insurer’s risk is distributed amongst the pool of employees. 

In some cases, the cost might be split between the employer and employees, especially if the latter chooses to add family members to their group health benefits plan. 

Why employees need to understand their work insurance policy

Key features of employer-sponsored plans

Some of the key features of employer-sponsored group benefits plans are:

✅ They can be paid for largely or in entirety by an employer

✅ Smaller organizations usually need 100% participation while larger ones will need 70%

✅ Employees can add family members to their group benefits for an additional cost 

❌ Employer-sponsored plans are typically not portable and only last for the term of employment

❌ Employer-sponsored plans have limited customization

❌ Some organizations might exclude part-time workers or employees on unpaid leave from these plans

Know more about how group health insurance works

Professional association benefits

Professional associations are organizations that offer networking opportunities to a group of people from a certain industry or profession. These associations include financial institutions, retiree organizations, college and university alumni groups, and clubs. 

Professional associations offer standardized group benefits to their members and their families. Similar to employee benefits, every member can choose to get coverage for health & dental, vision, prescription medication, and paramedical services. The premiums can either be paid directly by the members or deducted from their membership fees. 

Depending on the preference of the association, they might also offer life insurance, disability insurance, and accidental death and dismemberment (AD&D) insurance. For example, an armed forces or army veterans association might choose to offer life, disability, and AD&D insurance to its members while an advocacy group for a trade  association might not. 

Since a group of people are being insured under professional association benefits, the premiums are going to be lower and the plans will be customizable. It is beneficial to work with licensed experts when figuring out the best group benefits for a professional association. 

Key features of professional association benefits

Professional association benefits are a great way to increase and retain members of an organization. Some of the key features of these benefits include:

✅ Highly customizable plans, tailored based on the association’s member composition

✅ Lower premiums since the insurer’s risk is spread

✅ Group benefits extended to family members and loved ones 

❌ There is no portability with coverage which ends when a membership expires or is stopped

Provincial health care plans vs employee benefits plans 

The Canadian government provides healthcare to all its citizens. So the question that arises is: why are group benefits plans even necessary? It’s because provincial health care plans typically cover essential medical needs such as emergency healthcare and other basic medical care that includes surgeries and doctor visits. Employee insurance plans, on the other hand, provide wider, more extensive supplementary medical coverage. 

Traditional group health insurance plans

In Canada, traditional group health insurance plans are typically provided by employers to their employees. These plans cover various health-related expenses that may cause financial strain for individuals or their families. The main types of traditional group health insurance plans in Canada include:

1. Extended Health Care (EHC) plans

EHC plans are the most common form of group health insurance plan that employers provide to their team members as an additional perk for their efforts. Most EHC plans cover a comprehensive range of healthcare facilities, such as vision care, physiotherapy, chiropractor visits, prescription drugs, and more.

2. Dental insurance plans

Apart from EHCs, many group health insurance plans also offer dental insurance benefits that protect the individual as well as their dependents from any unforeseen expenses.

Dental plans cover a range of dental care services, including routine check-ups, cleanings, x-rays, fillings, extractions, and more extensive procedures like crowns and orthodontics.

3. Disability insurance

Another form of group health insurance includes disability insurance that may also be offered to employees. Disability insurance protects an individual when their health problem prevents them from working a job and earning a steady income for their family.

Individuals with disability insurance will receive periodic payouts that will help them easily cover basic day-to-day expenses such as groceries, mortgages, children’s education, etc.

4. Employee Assistance Programs (EAPs)

EAPs help with individuals’ overall well-being and can be added as a lucrative perk to a group health insurance plan. They offer support services such as mental health counseling, legal advice, and financial planning for employees dealing with personal issues that might affect their performance at work.

Find out more about how group health insurance can help small businesses in Canada

Health Spending Accounts (HSAs) 

HSAs are unique health accounts that provide a mutually beneficial way for employers as well as employees to work with health insurance. Otherwise known as Health Care Spending Account (HCSA) or Health Reimbursement Account, HSA is more of an out-of-the-pocket payment that the employer bears for their employees.

Employers receive high tax rebates from providing HSA facilities for their employees. On the other hand, employees prefer this scheme as it automatically eliminates the burden of copay and deductibles. Most HSAs have a set amount of annual coverage for each employee and their dependents.

Extended group health insurance

Extended group health insurance covers a detailed list of medical complications and illnesses that can be covered under the group health insurance plan as added benefits for employees. With a wide array of features to choose from, employers may provide some or all of the benefits that can be covered under this plan. 

