Prescription drug plan is one of the most important benefit of your group plan.

There are three options of drug plans when you want to customize.

• Prescription only(Name itself, It only covers prescribed drug that is not include over the counter drugs such as
  Tylenol)
• Any Prescribed (This covers prescription include over the counter drugs as well)
• Hybrid Plans(This plan covers drugs prescribed by a physician which are able to purchase without doctor’s
  prescription such as, Injectable drugs, Serums, Vaccinesthere

There are two types of claim payments.

• Pay-direct plan
• Reimbursement plan

There is Dispensing Fees that charged by the pharmacist for services rendered in dispensing the drug to customer
and this fee is different by drug store.

• You can select Dispensing fee cover amount on your group benefit starting $0, $5, $10 up to $20.

Group dental benefit are one of the most valued benefits by employees and their family member.
This is not considered as an insurance but more likely account reserve for expected dental expenses.

Dental plan benefit are typically have following options.

• Basic :
  It covers dentist’s diagnostic services, preventative treatments such as scaling, fillings, x-rays, oral
  examinations, recall examinations, endodontic services, periodontics, tooth extractions, minor surgical
  procedures, laboratory reports, fluoride treatment and repairing of dentures crowns or bridgework
• Major restorative :
  It covers for denture, bridges, crowns, veneers and prosthodontics to replace missing teeth and major
  surgical procedures which restore the functioning of natural teeth.
• Orthodontics :
  It covers for procedures and appliances related to braces required to straighten teeth and correct other
  dental defects including wires and tooth bonding.

Dental claim are one of primary factors to increasing renewal cost of group benefits, to help control cost and cost increase, you can add some of restriction features as follow.

• Deductibles :
  This help to limit cost by cost-sharing with employee. Deductibles usually in the form of calendar
  year deductible that requires employees and their family to pay a fixed dollar cost such as $25 per single or $50 per family
• Coinsurance :
  Coinsurance is the portion of eligible for reimbursement on dental benefit plan. Unlikely set amount of
  deductible, employee need to pay set percentage of services fee, from 0% to 50%. It depends on how
  employer set it up.
• Maximum coverage limits :
  Dental calendar year maximum is $1,000, $1,500, $2,000 or $2,500 and these can be applied to each
  service or combined basis up to maximum. Orthodontic service is usually life time maximum from
  $1,000 to $3,000.

Member Group Life and AD&D insurance is mandatory component of most group benefit plans
except HSA plan. Life insurance benefit amount is typically either based on annual income(1x or
2x) or flat amount(starting $25,000).

Dependant life insurance is also mandatory features and this benefit is added to group plan for
very small cost.

Example of selectable benefit amounts are :

• $20,000 for spouse and $10,000 for dependent
• $10,000 for spouse and $5,000 for dependent
• $5,000 for spouse and $2,500 for dependent

Most group benefit include the Travel insurance for employee and their family member.
This travel insurance provide benefit to employee while traveling for either personal or
business purpose.

Coverage amount usually start with $1million to $3million with maximum days( 30 days,
60 days or 120 days )per each trip. With this benefit feature, they can opt out travel
insurance coverage on credit card or through travel agency.

Vision coverage is limited to a maximum amount payable and also has a limit on the frequency of
benefits payable. The amount of coverage is usually in the range of $100 to $300. The frequency is
generally limited to 12 or 24 months. Since these limits effectively control claims costs, vision benefits
are not normally subject to the deductible or coinsurance feature of a health plan and the full cost of
the maximum will be reimbursable.

Paramedical practitioners benefit is second most famous after Dental benefit and it contribute entire claim
portion amount from 15% to 25% within a Group Health Insurance plan. Coverage for paramedical
practitioners is covered in most health benefit plans, however which practitioners are covered, and at what
maximums vary widely from plan to plan. Paramedical practitioners include :

• Physiotherapists
• Registered massage therapists
• Acupuncturists
• Osteopaths
• Chiropractors
• Podiatrists
• Chiropodists
• Naturopaths
• Speech therapists
• Psychologists

How group health insurance benefits are reimbursed is determined by the plan design which is based on
factors such as the deductible, coinsurance and benefit maximums.

