New job: 10 answers to your questions about group insurance

4 minutes
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When you start a job, all kinds of thoughts are going through your mind. To make starting a job a little easier, we’ll answer 10 common questions about group insurance. Which treatments are covered, types of plans, steps for filing a claim... In short, you won’t be left in the dark.

1. What does group insurance cover?

First of all, your employer selects the type of group insurance you’ll be getting. This could be an à la carte plan for more flexibility or a standard plan in which everyone gets the same coverage.

The employer then determines which coverages will be included in the group insurance plan for its employees.

These include the following types of insurance:

  • Health care
  • Prescription drugs
  • Care provided by healthcare professionals
  • Transportation by ambulance
  • Medical supplies
  • Dental care
  • Vision care
  • Life
  • Short and long term disability
  • Travel
  • Critical illness

Some of these are optional. You could, for example, add life insurance for your kids. It really depends on what you need!

2. How much does group insurance cost?

We’d love to give you a flat amount that will be deducted from your pay! Unfortunately, that’s not how it works.

The price for your group insurance depends on the following factors:

  • Benefits covered under the contract
  • The number of people insured (it costs more to insure a family of 4 than just one person) 
  • Your employer’s participation (if part of the group insurance is paid for by the employer, it will cost you less).

When you enrol in your plan, check if you can simulate the amount you would have to pay. Select the benefits and types of coverage you’d like and you’ll see the approximate amount that would be deducted from your pay.

3. How does the claim process work?

This part depends on what your insurer has implemented and what you’re claiming.

For your prescription drugs or dental care, you simply present your insurance card to the healthcare professionals. Then you only pay for the balance that is not covered.

With many insurers, you can make a claim online for treatments provided by healthcare professionals or medical supplies. In this case, you would likely be reimbursed much sooner.

With Beneva, it takes 48 hours (depending on the type of treatment) if you’ve signed up for direct deposit.

You prefer the good old-fashioned method? Then simply fill out a form and mail it to your insurer.

4. What's not covered by group insurance?

It all depends on your insurance contract! Some treatments and drugs are not covered under your group plan.

A few examples
  • You can claim up to $1,000 for acupuncture treatments per year.
  • Dental care is not covered by your group insurance.
  • Your disability insurance covers you, but not your spouse.

To find out about exclusions and limitations, check your contract or the booklet provided by your employer.

You can also visit the Client Centre. Do a mock claim to estimate the amount you would be reimbursed.

One thing’s for certain, your employer and you are both responsible for knowing what’s covered by your group plan.

5. Are other benefits included?

Sometimes, group insurance plans offer a bit more than healthcare benefits.

In our case, we add a few perks you might find very interesting:

  • Discounts on physical activities
  • Preventive reading
  • Health games-questionnaires
  • Online tool to improve the quality of your sleep, step by step
  • Online physical activity courses

All kinds to improve your health and wellness!

6. Can I do business with any healthcare professional?

You can indeed.

However, some of them are not covered by your insurance. What does that mean? It simply means you won’t be reimbursed for those claims!

Before you pay for medical treatment or supplies, be sure to check out our list of excluded professionals on the Client Centre.

7. What types of coverage are available?

When you enrol for group insurance, you must indicate who among your loved ones will be covered under the contract.

There are many options based on your marital status:

  • Individual (covers you only)
  • Couple (covers your spouse and you)
  • Single-parent (covers your children and you)
  • Family (covers your spouse, children and you, regardless of the number)

8. Who can I contact for assistance?

It depends on your insurer.

You can sometimes ask the person specifically designated to handle your group insurance plan. It can be a member of your company’s human resources department.

In other cases, you can contact your insurer directly.

9. How do I add or withdraw people from my insurance coverage?

All group insurance plans allow you to change your file based on major life events:

  • Cohabitation
  • Marriage
  • Birth
  • Separation or divorce
  • etc.

You can make changes when the event occurs. No need to wait!

To learn how, contact your insurance plan’s resource person.

10. And if I change employers?

Then your group insurance plan benefits terminate.

Unless your insurer knows in advance and can plan for it. Some insurers allow you to convert your group plan into individual coverage.

That’s reassuring to know, with the freedom to change jobs whenever you feel like it.