Some of the most prominent features of extended group health insurance may include the following:

• Prescription drugs: It may include coverage of prescription drugs such as medications for hypertension, thyroid, kidney problems, or even insulin shots
• Vision care: This covers the cost of regular eye checkups, prescription glasses or contact lenses, eye care essentials, and even surgery if required
• Paramedical services: This covers the cost of paramedical services such as ambulance charges, extensive therapy, additional medical supplies, etc
• Critical illness insurance: This ensures that employees or their dependents receive a lump sum amount of money on being diagnosed with a critical disease such as cancer, heart attack, stroke, etc
• Accident insurance: This safeguards employees as well as their families from financial turmoil in case of an injury or trauma due to an accident
• Travel insurance: This provides complete security to individuals and their dependents in case a medical emergency strikes while they’re traveling

Estimating costs of traditional group health insurance

Traditional group health plans may come in several different formats with limitless customization options. Hence, it’s safe to say that the cost of this insurance plan will also vary. Although prices may fluctuate across companies depending on employee demographics, here is an estimate:

• Small businesses (up to 50 employees): The cost per employee can range from $1,500 to $4,000 per year
• Medium-sized businesses (50-250 employees): The cost per employee can range from $1,200 to $3,500 per year
• Large businesses (250+ employees): The cost per employee can range from $1,000 to $3,000 per year

Importance of group benefits plans

Group health benefits or employee insurance plans are crucial to attract and retain talent. For professional associations, they work as an added benefit for the members. The different types of group benefits are important because:

Cost-sharing options for employee health benefits

Group health insurance may also be categorized based on how the insurance premium is being paid and who pays for it. Taking a look at the plethora of cost-sharing options, employee health benefits may be as follows:

• Employer pays: In this category, the employer bears the entire cost of the premium on behalf of the employee. The employee usually provides this facility as an added perk to their dedicated workforce
• Employee pays: In this arrangement, the employee bears the entire cost of the premium. However, the employer may provide assistance with the insurance paperwork for a streamlined procedure
• Employer and employee split: This procedure allows the employer as well as the employee to split the cost of the premium. In this way, both parties may receive tax benefits and other mutual perks
• Coverage-based split: In this method, there can be different cost-sharing arrangements for different types of coverage. The cost-sharing procedure can be customized based on the agreement between the employer and the employee

Explore more about employee benefits through our detailed guide

A group health insurance is a type of health coverage typically offered by an employer or organization to a “group” of people—the employees or members of the organization. Group health insurance is typically cheaper for members of the insured group as compared to separate individual plans since the insurer’s risk is spread across a large number of participating members of an organization. It is an important part of an employee benefits program and employers should know how group health insurance works in Canada. 

Whether you’re an employer who is looking to offer group health insurance to your employees in Canada or someone who is simply curious about how an employee benefits plan works in Canada, this blog is for you! 

What is group health insurance? 

Group health insurance, also known as a group plan or employer-sponsored coverage, is a type of health insurance that an employer purchases and offers to its employees and their dependents. This group of people is accordingly covered under a single policy, offering benefits such as:

• Dental and vision care
• Hospitalization
• Prescription drugs
• Chronic disease coverage
• Other healthcare services

Employers or organizations usually negotiate the terms of the insurance policy and may subsidize part or all of the premium costs for their employees or members. Group health insurance is typically offered to all full-time or part-time workers as part of an employee benefits program.

How does group health insurance work in Canada? 

Group health insurance in Canada provides employees with access to comprehensive healthcare coverage beyond what is provided by the provincial healthcare system. Most group health insurance policies in Canada typically work in the following way:

1. Employer sponsorship: Employers choose a plan they want to offer to their employees. The employer negotiates the terms of the insurance policy with an insurance provider and may subsidize part of the premium costs for their employees. Within the plan, the employer can choose to add various types of benefits such as  health, dental, vision and prescription drug coverage, plus optional access to life insurance, disability and family assistance plans.
2. Employee enrolment: Employees can choose to enroll in or decline a group health insurance plan during the specified annual enrollment period. They have the option to choose from a few plan options and coverage levels. To mitigate risk across a larger group and prevent adverse selection, most insurers require a minimum 70% participation. 
3. Premium payments: The premiums are typically split between the employer and employees. Employers pay directly to the insurance company and deduct the employee’s contribution through payroll. 
4. Access to dependents: Employees can add family members and current and future dependents to the group health insurance plan at an additional cost
5. Employee usage: Employees can thereafter claim on the benefits as needed. Pharmacies, dentists, as well as health and vision practitioners directly bill the insurance company for covered expenses
6. Annual renewal: Employers work with the insurance company for annual renewal and repricing of the insurance contracts
7. Administration: The administration of group health insurance plans can vary. Some employers choose to manage the plans themselves, while others may contract with insurance companies or third-party administrators to handle claims processing, customer service, and other administrative tasks.

Group health insurance is cheaper than individual policies. This is simply because of the higher number of participants in the group health insurance plan, making it one of the most affordable health care policies available in Canada. One of the key implications of group health insurance is that healthier individuals effectively subsidize the costs of those who require more medical care.