Typical reimbursements vary however the general range in most salaried plans is between $300 and $500
per practitioner per covered person annually. It is becoming more common for employers to include both a
per practitioner maximum as well as a combined overall maximum to assist in limiting utilization.

Long Term Disability insurance may be one of the most important benefits available for individuals through group benefit plan. It guarantees your source of income in the event that you are not able to work due to a disability. An extended disability typically creates a significant financial difficulty. Your inability to work, and the associated lost source of income, makes it difficult to pay expenses, both existing and added expenses related to the disability.

LTD insurance has the following characteristics:

• The LTD benefit is a percentage of earnings
• The benefit period ends at age 65
• Definitions of disability are defined by the level of employee’s ability to perform jobs
• The commencement of benefits start at the expiration of a qualifying period in which the employee is typically receiving benefits under :  short term disability (STD) plan, or Employment insurance, or A salary continuance plan.

Short-Term Disability benefits provide income, a percentage of a person’s salary, in the event that a person is unable to wor   k for a short period of time as a result of injury or sickness. Group STD benefit policies are designed with 2 different limitations: the amount of benefit and the duration of benefit period. The amount of benefit ranges between one half to two thirds of the insured person’s salary, and the policy is coordinated with the LTD benefits plan.    

The way sick days are accounted for depend from plans to plans. Some plans allow employees to accumulate sick days, use the sick days prior to retirement and “cash out” before retirement.

Critical Illness (CI) benefits are living benefits that pay out benefits in the event of critical illness. As a result, unlike LTD or life insurance, benefits are payable without having to die or be unable to work. Critical Illness benefits are becoming increasingly important as people are living longer and the financial burden of living with critical illness can be significant.

Group critical illness benefit offer piece of mind for employees, and the levels of coverage are typically : $10,000, $25,000, $50,000, $100,000.

Plan sponsors may choose to provide Medical and Dental Cost Plus Benefit Coverage (“Cost Plus”) for their plan members and family members to help with the unexpected medical expenses not covered under the group plan. “Cost Plus” provides reimbursement for these expenses that are qualified as medical or dental expenses under the Canadian Income Tax Act.

A Group RRSP is same as an individual RRSP except Master account was set by employer.

Group RRSPs facts

• A Group RRSP is one of pension plan that encourage employee to save at work by
  contributing through payroll deductions.
• Employer and employee may contribute depending on the rules of the plan.
• All contributions are tax-deductible to employee – and all investment earnings are
  tax-sheltered.
• Same as an individual RRSP, employee decide how your money is invested. The
  employer will provide a range of investment options to choose from.

* If the employee leave the company :

Group RRSP account is not locked in and can be transfer to individual RRSP or
can be cashed out after with holding tax.

Group TFSA plan can help employees save for their future need.

• Group TFSA has no mandatory requirement for employer to contribute.
• It works well over Group RRSP.

Deferred Profit Sharing Plan (DPSP) is a type of pension, and is an employer-sponsored profit sharing plan registered with the Canadian Revenue Agency. It is designed such a way that the business profits can be shared with all employees or designated group of employees, on a periodic basis.

Some of the key facts are as the following:

• Contributions are tax deductible to the employer and investment earnings are tax sheltered
• Individuals don’t pay taxes on either contributions or earnings until a withdrawal.
• Registered Retirement Savings Plan (RRSP) contribution room is reduced by DPSP contributions made the year before.
• DPSPs are often combined with pension plans or a Group RRSP to provide employees with retirement income.
• Most plans allow individuals to decide how their DPSP money is invested.
• When an individual leaves an employer, they can move their DPSP money to an RRSP or a Registered Retirement Income Fund (RRIF), use it to buy an annuity, or cash out (this would trigger a tax event in the year the money was received).