Group Benefits

• Extended Health Care (EHC) supplements provincial health coverage by paying for:
• Prescription drugs
• Dental care
• Vision care
• Paramedical services (chiropractic, physiotherapy, massage)
• Out-of-country emergency medical
• Semi-private or private hospital rooms

Drug formulary — the list of covered drugs. Plans may require generic substitution.

Co-insurance — the percentage split between plan and member (e.g. 80/20 means plan pays 80%, member pays 20%).

Deductible — amount the member pays first before co-insurance applies.

Stop-loss — once the member's out-of-pocket costs reach the stop-loss maximum, the plan pays 100% for the rest of the year.

Coordination of Benefits (COB) — when a member has two group plans, the primary plan pays first; the secondary plan may cover the remainder up to 100% of eligible expenses.

Group Life Insurance premiums paid by employer — not a taxable benefit to the employee. Death benefit received tax-free.

• Group Disability (LTD) premiums:
• Employer-paid premiums → LTD benefits are taxable to the employee
• Employee-paid premiums (after-tax) → LTD benefits are tax-free
• This distinction is critical for planning — many employees don't realize their LTD benefit will be taxed

Group health/dental premiums paid by employer — generally not a taxable benefit to the employee (except in Quebec, which has different rules).

Health Spending Account (HSA) — employer-funded account allowing tax-free reimbursement of eligible health and dental expenses. Also called a Private Health Services Plan (PHSP).