Group Insurance and Benefit Plans

Group insurance for employees, or “group benefits”, refers to a form of group health insurance plan that covers all eligible members of a pre-defined group, such as all employees in an organization. Employees receive a flexible benefits plan that usually includes medical coverage for employees or their dependents, either directly or through insurance, reimbursement, or other methods provided by a group health insurance company.

How Group Insurance and Benefit Plans Work

Group health insurance plans are policies purchased by companies or organizations and then offered to their members or employees. Individuals cannot purchase coverage through these plans as they are only available for groups, and at least 70% participation in the plan is required for it to be valid. Due to the vast differences in insurers, plan types, costs, and terms and conditions, each plan is unique.

After the organization selects a plan, group members have the option to accept or decline coverage. In some cases, plans may come in tiers, with basic coverage or advanced insurance with add-ons as options for insured parties. The plan premiums are divided between the organization and its members based on the plan, and the coverage may extend to the immediate family and/or other dependents of group members for an additional fee.

Advantages of Group vs. Individual Coverage

While individual coverage allows for more control over the type and amount of coverage, group coverage is chosen by the employer and may offer a larger selection of benefits from a variety of insurers.

Portability is another factor to consider; group coverage is only valid while employed with the company, while individual coverage is portable and can be carried over to new employers. With group coverage, medical evidence is usually not required, which can be beneficial for those with pre-existing medical conditions.

Group coverage is also usually less expensive than individual coverage, with the cost being spread amongst the group. However, sometimes employees are responsible for a portion of the cost. Overall, while individual coverage provides more control and portability, group coverage offers a greater selection of benefits and is often more cost-effective.

How Group Insurance Plans Have Changed in Ontario, Canada

With a group benefits plan from The Benefits Edge Insurance, the top insurance company in Ontario, premiums are typically lower while providing coverage equivalent to individual health insurance. We can provide reassurance that there are now more options available than ever before for coordinating a plan that fits your budget before providing insurance for your employees.

Designing a plan strategy has become essential to ensure cost sustainability when working with Canada’s top insurance companies. Many expenses within employees insurance increase at a faster rate than the Consumer Price Index (CPI), and business owners need advice to make sure they are choosing appropriate plan options and budgets for their company.

Common concerns with employee benefit insurance include how to set a Prescription Drug maximum and cover Wellness Items under a Health Spending Account, but these answers are usually determined on a case-by-case basis. Thankfully, group health insurance plans have evolved in recent years, with the best insurance providers in Ontario and other great group health insurance brokers now offering options such as:

  • Cancer Assistance Plans and Online Health Assessment Tools
  • Group Critical Illness Insurance
  • Health Spending Accounts
  • Mental Health Care Consultative Services
  • Second Opinion Services for Serious Illness Diagnosis
  • Tele-Health, Employee Assistance Plans
  • Web-Based Wellness Resources

Web-based administration applications have made it possible for real-time enrolment of new employees, terminations, and changes to employee information. Some insurers offer smartphone applications for submitting claims, and a debit-type card for expenses is available with other insurers. Employees can view their claims history online with certain insurers, print benefit information, claim forms, member cards, and access health awareness resources through an employee web portal.

Trust In The Benefits Edge Insurance for Reliable and Comprehensive Insurance Plans in London, Ontario

Is your benefit plan still relevant to your current needs? Whether you need help with your health savings account If you’ve had the same plan for an extended period and the goals and design considerations are no longer apparent, it may be time to conduct a review with The Benefits Edge Insurance, provider of top-quality group health insurance in Ontario. Give us a call for a plan assessment and cost/benefit analysis, and we’ll make sure you get the best health insurance in Ontario!

Group Insurance
and Benefit Plans

In a recent survey, employers ranked the top items that are most important when making decisions regarding a benefit plan. The top 4 in order are:

  1. Overall price of the plan
  2. Level of protection for the employees
  3. Cost/Benefit Analysis of Various plan options
  4. Flexibility of the plan
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Group benefit plans have evolved over the years to provide benefits to smaller employers and benefits are available even for just 2 employees. If your company is small and cost is an issue, be assured there are more options than ever before to co-ordinate a plan to meet your budget.

Plan design strategy has become very important to provide sustainable cost for benefit plans. Many costs within the benefit plan can rise at a faster rate than CPI and business owners need advice to ensure they are choosing plan options and a budget appropriate for their company.    Some topical questions for the current environment are: Will we cover medical cannabis under the Benefit Plan?  Should we have a Prescription Drug maximum on our plan?  Do we extend benefits past age 65/70 until retirement?  Should we cover Wellness Items under our Health Spending Account and which ones?  Do we have a combined maximum for Paramedical Practitioners under the plan?  Should we allow Adult Orthodontia?  The answers to these questions requires some discussion and may be made on a case by case basis.

Plans have changed in recent year to now include Group Critical Illness, Tele-Health, Employee Assistance Plans, Web-based Wellness Resources, Health spending Accounts, Mental Health Care consultative services, Second Opinion Services for serious illness diagnosis, Cancer assistance plans and Online Health Assessment Tools to name a few.

Administration through web-admin applications has facilitated real-time enrolment of new employees, terminations and employee information changes. Smart phone applications for submitting claims are a new feature with some insurers and you can use a debit type card for expenses with another insurer.

Employees can view their claims history on line with some insurers, print benefit information, claim forms, member cards and access health awareness resources through an employee web portal.

The benefits industry has evolved to make benefits more flexible, administration easy and quick and employee access simple and robust with information and assistance. Has your plan evolved along with it? Do you have a plan designed for yesterday or today? If you have a benefit plan that has been in place for a long time and the objectives and design reasons aren’t clear anymore, perhaps its time for a review. Give us a call for a plan assessment and cost/benefit analysis.

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