What is it?
Group Health Insurance (aka Group Benefits) is insurance coverage for dental and medical costs and is often offered through one’s employer as a way to attract and retain employees. These plans can be purchased individually to protect against unforeseen medical expenses.
What to consider:
1. Your financial responsibilities
It is important to know what (if any) deductibles you might have in your plan. For example, your prescription drug coverage may require you to pay a one-time $50 deductible per year, or your coverage amount may vary from 50% to 100% depending on the plan.
2. Your plan’s renewal date
Many people believe their plan operates within the calendar year and may not plan their visits and procedures accordingly. It is important to know when your coverage “resets” each year to ensure you aren’t paying out-of-pocket by accident.
3. Understanding your dental coverage
Many people are under the impression that they are covered for crowns, caps, root canals, etc. when these are considered “major restorative services”. Always check with your plan to see what expenses are covered.
- Take the time to be fully aware of what coverages and services are available to you. It is better to have the answers ahead of time than to go searching when something happens – and you wouldn’t want to pay for something out-of-pocket only to find out later it would have been covered.
- Work with your practitioners. Bring your dentist a copy of your dental coverage page so they can guide you on your coverages. Tell your massage therapist how much your plan maximum is and the benefit renewal month so they can ensure you stay within the guidelines.
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Frequently Asked Questions
(50% single, 50% family)
(0.08 per $25,000)
|Company||# of Employees||Life Insurance, $ monthly||Extended Health, $ monthly||Dental, $ monthly||Total, $ monthly|
(0.09 per $25,000)
(0.05 per $25,000)
|Insurance Plan Component||Insurance Coverage|
|Basic Life Insurance||Flat $25,000
Dependent Life Coverage $5,000
|Extended Health Coverage|
|Prescription Drugs||80% covered|
|Additional Coverage Included||Vision Care, Paramedical practitioners ($500 per practitioner) such as Chiropractor, Massage therapy, Acupuncturist, Osteopath, Naturopath, