Collective insurance in Quebec

[Magalie05]

Hi all !
To present myself quickly, I'm Magalie and I live in Montreal with my husband. My husband really loves to ski at a rather high level and he injured himself several times. I've just changed my job and my company proposed to me a collective insurance. At first sight I didn't know what it mean so I checked on this website. I wanted to know what you think about the collective insurance and if one of you had one. Indeed, as my husband is doing a dangerous sport, I want the insurance to cover a lot of things and especially medical fees. Also, I would like to know if I am obliged to subscribe to this insurance or if I can take the one that I want. Plus, is this insurance really advantageous?
Thank you so much for your answers,
Regards,
Magalie

 

[BeSki]

Fellow Canadian here. As a Canadian, you receive guaranteed health coverage for any regular health services from a doctor, and most treatment delivered in a hospital. There are many services, however, that are not covered by the basic provincial health plan. "Assurance collective" in Quebec is what is commonly known as group insurance in Ontario. When I was working, I was covered by Manulife/Manuvie group insurance and my husband was covered by Sun Life. Generally speaking, group insurance offers employees a broader, more comprehensive plan for a lower price than what an individual could acquire for themselves. Both of our employers paid a portion of the monthly fee as part of our negotiated collective agreements, and we paid the rest. Usually, the employer offers just one insurer in their group insurance plan. Usually, there are several levels of coverage within the plan offered to the employee. We were able to increase our level of coverage as we got older/life circumstances changed.

Why would you want this additional coverage above what you get through your provincial health benefits? Because: it will likely cover a large portion of your drug costs, eye exams, physiotherapy, upgraded hospital room choices, out of province coverage, out of country coverage, repatriation, some medical devices like orthotics, crutches, glasses, etc. and possibly dental coverage for an additional fee. Most group plans do not require a medical exam to qualify for coverage, unlike individual plans. This benefit (no qualifying medical exam) may require that you enroll in the plan when you first start work for your new employer. So this is a huge plus, if you become sick or unhealthy when you get older and may need extra help, or if you no longer easily qualify for the/a supplemental plan. When we were both working, we were able to file for coverage under both plans, so expenses such drugs or dental work were very low, because the two plans together essentially meant that the deductible from the primary earner's plan was covered by the other earner's plan. Same would apply if you have children. After retirement, you may be able to opt into/switch to a group plan for retired employees. We did this, keeping just the less expensive option offered by my husband's former employer. This still covers all of the things that I listed above. At age 65, your provincial drug benefit will cover the cost of most drugs, but you will still need to pay a yearly $100 fee and dispensing fees. These are covered by our group insurance plan. We have never had to use the out of province coverage or out of country coverage, but as skiers who rarely ski near home, it is good for peace of mind to know that we can rely on help should we have an accident while travelling or skiing during our trips.

 

[Jilly]

I'm an employer that has this benefit for my staff. We have used Empire Life and just switch to ManuLife/Manuvie. Coverage is mandatory for my staff, but not their spouses.

Our group plan covers much of what BeSki states as well as Life insurance, short and long term disability for the employee. There is a small life insurance on the spouse and kids if wanted.

Our short and long term disability covers only the employee. So for you, your husband may not be covered by your plan. He would then need his own. Workman Comp (or whatever it's called in Quebec) would cover injuries at work, but not outside of work. There's where the ST and LTD come in. As an employer having that coverage lower my cost of EI too. If your husband is subject to hurting himself then he needs this coverage more than anything. So you need check your coverage for him.

As far a medical insurance coverage, our plan is prescriptions (with a co-pay), semi private hospital room, chiro, PT, RMT, a whole list of different practitioners, medical appliances like knee braces, hear aids etc. A knee brace can put you back $2000. Some items have a $ limitation/year. This can be either the employee or his family.

And we have that out of province and country coverage too.

In Ontario the employer usually picks the plan or not. Some small businesses don't have it. Our deal is the employee pays 1/2 the cost. Because their 1/2 includes the life insurance premium, it not a taxable benefit according to CRA. When I worked for a large company that paid the full premium, the amount of that premium got put on my T4 as income.

As for whether or not to take it, I'd ask around and your employer should have someone that can talk to you about it and answer your questions.

 

[Magalie05]

All right thank you so much for your answers, it really helps me !!

 

[Jenny]

This is fascinating. If we can talk about this without it being considered political . . .

Canada’s insurance is province based, correct? Do all of the provinces offer the same basic coverages? Sounds like it's a pretty limited level of coverage, but at least it's something. And it's paid for by tax dollars? Does the amount show up as a separate deduction line on your paystubs? And how similar are the costs from province to province?

 

[Jilly]

Health insurance is provincial, mandated federally. So minimum coverage. We also have Employment Insurance that the employer and employee pay into. So if you are laid off, or can't go to work (with a reasonable reason) you get 58% of your pay. If you get hurt at work, here in Ontario, you are covered by Workplace Safety and Insurance. That is paid by the employer.

None of that matters if you get in a car accident Saturday afternoon. You can get EI, but it's only 16 weeks. Medically the provincial health insurance covers you for operations. They also can cover PT etc, but there are few practitioners that are covered by the plans. So it takes forever to get into them. Now in the case of car accident, your car insurance may cover loss wages etc.

We offer our employees the benefit because years ago, my cousin lost all his fingers and thumb in a workplace accident. Yes WSIB covered him, but he had no life insurance, no disability insurance, a wife and 2 kids to provide for.

Prescriptions unless your in the hospital and some medical appliances are not covered by the provincial plans. I'm trying to remember if my Mom's ostomy stuff was covered, or we had it with the company plan. So being a diabetic or having epilepsy could be expensive.

Once you hit 65, a lot more stuff is covered, but not all.

As for who pays for all of this....some is tax dollars and some is premiums paid by the employer. The large employers pay premiums. So locally here it's the big plants, community college, etc. It's based on payroll. My company doesn't have to, our payroll is too small. So that is payroll tax and not something that is added to personal income.