Check out a variety of group health insurance types available for Canadians

Employee enrollment process for group health insurance

To ensure a smooth administration of group health coverage, employers should follow the steps mentioned below:

• Inform the employees about the available health plans, coverage options, and enrollment period
• Employees should select their plan and if they want to add dependents, if applicable
• Employees will have to fill out a form with the designated coverage options as well as their personal information
• Employees will submit the forms to the employer or HR department within the pre-discussed timeframe
• Once the enrollment procedure and verification are complete, employees will receive confirmation and health insurance cards

Employee eligibility criteria for group health insurance in Canada

• Employment status: Employees must be actively employed, either full-time or part-time, by the organization offering the group plan. Depending on the plan’s requirements, temporary, contractual, or seasonal workers may also be eligible
• Minimum hours worked: Employees typically need to work a minimum number of hours per week, often 20-30 hours, to qualify for the group plan. Some plans may have different minimum-hour requirements
• Waiting period: New employees may need to complete a waiting period, often 3 months, before becoming eligible for coverage. The waiting period allows the employer to confirm the employee’s employment status
• Residency requirements: Employees must be Canadian citizens or permanent residents to be eligible for the group plan. Some plans may also accept employees with valid work permits
• Age limits: Group plans typically cover employees up to the age of 65 or 70. Dependent coverage may be available for spouses and children up to a certain age, often 19-25 years old
• Pre-existing conditions: Group plans cannot exclude or limit coverage for pre-existing medical conditions. Employees are covered for pre-existing conditions from the start of the plan
• Minimum group size: Employers must have a minimum number of eligible employees, often 3-10, to qualify for a group health insurance plan

How is group health insurance different from individual plans?

While group health insurance is purchased by an employer and covers the employees of an organization, an individual health insurance plan, as the name suggests, is purchased independently by an individual for their own needs. Individual health insurance plans, also known as personal health insurance or private medical insurance, vary based on the individual’s age, medical history, and lifestyle (whether they’re smokers etc.). 

Benefits of group plans for employers

Offering group health benefits is an effective way to promote employee well-being and morale. It also:

✅ Helps organizations attract and retain talent 

✅ Can be written off as a business expense, hence saving tax for the organization

✅ Encourages employees to seek preventative care, promoting a more healthier and productive workforce

✅ Depending on the location of the organization, offering health insurance coverage to employees may be required by law. Providing group health insurance ensures compliance with applicable regulations

Group health benefits for employees

With a group health insurance plan in Canada, employees also get:

✅Access to a wider range of medical services like dental care, vision care, prescription medication, emergency travel, life insurance, etc.that are not covered under provincial plans

✅ Lower premiums as compared to other individual plans

✅ The option to add family members and current and future dependents to their policy

✅Coverage for pre-existing medical conditions

✅Incentives for preventive care and wellness programs, motivating employees to adopt healthier lifestyles 

What do employee benefits cover?

Group health policies and employee benefits, although distinct, are often used interchangeably. A group health insurance plan is part of an employee benefits package, offered by employers to their employees. While group health insurance is a significant component of employee benefits, it is not the only one. Other common employee benefits may include life insurance, disability insurance, paid time off (such as vacation days and sick leave), wellness programs, and more.

Depending on the plan an employer chooses, group employee benefits typically include a variety of health and other non-medical benefits.

How can I enroll in group health benefits?

Once hired, you need to enroll in the group health insurance plan within a deadline. If this deadline is missed, you might have to wait until the annual enrollment window is open. Typically, a new employee who joins after the enrollment period is over has to wait for a period of 30-90 days before they can get group health benefits. This period is designed to ensure a degree of commitment from the employee to the employer before benefit enrollment.

Some group health insurance plans offer supplemental benefits like dental and vision care. During the enrollment process, you can choose any additional benefits you might want and add your family members and/or dependents.

Who pays for group health insurance?

Different organizations have different rules when it comes to paying group health insurance premiums. Generally, there are three ways in which the premiums for group health insurance are paid. These are: 

1. Employer-sponsored plans: The employer pays the entire cost of the group health benefits plan and the employee is not expected to contribute.
2. Cost sharing with employees: An employer and their employees split the premium costs at a predefined rate. Commonly used splits are50 percent each or 70 percent by the employer and 30 percent by the employee. These arrangements can differ depending on the specific plan and the agreements between the employer and their employees.
3. Employee add-on costs: If employees want to add dependents or get an advanced plan with additional benefits, they have the option to pay the extra premium

How much do group health plans cost?

The cost of a group health plan varies depending on the type of package an employer purchases with options such as basic, advanced, premium offering different levels of coverage. Each package offers different coverage and depending on who is covered, the premiums can vary. For small businesses, a benefits plan can cost about 5-15 percent of the total payroll on an annual basis. 

In the following table, we’ve included representative average premium costs for a group health insurance plan based on who is covered, the plan type, and coverage options: