Group Benefits

I would like to help you understand what kind of benefits you can have at your work (Group Benefits).

They are the following:

  • Dental Cover – expenses for teeth treatment and denture
  • Medicine Expenses Cover
  • Medical expenses not covered by OHIP (massage therapist, homeopath, orthopedic shoes, etc.)
  • Life Insurance for the employee and family members
  • Disability Insurance

Usually people first of all find out about things they need the most (dental treatment and medicine cover). In course of time one may need other specialist, like: massage therapist, orthopedist, homeopath, and etc. It is seldom for people to know the exact sum of Life Insurance they have for themselves and family members; all the more they usually do not know about the cover they may have in Disability Insurance. To get a better idea of your situation try to answer the following questions:

“If I get sick will I be able to receive any compensation from my employer? If yes – how much is it going to be? What is the starting date? How long does the coverage work?”

Let us look more closely at Group Programs of Life Insurance and Disability Insurance. These are themes, which present the most difficulty for average people. It happens because of lack of time and because benefits are described at the end of the brochure and our attention starts weakening because of limited English.

Types of Life Insurance for employees

  • Basic Insurance – usually it is $25,000 for the employee, $10,000 for the spouse and $5,000 for children. If the business is rich enough, they can afford to provide the cover of 1-year salary (sometimes the wording reads “up to $500,000” and it often confuses people, because they think that they have half a million coverage), some businesses can offer 2-year salary cover, etc.
  • Optional Insurance – the employee is offered to buy Life Insurance at his own expense. Usually the cost of such insurance is quite acceptable. I would like to give you advice: do not be too much carried away by additional Life Insurance at work. It is essential to have your own Life Insurance, which will cover you independently from your work places, it will have power everywhere you go and you are the immediate owner of this Insurance. Combination of Individual and Group Insurance may be of big interest for anyone.
  • Accidental Life and Dismemberment Insurance – this kind of Life Insurance works in case of accident. Of course, it is very beneficial to have it and we are not going to refuse it. Accidental Life Insurance cannot be looked at as real protection of the family, because not any kind of accident may be included in it. For example, if a person had a car accident and had his spine broken as the result, but he is alive and is striving to recover. He has 3 surgical operations and dies 1year and 10 days after the accident. This kind of death is not looked at as the result of an accident; it is the result of illness. The benefit is not paid. If a person had a sip of alcohol and died as the result of car accident, the benefit is also not paid, because this case does not fall under the conditions of the Contract. Do we really need such kind of insurance, where there are so many “snags”? No, we do not, but if we are offered it for free or very cheap, then we may take it. Usually the sum of Accidental Life Insurance is the same as Basic Life Insurance. Dismemberment – loss of members of the body, as the result of which the person receives the sum insured (it must be stated in the contract in advance) in proportion of Accidental Life Insurance benefit.

Disability Insurance – is provided for employees in case of illness. It is the most important benefit of all. It is so important because it gives us peace of mind and we can work and know that our firm is going to pay us compensation beginning with a certain day of illness. To find out about Disability Insurance at your work, you should look it up in the Book describing benefits. If you found it, then you have it. It can happen so, that your firm offers you a choice of benefits from a list. Please, be sure, that you do not refuse to have Disability Insurance. Now you have to study the definition of this kind of Insurance.

Pay attention at the following questions:

  • What is the Elimination Period? (What is the starting day, when the company starts paying you)?
  • How long is the Benefit Period?
  • How large is the sum you are going to receive? It can be a fixed sum of money or a certain percent of your income (maybe 66.6% of a monthly income).
  • What is the definition for disability (own occupation, regular occupation, or any occupation)?

Group Disability Insurance can be of two kinds: Short Term Disability and Long Term Disability.

Short Term Disability (STD) can begin, say, on the 5th day and last till 119th day of illness (sometimes till 180th day). Maximum payments can be indicated as $600 per week. This means, that beginning with day 5 till day 14 the firm will pay $600 per week, this sum is not taxed. Starting with day 15 and till day 119 the firm will pay the sum to add to the $413 provided by the government to make it $600 per week.

Long Term Disability (LTD) begins at the moment when STD ends. It may be 120th or 180th day of illness. Sometimes employees do not have STD, and then the LTD starts on the 120th day beginning with the first day of illness.

Usually the LTD cover is determined as 66,6% of income per month. If this is your case, you must be glad, because you will not have to buy Individual Disability Insurance, because 66,6% is maximum benefit you can get, which is not taxed.

If a person falls ill, he cannot make more money than before his illness. That is why all the benefits on government Disability programs, starting with Automobile Insurance Companies (in case of car accident) and Group Benefits at work and ending with Individual Insurance, cannot be more than 66.6% of income before the illness. It means, that all the benefits will be paid in addition to each other to make up total certain sum of money. That is why there is no sense in buying Individual Disability Insurance in case you have a Group Insurance at work with good conditions.

We answered questions: “What is the starting date of Disability coverage?” Now comes the next question: “How long does the coverage work?”

To answer this question we must look closely at the wording of Disability. A person may have an Insurance, which says that the insured will be paid the benefits in case of illness or accident, which resulted in inability to perform the duties of his regular occupation. It can also be said in the contract, that the benefits will be paid if the insured one cannot perform duties of any occupation.

We often get Group Insurance at work, which says that the benefits are paid for “regular occupation” during 2 years, then the person is paid up to 65 years of age under the wording “any occupation”. This means, that if you are sick and unable to perform your duties at work, but you are still able to work somewhere else, in 2 years they will stop paying you.

It is wonderful if a person receives certain benefits at work, but a great number of people work on contract positions, are self-employed or develop their own business. Some have no benefits at work at all. It is so hard to answer the question: “How long can you afford not to work? A week, a month, two, three, six, a whole year?”

The most frequent answer I get is like this:

“What are you talking about? How can I pay the bills, the apartment, the mortgage and etc?

I MUST WORK!” What if a person is not able to work? What if he or she is seriously ill or had an accident? What if you do not have any benefits at work? Does it mean that you should not protect yourself? Do your best to protect yourself still more! Your health is above wealth. Our health gives us an opportunity to make our living.

If you do not have group benefits, you can get them. Please, look up information on Individual Benefits in section “All about Insurance” (Personal Health Insurance), you can also find there information on Disability Insurance.