Employee Benefits Available in Group Insurance Programmes


   Life Insurance

Insurance Amount for each employee either as :

1) a flat amount per individual (eg., $10,000, $25,000) or as

2) a multiple of annual salary (eg., 1 times annual salary, 2 times annual salary).

Life Insurance for Dependents is also available; some companies require that this benefit be mandatory.

   Accidental Death & Dismemberment

The benefit amount payable in the event of Accidental Death is equal to the benefit amount payable under the Life Insurance.

The benefit amount payable in the event of Accidental Dismemberment is in accordance with a schedule based on the type of dismemberment and is calculated as a percentage of the Accidental Death benefit amount.

   Extended Health Care


Insurance benefits supplement and do not replace benefits payable under OHIP.

A Partial Listing of the Covered Benefits:

  • Prescription Drugs
  • Semi-Private or Private
  • Hospital Room
  • Ambulance Service
  • Private Nursing Services
  • Convalescent Care
  • Accidental Dental Hearing Aids
  • Orthotics
  • Out-of-Country Medical
  • Vision Care

Paramedical/Practitioners

  • Chiropractor
  • Osteopath
  • Psychologist
  • Podiatrist
  • Naturopath
  • Massage Therapy
  • Speech Therapist
  • Physiotherapist
  • Acupuncturist

Claims Reimburement


The reimbursement amount for claims may vary from 50% to 100%.
Amounts are at the employer's option.

Reimbursement for Hospital and Vision Care claims are usually set at 100% .

   Dental Care

Basic Services

  • Diagnostics
  • Anaesthesiology
  • Extractions
  • Fillings
  • Basic Oral Surgery
  • Preventative Work
  • Drugs
  • Cleaning
  • Endodontics
  • Periodontics
  • Denture Repair &
  • Re-lining
  • Root Canal Therapy

Major Services

  • Crowns
  • Bridges
  • Inlays
  • Extensive Oral Surgery
  • Orthodontics
  • Fixed Appliances
  • Removable Appliances
  • Orthodontic Services

Reimbursement Amounts are at the employer's option.

The reimbursement amount for claims on Basic Services may vary from 50% to 100%.

A 50% reimbursement level is available for claims for Major Services (80% sometimes available) and for Orthodontics.


    Weekly Indemnity


This benefit provides income replacement in the event of total disability due to accident or sickness. The amount of the weekly benefit is equal to 67% of the employee's weekly salary. The benefit period is at the employer's option. Also at the employer's option:

  1. commencement date for benefit payment (eg., 1st day accident/8th day sickness, 15th day accident/15 day sickness);
     
  2. whether or not the benefit is taxable in the hands of the employee; and
     
  3. whether or not the benefit will insure disability due to non-occupational causes.

   Long Term Disability


This benefit provides income replacement in the event of total disability due to accident or sickness. The amount of the weekly benefit is equal to 67% of the employee's weekly salary. Features that are at the employer's option:

  1. commencement date for benefit payment (eg.,after 4 months, the cessation of any weekly indemnity benefit period);
     
  2. whether or not the benefit is taxable in the hands of the employee;
     
  3. whether or not the benefit will insure disability due to non-occupational causes; and
     
  4. term of the benefit period (eg., 2 years, 5 years, age 65).