OPTIONAL GROUP LIFE INSURANCE
Employees can supplement the life insurance coverage provided by their group benefit plan by applying for optional life coverage. Optional life can be available to only/both employee and their spouse. Medical evidence is required and coverage typically ceases at age 65 or earlier of the employee's retirement. Premiums are paid for by the employee.
Rates are usually based on age bands (e.g. 40-44, 45-49, etc.), gender, and smoking status.
OPTIONAL GROUP ACCIDENTAL DEATH & DISMEMBERMENT (AD&D)
Optional AD&D coverage provides an accidental death and dismemberment benefit typically equal to the employee's optional life amount.
Most plans offer eye exams once every 24 months when the provincial plan does not cover these expenses. Vision care benefits also pay for eyeglasses, including frames and lenses, as well as contact lenses. A maximum is normally imposed on the amount as well as the frequency of benefits payable. Maximums usually range between $100-$300 every 24 months, 12 months for dependent children under 18. Additionally, Vision Care is normally not subject to a deductible or coinsurance given the low benefit maximums.
EMPLOYEE ASSISTANCE PROGRAM (EAP)
EAPs can be considered early intervention methods intended to reduce the number of disability claims. They focus on two key elements:
Organizational wellness: managing business functions and employee well being in a manner that allows the business to be more resistant to environmental pressure.
Employee wellness: managing both psychological and physical issues in response to environmental stress including the employee's work environment. The EAP will offer confidential and professional consulting service to help employees and their families address a wide range of personal and work place issues.
Critical Illness covers the gap between life and LTD insurance by providing a once in a lifetime lump sum payment to an insured employee who has been diagnosed with and survived a life threatening illness such as cancer, heart attack, and stroke, among others. The benefit can be used to pay for ongoing medical expenses, experimental treatments (not covered in provincial plans), lifestyle/mobility changes resulting from the illness, or even a vacation that would otherwise not be affordable.
GROUP PENSION PLAN
A plan, fund, or program maintained by the employer, employee organization, or both. Such a plan provides retirement income to employees or results in a deferral of income by employees for periods extending to or beyond the termination of covered employment.
HEALTH CARE SPENDING ACCOUNTS (HCSA OR HSA)
A HCSA is an individual employee account that reimburses the employee for health and certain non-health related expenses not covered by government plans or other plan (i.e. an individual health plan). A HCSA can be introduced on a stand alone basis, supplementary to an existing plan to add flexibility, or as another option within a broader flexible benefits program. Employers should introduce HCSAs for the following reasons:
- Allows the employer to offer a new type of health benefit to their employees without having to be locked into providing a benefit that may become expensive
- Provides benefits tax effectively
- Provides relief to employees if their cost sharing is increased through deductibles and/or coinsurance
- Allows employees to claim expenses that are otherwise not reimbursable through their base plan
- Allows coverage for predictable expenses like vision care to be eliminated from benefits to reduce potential for adverse selection
ADMINISTRATIVE SERVICES ONLY PROGRAM (ASO)
ASO agreements are usually utilized by employers who self insure and enter into an agreement with a third party administrators (TPAs) to administer the plan, with financial and legal liability for all the plan costs remaining with the employer. The administrative service that must be paid for by the employer includes adjudication and payment of claims.