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Plan Designs – Core Benefits
We are excited to present, Benefits for Small Business, a unique product specifically designed for groups of your size. It is flexible, affordable, and gives employees valuable life and health insurance that goes beyond traditional coverage. We have seen a great response to Benefits for Small Business from both plan sponsors and advisors for its ease of sign-up and administration, and how it meets the needs of entrepreneurs and small business owners who are looking for a ‘big company’ health benefits plan for their employees.
Please review the Plan Specifications before proceeding.
We are excited to present, Benefits for Small Business, a unique product specifically designed for groups of your size. It is flexible, affordable, and gives employees valuable life and health insurance that goes beyond traditional coverage. We have seen a great response to Benefits for Small Business from both plan sponsors and advisors for its ease of sign-up and administration, and how it meets the needs of entrepreneurs and small business owners who are looking for a ‘big company’ health benefits plan for their employees.
Please review the Plan Specifications before proceeding.
| Life | Entry | Essential | Enhanced |
|---|---|---|---|
| Basic Life – Employee (50% reduction at age 65) | $25,000 | $50,000 | $50,000 |
| Dependent Life – Spouse | $2,500 | $5,000 | $5,000 |
| Dependent Life – Child | $1,000 | $2,500 | $2,500 |
| Accidental Death and Dismemberment (50% reduction at age 65) | $25,000 | $50,000 | $50,000 |
| Extended Health Care 2 | Entry | Essential | Enhanced |
| Reimbursement level | 80% | 80% | 80% |
| Health practitioners 3 | $500 per practitioner | $600 per practitioner | $600 per practitioner |
| Accidental dental | $2,000 per lifetime | ||
| Ambulance | Unlimited ground and air within Canada | ||
| Custom orthotics and orthopedic shoes | $250 per 2 calendar years | $300 per 2 calendar years | $300 per 2 calendar years |
| Convalescent Care | No coverage | $30 per day, up to 180 days | $30 per day, up to 180 days |
| Diagnostic tests | $1,000 per calendar year | $1,000 per calendar year | $1,000 per calendar year |
| Durable medical equipment | $5,000 per lifetime | $5,000 per lifetime | $5,000 per lifetime |
| Hearing aids | $700 per 3 calendar years | $700 per 3 calendar years | $700 per 3 calendar years |
| Hospitalization | No coverage | $200 per day for semi-private and private room | $200 per day for semi-private and private room |
| Mobility aids and orthopedic appliances | $2,000 per calendar year | ||
| Nursing care | $10,000 perr year; up to a maximum of $25,000 lifetime | $10,000 perr year; up to a maximum of $25,000 lifetime | $10,000 perr year; up to a maximum of $25,000 lifetime |
| Other medical services and supplies | Covered | Covered | Covered |
| Oxygen | $1,000 per lifetime | $1,000 per lifetime | $1,000 per lifetime |
| Prostheses | $10,000 per lifetime | $10,000 per lifetime | $10,000 per lifetime |
| Vision – Eye exams | $75 per 24 months; 12 months for children | Reasonable and customary limit per 24 months; 12 months for dependent children | |
| Vision – Frames and lenses | No coverage | $200 per 24 months | $300 per 24 months |
| Dental Care 4 | Entry | Essential | Enhanced |
| Basic care reimbursement level | 80% | 80% | 80% |
| Basic Care maximum | $1,000 | $1,500 | $1,500 |
| Composite fillings | All | All | All |
| Major restoration reimbursement level | No coverage | 50% | 50% |
| Major restoration maximum | No coverage | $500 | $1,500 |
| Recall exam frequency | 9 months | 9 months | 9 months |
| Fee guide | Current | Current | Current |
| Prescription Drugs 5 | Entry | Essential | Enhanced |
| Reimbursement level | 80% | ||
| Prescription drugs maximum | $3,000 | $5,000 | $20,000 |
| Diabetic supplies | $1,000 | $2,000 | $5,000 |
| Glucose monitoring systems | Covered under diabetic supplies maximum | Covered under diabetic supplies maximum | $4,000 |
| Blood glucose test strips | Allowable quantity based on diabetes treatment | ||
| Managing Chronic Disease | $500 | $500 | $500 |
| Modules included | Viscosupplementation, Opioid Management, ASA therapy, Weight Loss Drugs | ||
| Worldwide Travel | Entry | Essential | Enhanced |
| Reimbursement level | 100% | 100% | 100% |
| Travel maximum | $5,000,000 per person per incident | $5,000,000 per person per incident | $5,000,000 per person per incident |
| Travel days per trip | 180 | 180 | 180 |
| Out of country referrals maximum | $500,000 per person, per lifetime | $500,000 per person, per lifetime | $500,000 per person, per lifetime |
| Trip cancellation and interruption | No coverage | $5,000 per person per trip | $5,000 per person per trip |
| Baggage loss | No coverage | $500 per person per trip | $500 per person per trip |
| Worldwide travel assistance | Yes | Yes | Yes |
| Wellness & Prevention Solutions | |||
| Included with all plan options | |||
| Online Doctors 3 visits per year | Second Opinion | My Good Health | |
| CONNECTED CARE – Member pays at preferred rates | |||
| Mental Wellness | Personalized Medicine | Virtual Physiotherapy | |