Explore Health Benefit Plan Options Available

There are a lot of good reasons to support your employees with a health benefits plan. Many health-related products and services aren’t covered by the federal and provincial healthcare plan; without coverage your employees may not have the resources to access the care they need. The good news is, if you do want to sponsor a plan, there are lots of health benefit plan options available so that you can find the right fit for your company and your budget.

Medicare and What’s Missing

It’s true that Canada does have a universal healthcare system (Medicare) that aims to ensure all Canadians have reasonable access to health services. It’s publicly funded and covers everything that is deemed “medically necessary.” Medicare is financed by both the federal and provincial governments, who are each responsible for designing and delivering healthcare.

Because each province and territory administer their own plan, some provinces choose to charge premiums for access to Medicare, while others collect the necessary funds through other taxes.

Medicare across the country covers things like:

  • Visits to a doctor
  • Surgeries (in-hospital and out-patient)
  • Medical emergencies
  • Prescription drugs administered in the hospital
  • Immunizations

Unfortunately, there are some gaps in what Medicare covers and what your employees need. The biggest missing pieces of healthcare coverage are prescription drugs, dental and vision care, paramedical services, ambulance rides, and emergency medical while travelling.

Group Health Benefit Plans

Group health benefit plans were created to fill in the gaps left in Medicare coverage. They are offered through an employer or organization, and in most cases it’s mandatory for everyone in the group to be part of the health benefits plan. The benefits cover your employees and their families, but you (the employer) are the policy holder. There are many, many different types of health benefit plans available in the market.

1. The Basics

Extended Health

Extended health benefits are the biggest category of employee health benefits. They usually include a wide scope of coverage.

  • Prescription Drug Coverage – When not dispensed inside a hospital, your employees must pay out-of-pocket for prescription drugs when they don’t have coverage. Some provinces have developed provincial prescription drug coverage programs, but often these do require some out-of-pocket payment. Prescription drug coverage as part of an employee benefits plan can be configured to pay for all or part of the cost of prescription drugs.
  • Vision – In most cases, vision benefits cover eye examinations, corrective glasses or lenses, and sometimes laser eye surgery. As eye health can have a significant impact on overall health, these benefits are an important part of any plan.
  • Paramedical Services – These benefits cover visits to medical professionals that are not covered by Medicare. Examples of paramedical services include massage therapy, physiotherapy, clinical counselling, naturopath, and more.
  • Emergency Out-of-Country Medical – This coverage means your employees will have emergency medical coverage while travelling.


Dental benefits are a staple in most employee benefit plans. Dental benefits usually cover preventative services, basic comprehensive services, and major restorative. They sometimes include orthodontic coverage. For those without coverage, dental services are very costly and oftentimes people without coverage do not regularly visit a dentist.


Disability benefits provide some income replacement when an employee is absent due to injury or illness. These benefits help with the financial burden of not being able to earn an income.

Life insurance

Life insurance is meant to protect an employees’ family from financial hardship in the event of the employee’s death. It provides peace of mind for employees knowing that their family will have financial support during a very difficult time.

Accident and Serious Illness(ASI)

Accident and serious illness benefits are another “peace of mind” benefit for both employees and their families. These benefits provide a lump sum payment in the event that the employee incurs an accident or is diagnosed with a serious illness.

2. Customize

Moving beyond basic or traditional employee benefits means customizing what is included in your plan. The right employee benefits provider will encourage you to customize the plan to best support your employees, while being mindful of your budget. Some additional options you can choose to add or substitute in your plan include:

Health Spending Account (HSA)

A Health Spending Account is often included alongside a more traditional benefits plan. You set aside a specific amount of money to put in the health spending account and employees can spend it on eligible health and dental expenses. It gives employees choice and flexibility around where their benefit dollars are spent. It gives you cost transparency because you know exactly what it is going to cost you.

Employee and Family Assistance Program (EFAP)

Employee and family assistance programs have become so common that they can almost be included in “the basics” category above. This benefit gives employees access to 24/7 counselling and support. It is an essential way to support the mental health of employees and it comes with a host of other resources that can help reduce stress and give employees tools to deal with life’s challenges.

Virtual Healthcare

Virtual healthcare is a benefit that allows employees to connect with a physician or nurse practitioner 24/7 using technology. The physician or nurse practitioner can address many of the issues that typically require a visit to a doctor’s office, all from wherever and whenever is convenient for your employee. It really does improve access to healthcare.

Smart Rx Solutions

These products help manage prescription drug costs while also giving employees the convenience of having their prescription drugs delivered to their door. It focuses coverage on lower cost/equally effective prescription drugs and a central dispensing pharmacy that ships medication to the employee. It’s easy to use and convenient.

These are just a few examples of ways you can build an employee benefits plan that works for your organization.

Why Sponsor a Plan at all?

Now that we know there are many health benefit plan options available to you, the question looms: why should you sponsor a health benefits plan to begin with?

Sponsoring a health benefits plan is an important investment for a number of reasons. It will help your organization recruit the best employees and retain the ones you already have. This is especially important in a competitive job market.

The other big reason to sponsor a plan is that giving employees these benefits can help them achieve better health. Better health pays off in higher productivity, fewer absences, and less presenteeism. A health benefits plan isn’t just good for employees, it’s good for business.

Good advice is key

Are you ready to explore health benefit plan options to find the right one for you? Review your options with one of our licensed advisors on the phone or in-person or contact us for a comparison quote.

Whether you’re looking for extended health and dental coverage, disability coverage, or life and critical illness coverage, GroupHEALTH has affordable benefit packages that work as hard as you do.

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