Critical Illness Coverage in Group Benefits Programs

A group benefits plan is an employer-sponsored program offering insurance and health-related benefits to employees, often including health, dental, vision, life insurance, disability coverage, and more.

Eligibility varies by employer, but typically full-time employees are eligible. Some plans may also include coverage for part-time employees or dependents, such as spouses and children.

Common coverage includes:
• Extended health care (e.g., prescription drugs, paramedical services)
• Dental care
• Vision care
• Life and AD&D insurance
• Disability insurance (short-term and long-term)
• Critical illness coverage
• Employee assistance programs (EAPs)

Group benefits can be fully employer-paid, employee-paid, or a shared-cost arrangement between the employer and employees.

Some benefits, such as employer-paid life insurance premiums, are considered taxable income to employees in Canada. However, health and dental benefits are generally non-taxable.

Some plans, largely depending on the size of the group offer flexibility through “flex benefits,” allowing employees to choose coverage that best suits their needs. Standard plans typically offer less customization.

Coverage under the group benefits plan usually ends upon termination or resignation. Some plans may offer the option to convert coverage (e.g., life insurance) to an individual plan within a specific time frame.

Generally, group benefits do not exclude coverage for pre-existing conditions, although waiting periods or exclusions may apply for certain optional benefits.

Costs vary depending on the type and level of coverage, the number of employees, and the insurance provider. Employers often pay a percentage of the total premium.

Group benefits help attract and retain talent, boost employee morale, and support the health and well-being of the workforce, leading to improved productivity and loyalty.