Category: Disability insurance

This year alone, the Immix Group, based out of Vancouver, British Columbia, has set up employee benefit programs for businesses head-officed in multiple countries around the world. Whether you’re in Australia, Singapore, Ireland, or the United States, there are key pieces of information to know if you are setting up a Canadian entity.

Companies are driven to expand into Canada by many factors including market opportunities, economic conditions, and strategic considerations. In particular, the highly educated, diverse workforce makes Canada an attractive location for companies, often at a lower cost than expansion to comparable locations.  

To be competitive and successful in this expansion, companies must consider providing the right set of employee benefits for their Canadian employees. And this involves understanding the legal requirements and offering the right benefits. Here’s a list of key things to help you navigate the process:

The Basics: Canada has a Universal Healthcare System

Canada has universal healthcare, which is adjudicated provincially; this means coverage differs slightly depending on the province or territory of residence of your employees. All employees must be residents in order to qualify for provincial healthcare.

The reason this is important is that employer-sponsored extended health and dental programs may require provincial healthcare to be in place, as the two programs are complementary.  

For most full-time permanent employees in skilled positions, the expectation is that the employer will provide an employee benefits program with a range of coverage. However, providing an employee benefits plan is not mandatory (please note the province of Quebec has special requirements) and coverage levels differ significantly from employer to employer. Many employers do not provide any extended benefits at all.

While not mandatory, a comprehensive benefits program is integral in attracting and retaining talent, and in protecting and promoting the well-being of employees.

What coverage does a typical Canada employee benefits plan include?

Within Canada, when one refers to their employee benefits plan, they are usually referring to the insurance package their employer sponsors, which is typically facilitated through a major insurance provider (Manulife, Sun Life, Canada Life, Blue Cross, RBC Insurance etc).  

We will indicate the most basic components of an employee benefits program, followed by additional benefit offerings that comprise a more comprehensive offering.

The following are the core components of a group benefits plan:

Life Insurance

Life insurance amounts are usually either a small flat amount of coverage such as $25,000 or a salary-based benefit such as 1 x earnings, to a maximum. Higher amounts of coverage are usually extended to those in larger companies, or for more highly skilled professional firms employing those in more “white collar” occupations.

Accidental Death & Dismemberment (AD&D) is usually included alongside the Life insurance benefit, for the same amount of coverage.

For small groups, Life Insurance and AD&D are usually a very inexpensive component of the program, often running just a few dollars per employee, per month. The cost varies depending on the demographics of the group, and the overall volume insured.

Extended Health Care

As mentioned previously, Canada has universal health care. Extended Health Care is exactly that – an extension of the basic components provided through the provincial programs. Provincial healthcare is complex and differs across the country. The most simple way to understand what an employee benefits plan provides is to focus on the core components of a typical extended health care package:  

• Prescription drugs
• Paramedical practitioners (massage, physiotherapy, chiropractor, naturopath, therapists etc).
• Vision Care (eye exams, contact lenses, glasses)
• Medical Equipment (orthotics, knee braces, crutches, wheelchair)
• Emergency Medical Travel Insurance

The categories listed above fall outside the scope of what is covered through our provincial health care, which provides coverage for doctor visits (including specialists), hospital care, surgeries, diagnostics etc. There are exceptions to all of the above, for example, for low-income households, children, or certain medications such as those dispensed in hospitals.

In short, while we have a robust universal healthcare system in Canada, many day-to-day routine medical expenses are not covered for average working people, and thus, an employer-sponsored group benefits program fills this gap.  

A typical extended health care program will provide coverage for the areas listed above; where a plan becomes more competitive than another is based on the percentage of reimbursement and dollar limits included for various items. It is important to use a qualified advisor who knows the market in order to ensure you are providing a competitive program for your industry, size and location.

Dental Care

For most people, dental coverage comes via their employer program. It is not part of Canada’s universal healthcare system, although programs exist to provide dental coverage to low-income individuals (including the new Canadian Dental Care Plan).

A typical dental plan provides at minimum “basic” coverage which includes cleanings and routine maintenance procedures. The second level of coverage is for “major” dental, followed by a third level, for orthodontics.

It would be common to see a small employer provide only basic coverage, whereas a larger company, or those with highly skilled professionals on the higher end of the income spectrum, tend to provide better dental coverage.

In addition to the core components listed above, many programs provide:

• Long Term Disability insurance
• Short Term Disability insurance
• Critical Illness insurance
• Health & Wellness Spending Accounts
• Retirement Savings Plans

Long-Term Disability Insurance

Group Long Term Disability insurance provides salary continuance for those who are unable to work due to injury or illness and are therefore deemed “disabled” per the terms of their contract. Typically, Long Term Disability begins after 120-180 days of disability.

During these initial months, a person would be either on Short Term Disability coverage or would claim EI Sickness benefits through Service Canada (the federal government). This is a program that people pay into, as part of payroll taxes.

Many smaller employers do not provide group long-term disability insurance; they may not qualify to obtain this coverage, or they may choose to exclude it due to reasons such as cost.

Short-Term Disability Insurance

While most employers rely on Employment Insurance Sickness Benefits rather than insuring Short Term Disability, insuring this benefit does make sense in certain industries and for specific demographic profiles. Federal EI Sickness Benefits are 55% of weekly earnings to $668 per week (taxable, 2024 amount) so an obvious reason to insure this benefit is for greater coverage amounts that provide for greater income replacement levels. There are other advantages as well, which a qualified advisor can assist you in understanding.

Critical Illness Insurance

Critical Illness insurance provides a lump sum payment based on the diagnosis of one of the covered illnesses (cancer, heart attack, stroke, MS, for example). This is different than Long Term Disability insurance in that it provides a lump sum payment, rather than an ongoing income stream, and you can claim while still actively at work. Comprehensive programs often include this coverage in amounts ranging from ~$10K to $50K per employee.  

Health & Wellness Spending Accounts

An extremely popular offering, Health & Wellness Spending Accounts provides a lump sum dollar amount to be used at the employee’s discretion, for health and/ or wellness expenses.

In Canada, Health Spending Accounts usually refer to non-taxable medical expenses that the Canada Revenue Agency lists as “eligible.” In contrast, Wellness or Lifestyle Spending Accounts cover other items related to fitness and lifestyle and are a taxable benefit to employees. The amounts extended to employees vary significantly between employers, but it is important to remember that a Health Spending Account is intended to supplement insurance, rather than replace it.