Supplementary health insurance coverage is most commonly available under group insurance plans. Group plans cover all members of a specific group and their eligible dependents. If you or your spouse / partner are employed, you probably have an insurance plan sponsored by your employer or your union as part of your employee benefits program.
Alternatively, you may be able to purchase group insurance through a professional association or group such as an alumni association.
Under employer- and unionsponsored plans, the employer or union typically pays all or part of the cost of the premiums. Under an association plan, though, the members pay the full cost.
Nevertheless, the cost of such coverage is usually lower than it
would be if purchased under an individual contract, because administration costs are less for group plans.
What Is Covered?
Your group insurance plan will provide you with a certificate and/or a booklet that outline the key features of your coverage,including covered expenses, eligible dependents, deductibles and coinsurance, limits and exclusions, and claim procedures.
Your human resources officer and/or benefits administrator can help you obtain additional information.
The complete details of the plan are contained in the master contract that is issued to the plan sponsor by the insurer.
For a description of other kinds of health-related coverage your
employer may provide, such as disability, travel, critical illness and
long-term care benefits.
Who Is Covered?
To be eligible for coverage you typically must be a member of the
sponsoring association or union, orâ€“in the case of employersponsored
plansâ€“a permanent, full-time employee. Under some employer-sponsored plans, you must also have been at work for a specified period such as one month or three months. Check your plan to find out what the
enrolment requirements are, for yourself and your dependents.
Under most group plans, you are insured only as long as you remain part of the group. In general, if you leave your job, or cease to be a member of the association, your coverage ends.
However, if you are laid off or leave because of a downsizing program, your benefits may be continued for a period of a few
weeks. And in some instances, replacement coverage may be available if you apply within a specified time period, such as 90 days.Your benefits administrator or the industry Consumer Assistance Centre may be able to provide more information about replacement coverage and how to get it.