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Group Insurance Coverage
Life Insurance
Disability Insurance
Accident/Illness Insurance
Dental Insurance
Critical Illness Insurance
Life Insurance
Group plan life insurance coverage may include the
following:
-
Basic Life
Insurance:
Although each plan is unique, most offer life insurance providing for the
payment of either a fixed amount or an amount equalling a multiple of the
insured's earnings (e.g.: one or two times his or her wages).
-
Accidental
Death or Dismemberment Insurance:
This coverage provides for the payment of a lump sum over and above the
amount supplied by basic insurance in the event of accidental death, as well
as a percentage of the amount of basic life insurance in case of accidental
dismemberment.
-
Supplementary
Life Insurance:
This coverage provides for the payment of either a fixed amount or an amount
equalling a multiple of the insured's earnings (e.g.: one or two times his
or her wages) above and beyond the sum provided by basic life insurance.
-
Dependent Life
Insurance:
This coverage generally provides for the payment of a fixed amount in the
event of the death of a dependent.
Disability
Insurance
-
Disability insurance
is designed to help insureds cope with the loss of income resulting from an
inability to work due to illness or injury.
-
This type of insurance
may include the following types of coverage:
-
Short-Term
Income Insurance:
This coverage provides for the payment of a benefit equalling either a
percentage of the insured's weekly earnings or a fixed amount.
-
Long-Term
Income Insurance:
This coverage provides for the payment of a benefit equalling a percentage
of the insured's monthly earnings.
-
As a rule, individuals
may choose from a range of insurance amounts, but the disability benefit is
limited to a percentage of the insured's regular compensation (e.g.: 60%, 66
2/3% or 70%).
-
Such benefits are
usually coordinated with private and public-plan benefits (e.g.: Quebec
Pension Plan and Canada Pension Plan or workers' compensation benefits),
meaning the amount of the benefit specified in the policy is the maximum the
insured can collect.
Accident/Illness Insurance
-
Accident/illness
insurance is meant to provide coverage in the event of an illness or
accident, as well as during pregnancy.
-
Group-plan
accident/illness insurance may include the various types of coverage below.
In practice, each type may be offered as an independent option-often the
case for vision care and travel insurance, for example.
-
Hospital
Expenses:
Where the insured is hospitalized in Canada, the insurer will refund the
attendant costs (e.g.: private or semi-private room) not covered by the
public healthcare system.
-
Prescription
Drugs:
The insurer generally refunds the cost of drugs prescribed by a physician
or dental surgeon. However, the kinds of drugs covered and terms and
conditions of reimbursement may vary from one policy to another.
-
Medical and
Paramedical Expenses:
This coverage applies to services rendered by healthcare professionals as
well as services and equipment not paid for by public plans (e.g.:
physiotherapy, rehabilitation therapy, orthopedic prostheses, wheelchairs,
etc.).
-
Vision Care:
This coverage pays for costs incurred to provide the insured with
spectacles, contact lenses, and so on.
-
Travel
Insurance:
This type of insurance covers the costs incurred by Canadian residents
because of an accident or illness occurring during a trip of less than
three months outside their province of residence.
For each type of coverage
mentioned above, the policy will stipulate exactly which costs are covered,
the terms and conditions of reimbursement (e.g.: applicable limits),
deductibles, and co-insurance percentages, where applicable.
Dental
Insurance
-
Dental insurance is
intended to protect insureds who incur expenses for therapeutic and
preventive care.
-
Clauses providing for
the payment of regular dental costs such as examinations and fillings, as
well as special treatment such as crowns and prostheses, vary from plan to
plan.
-
Most plans impose a
maximum limit per calendar year per insured, for the lifetime of the
insured.
Critical
Illness Insurance
-
Critical illness
insurance provides for the payment of a lump sum during the lifetime of the
insured upon the diagnosis of one of the critical illnesses specified in the
policy.
-
Critical illnesses and
surgical treatments most often covered are heart attacks, strokes, heart
surgery, cancer, kidney failure, organ transplants, paralysis, multiple
sclerosis, blindness, deafness, coma, Parkinson's disease and Alzheimer's
disease.
The above descriptions are general in nature and are
intended for explanatory purposes only. Each type of coverage discussed here
has its own specific features. Furthermore, only the group plans pertaining to
these types of coverage contain all the relevant terms, conditions,
restrictions and exclusions.
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Group Insurance
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