This page provides information to Canadians about group health insurance
including coverage and benefits.
Group health insurance is a company insurance plan devised to share the
financial cost of healthcare among a group of employees, who contribute
to a fund. Hence, when a participating employee falls ill or needs healthcare
services, they are remunerated by the insurance company under the terms
of the contract. A group plan can take many forms; its coverage usually
depends on the number of persons participating, the goal of the group’s
sponsor, and the company’s budget. Typically, only the employer
has a business relationship with the insurance company - the insured individuals
Health Insurance Coverage
Many group health insurance plans cover dental, vision and prescription
drugs, and may also include life insurance, group disability, accidental
death and dismemberment, short-term disability, critical illness, and
Best Doctors (Medical Referral service) services. Some group plans will
extend benefits to a participant’s family members.
Many people will opt for a job with a company that offers health insurance
coverage over one that does not. Group plans provide various advantages
for employers as well as employees.
Benefits of a Group Health Insurance Plan for Employers
- A group health insurance plan offered to employees gives the company
an edge. Not only is it an attractive feature in a job offer, but it
can also be a factor in retaining employees.
- Group plans allow access to health insurance at a reduced cost.
- They are less selective and less discriminatory than individual insurance
plans, ensuring that all employees are treated under equal terms.
- Most premiums paid by an employer are tax-deductible as a business
- Group health insurance gives workers a sense of security and may help
to boost productivity and morale.
Benefits of a Group Health Insurance Plan for Employees
Although individual health plans may provide more flexibility, the rates
cannot be negotiated and there exist exclusions for pre-existing medical
conditions. On the other hand, a group health insurance plan offers many
advantages to an employee:
- The premiums are typically more affordable than individual health
- There are no exclusions for pre-existing medical conditions
- One family rate is charged - you do not have to pay a premium for
- Higher limits are permitted for drug and dental claims
- The group renewal rate is negotiable.