Products & Services

Life Insurance

Benefits Schedule – Most Group Life Programs are either flat amounts of coverage (e.g. Flat $25,00), or an amount outlined as a percentage of earnings (e.g. 100% of the employee's annualized earnings).

Non-Evidence Maximum – Based on the size of the account and the insurance company you are dealing with, the Group Insurance account is able to obtain amounts of Life Insurance coverage non-medically, i.e. without any medical evidence required.

Waiver of Premium - If you become disabled prior to age 65 and your disability lasts for a continuous period of 6 months, your Life Insurance can be continued without any payment of premium as long as you remain totally disabled. This coverage would terminate at age 65.

Conversion Privilege - Should an employee's coverage terminate prior to age 65, they are allowed to convert their Group Life Insurance to a program of individual insurance without having to provide medical evidence. In order to do so, application for this insurance must be made within 30 days of the plan member's termination date.

Benefit Reduction - With most Group Insurance programs, the Group Life Insurance reduces by 50% at age 65 and terminates at age 70. This coverage, however, can be changed if needed. Whatever changes a carrier can make are often a function of the size of the account, and the total volume of in force coverage.

Dependent Life Insurance

This is insurance coverage that would be on an employee's spouse and dependent children. This coverage is simply designed to cover last expenses should an employee lose a dependent.

Benefit Amount – The most common schedule in today's Group Insurance environment is $10,000 on the spouse and $5,000 on each dependent child. Coverages can vary, though, and can be either higher or lower than the previously mentioned schedule.

Optional Life Insurance

This type of insurance would be elected by an employee. Generally speaking, this insurance is sold in units of coverage, e.g. a flat $10,000 or flat $25,000 of coverage. As well, sometimes this type of insurance will be sold as a percentage of earnings, e.g. 100% of the employee's annual earnings.

These coverages are subject to medical evidence, and the premiums for these coverages would be paid for by the employee. Typically, Optional Life Insurance coverage will cease at age 65, or the employee's termination of employment.

Accidental Death & Dismemberment

Coverage - Most AD&D plans have a schedule of coverage which will match the Group Life Insurance schedule.

Benefit Amount – The AD&D schedule of coverage generally matches the Group Life Insurance schedule. With respect to reduction and termination of coverage, the AD&D benefit generally matches the Life Insurance contract.

Short Term Disability (STD) / Weekly Indemnity (WI)

These programs will cover employees in the event of both an accident or a sickness. Typically, these programs are put in place as they provide superior benefits to the disability benefits provided for employees through Employment Insurance.

Employment Insurance Registration

As long as the Short Term Disability program is as good as or better than the benefit offered through EI, then this qualifies your plan for registration with EI.

Once registered, the amount of premium that the employer has to pay to EI will drop from 1.4 times employee contributions to 1.169 times employee contributions (for 2011).

The main features for a Short Term Disability Plan design include the following:

Elimination Period - Typically, most STD programs have a payment schedule which would start paying on the first day due to an accident, hospitalization, or out-patient surgery and on the eighth day due to a sickness.

Benefit Schedule – Schedules can vary; however, the most common schedule is 66.67% of weekly earnings.

Benefit Maximum – The maximums can vary, however, in order to qualify for EI registration, plans need to have a minimum amount of coverage equal to the EI maximum benefit.

Benefit Payout - Likely the most common payout for a STD program is 17 weeks. STD plans can pay out for as long as two years, and the shortest payout would be 15 weeks. A 15 week plan would help ensure that the plan would gain its EI registration.

Taxability - If the employee pays 100% of the STD premiums, and goes off on claim, the benefit will flow to the employee tax free. However, should the employer pay any part of the STD premium, then the employee would get taxed on this benefit if received.

Long Term Disability

Long Term Disability is the one benefit where typically, employees will have no personal coverage for disability income protection in the event of an accident or sickness.

For the short term, even if an employee has no coverages, they do have coverage through Employment Insurance. However, on the long term, the only coverage available is through Canada Pension Plan (CPP).

CPP's disability benefit only pays out about one half of the EI benefit. However, the biggest issue with CPP is the Definition of Disability used to determine total disability. The two key words which CPP uses are "severe" and "prolonged". Hence, it is not uncommon for people to be approved for Group LTD; however, be declined for disability coverage through CPP.

