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Qualification for Group Benefits (Small Business)

Who is eligible?

• Businesses with 2 to 50 employees. (some companies will request medical evidence of insurability for groups with 2-3 lives, consult us)

• Employees that are actively working for the policyholder or any associated company on a full time basis at the employee’s usual place of work in Canada. 

Employees may waive Extended Health Care and/or Dental care benefits under certain circumstances. Valid reasons to waive Health and/or Dental benefits include:

  • spousal coverage exists
  • coverage exists through social assistance
  • coverage exists through another and/or previous employer (i.e., severance package, retirement package)
  • armed forces, reserve forces coverage
  • Indian status
  • Alberta Blue Cross Group 66 coverage
  • union coverage
  • a student has benefit coverage through university/college
  • decrease in spousal coverage
  • dental only: spouse works for dental office and obtains free dental services
  • Health only: if spouse is over age 65 and has coverage through RAMQ

Type of benefit plans

Plans could include the following benefits: health care ( drugs, paramedical practitioners, hospital, out of country travel, vision care, medical services and supplies, private duty nursing), dental care, life, accidental death and dismemberment, dependent life, short term disability, long term disability and critical illness.

A combination of benefits can be used, depending on your needs.

Group benefit plans can have annual deductibles, out-of-pocket amounts, different maximums and separate types of coverage based on employee classification.

What we can do for you

Many small business owners are too busy growing their business to spend time looking after their personal wealth. Others put all their eggs in one basket, relying too heavily on the equity they have built in their business as their ticket to a comfortable retirement.

Along with greater independence and the increased earnings potential that self-employment can provide comes financial risk. If their enterprise fails or they succumb to a disability, many small business owners are on their own.

Small business owners face a unique set of challenges where the lines are often blurred between business requirements and personal financial goals. Taking a holistic approach ensures that both business and personal plans complement each other.

To bring their best to work, employees need to be physically, mentally and financially healthy. Through our ongoing research, our goal is to help employers of all sizes come to a deeper understanding of the connection between employee health, wealth and their company’s success.

This is where a financial advisor comes in, adding the much needed support and advice for all of the above, including group benefits coverage for your business.

We will review your needs and expectations, and request quotations from insurers. We will review the plans with you and make the necessary changes, based on your needs and budget.

We will handle implementing the plan with the chosen insurer and guide you through the administration of the plan, the renewal process and everything else related to a smooth experience.

Worth knowing

The Ontario government is making changes to OHIP+ under the Ontario Drug Benefit Program

What’s changing

Starting April 1, 2019, OHIP+ will no longer cover individuals 24 years old and under with drug coverage through a private insurance plan, such as a company group benefits plan.

You can see the official announcement from the Ontario government here as well as their FAQs for Patients.

  • Manitoba to reduce retail sales tax on insurance

In its 2019 budget, the Manitoba Government announced it’s reducing the retail sales tax (RST) rate from 8% to 7% on July 1, 2019. Read: Manitoba Government Information Notice

The Manitoba RST applies to the following group benefits products:

  • Accidental death and dismemberment (AD&D)
  • Critical illness
  • Disability – short and long term
  • Life

The RST does not apply to extended health care, dental benefits and Administration services only (ASO) arrangements

Healthcare Online: An innovative way to look at healthcare

Studies show that 68% of Canadians skipped a scheduled doctor’s appointment or even avoided seeing one when they were sick1. This is either because of long waiting times or because they just couldn’t book an appointment at a time that worked for them. Not only does this delay their treatment, but it can also impact absenteeism, presenteeism and disability in organizations, leading to loss of productivity and lower engagement levels2.

So how can we help? By launching Healthcare Online! 7 out of 103 Canadians say they would take advantage of virtual physician visits if they had the chance. Healthcare Online is a suite of services that will give them that advantage. Employees will have online access to healthcare professionals through web and mobile applications so that they get the care they need when they need it – at home, at work or on the go.

Primary care is the first service available under Healthcare Online. With this service, employees will get 24/7 online access to doctors and nurses that can diagnose and treat their health concerns. These professionals will give advice, prescribe and renew existing prescriptions, receive labs and imaging requisitions, and even refer to specialists and allied health professionals.

Our Healthcare Online

Healthcare Online is a game changer for the healthcare industry, but how will our service stand out from the rest of the Canadian market?

In three simple ways: Flexibility, Quality and Patient Care Experience

  • Flexibility: plan sponsors can offer these services as part of their benefits package or simply give employees access to preferred pricing.
  • Quality: Healthcare Online is a curated service –we only retain the best-in class vendor for each service.
  • Patient Care Experience: moving forward, we’ll be able to refer patients to other healthcare services and/or products like Manulife Vitality, Employee Assistance Program, or Health Risk Assessment. This will help them in their overall wellness journey.

What’s the real value to organizations?

A BC study4 conducted in 2015 showed that among patients who had an online physician visit:

  • 87% avoided work absence
  • 57% avoided an in-person visit with a doctor or their regular place of care
  • 98% saved travel time

Healthcare Online combines timely care, convenience and better overall health for employees. They’ll be able to bring their best to work so they can help their organization thrive.

[1] IPSOS (2017), Seven in Ten Canadians (68%) Have Skipped Seeing a Doctor    https://www.ipsos.com/en-ca/news-polls/seven-ten-canadians-skipped-seeing-doctor-due-long-wait-times

[2] Manulife Financial Wellness Study – 2016 Index  https://www.manulife.ca/content/dam/consumer-portal/documents/en/other/CS5156.pdf

[3] Ipsos, Inspiring a future of better health (2018), https://www.ipsos.com/en-ca/news-polls/future-of-health

[4] Virtual Visits in British Columbia: 2015 Patients Survey and Physician Interview Study https://www.infoway-inforoute.ca/en/component/edocman/3105-virtual-visits-in-british-columbia-2015-patient-survey-and-physician-interview-study/view-document?Itemid=0