Starting a new job? 10 things to know about group insurance

1. What does group insurance cover?

Group insurance can provide coverage for health expenses, life insurance, disability and other valuable protections. The details depend on the plan offered by your organization. Some employers offer flexible plans with different coverage options, while others provide the same plan to all employees.

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

These include the following types of insurance:

• Prescription drugs, hospital accommodation, physiotherapy, dental care and other health expenses
• Short- and Long-Term Disability Insurance
• Life Insurance
• Accidental Death and Dismemberment Insurance
• Critical Illness Insurance
• Extended health and wellness services

Depending on your plan, some coverages may be optional. You could, for example, add life insurance for your children.

Be sure to review your plan documents before making your selections.

2. How much does group insurance cost?

The cost of your group insurance depends on several factors:

• The coverages included in the plan.
• The number of people insured (it costs more to insure a family of 4 than just one person).
• The employer contribution. If part of the group insurance is paid for by the employer, it will cost you less.

If your enrolment tool offers plan comparisons, take advantage of it. You can estimate payroll deductions before finalizing your choices.

3. How does the claim process work?

The claims process varies depending on the expense and the services available through your insurer.

For your prescription drugs or dental care, you simply present your insurance card when paying. If direct billing is available, you'll only pay the portion not covered by your plan.

For other eligible expenses, such as certain treatments or medical equipment, you'll need to submit a claim. Many insurers now offer online claims making reimbursement faster and more convenient.

At Beneva, members enrolled in direct deposit can receive reimbursement directly into their bank account. Depending on the type of service, reimbursement is generally processed within about 48 hours.

You can also use the Client Centre to track claims and review your coverage.

4. Are any services excluded?

It all depends on your insurance contract! Every plan includes specific exclusions, limits and reimbursement maximums.

Here are some examples:

• Some services may be subject to annual reimbursement limits.
• Dental care may not be included in your group insurance plan.
• Disability insurance may apply only to you and not to your spouse.

Want to avoid surprises? Review your contract and any information provided by your organization. If a claims estimator is available through your Client Centre, use it to estimate your reimbursement before receiving care. After all, knowing how your plan works is a shared responsibility between you and your employer.

5. Are there other benefits included under your group insurance plan?

Absolutely. Many group insurance plans include access to health and wellness tools, resources and support services.

At Beneva, that can include:

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

6. Can I choose any healthcare provider?

In most cases, yes.

However, some plans exclude certain professionals, facilities or associations. Services provided by those excluded providers will not be reimbursed.

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

7. Who can I cover?

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

Typical options include:

• Individual: just you
• Couple: you and your spouse
• Single-parent family: you and your children
• Family: you, your spouse and your children, regardless of family size

8. Who can answer my questions?

Your first point of contact should be the person responsible for administering your organization's group insurance plan, often someone in Human Resources.

Depending on the nature of your question, you may also be able to contact your insurer directly.

Before calling, have your certificate and contract numbers handy.

9. When can I add or remove a dependent?

You can usually make changes following a major life event, such as:

• Living together for one year
• Marriage
• Birth
• Getting separated or divorced

Contact your plan administrator promptly to learn about the required steps and supporting documents.

10. What happens if I leave your organization?

When you leave your employer, your group insurance coverage typically ends, unless your insurer knows in advance and can plan for it. In some cases, however, your insurer may allow you to convert your group coverage into an individual plan. This can help you maintain certain protections during a period of transition or into retirement.

Thinking about leaving your job? Before your last day, take the time to understand your insurance options. Be sure to check:

• The date your coverage will end
• Whether you can switch to an individual plan
• The steps required to maintain coverage, if applicable
• Any deadlines you need to meet before your benefits expire