The main features of an LTD program include:

Elimination Period – In most cases, plans are set up so that the LTD benefit will start right after EI runs out, or after the Short Term Disability benefits cease. With this in mind, the most common elimination period before an LTD program kicks in is 17 weeks (120 days).

Benefit Schedule – For LTD programs, there is a greater variance in schedules, most of which is a function of whether the plan is established on a taxable or non-taxable basis. The very same tax implications apply to an LTD program as those that apply for a Short Term Disability program.

A common schedule for an LTD program on a taxable basis would be anywhere from 66.67% of monthly earnings to as high as 75% of monthly earnings.

On a non-taxable plan, most schedules generally grade down as income levels go up e.g. 66.67% of the first $2,500 of monthly earnings, plus 50% on the balance of monthly earnings. By grading the schedule down as income levels go up, this ensures that employees are not paying for a benefit they could never receive.

Benefit Maximums – There are two types of maximums which apply for LTD programs:

Non-evidence Maximum
Overall Maximum

The Non-Evidence Maximum is the amount of insurance coverage which the insurance company will give to an employee no medical questions asked. The Non-Evidence Maximum will vary depending on the size of the group and the volume of the coverage in force. As well, NEM's do vary between insurance companies.

The overall maximum is normally set to be high enough so that all employees can obtain full coverage based on their income level. Again, the size of the account often affects what the overall maximum can be for that particular group.

Benefit Period – Most LTD contracts have a payout which will cover an employee up to age 65, as long as the employee is considered totally disabled. There can be shorter benefit periods (e.g. two years or five years), however, these types of plans are not that common and are often associated with union accounts.

Extended Health Care

For most clients, the Extended Health Care premium normally makes up the largest component of their plan from an expense perspective. For the most part, an EHC program will cover the majority of services not covered by Provincial Medicare programs.

Most EHC programs are subdivided into a number of categories including:

Private / Semi Private Hospital Room coverage
Prescription Drug coverage
Medical supplies and equipment
Paramedical services
Out-of-Province Emergency Medical Protection

Plan designs can vary significantly with respect to deductibles and/or co-insurance (e.g. 80% versus 100% coverage).

It is our job to ensure that your EHC program is working the way you want it to work, and is providing the coverages you need for your employees.

Dental Care

Insured Dental programs are generally grouped into three major categories:

Basic & Preventive
Major Restorative
Orthodontics

Similar to your EHC program, it is our job to ensure that your Dental Care program is fulfilling your needs, and providing the amount and levels of coverage which you deem appropriate for your staff.

Cost Plus

Cost Plus is a tax effective manner of pushing additional Health and/or Dental Claims through your Group Insurance plan for items which are not covered under your basic contract. In order to qualify, the item must be considered an eligible medical expense by Canada Revenue Agency.

In order to run claims through on a Cost Plus basis, the insurance company will typically charge an administration fee. As well, all Government taxes must be paid in order for this type of claim to be processed. As a rule to thumb, for anything to go through on a Cost Plus arrangement, expenses are generally the cost of the claim plus about 20% for the administration fees and taxes.

Most commonly, the Cost Plus benefit is used at an Owner / Executive / Management level. However, we always strongly urge our clients to set this benefit up for all employees. At the end of the day, it is the Owner / Executive / Management Group who decides who will have access to this benefit and to what level.

Employee Assistance Programs (EAP)

An Employee Assistance Program is typically offered in conjunction with an Employee Benefits program.

EAPs are intended to help employees deal with their own personal problems that might arise, and subsequently impact their work performance. These programs include a confidential phone number that an employee can call.

EAP programs generally include phone-in assessments, short-term counselling and referral services for employees and their families. In today's fast-paced world, an EAP can often be the difference re: an employee's ability to stay on the job versus going on disability claim.

Group Critical Illness

Group Critical Illness insurance is intended to provide insurance for employees who become sick with a Critical Illness, e.g. Cancer, Stroke, etc.

A Critical Illness program provides a one time lump sum payment if an employee is diagnosed with one of the critical illnesses outlined in the contract.

This coverage differs from disability coverage as it is a one time payout, and the amount of coverage is generally a flat amount, e.g. flat $10,000.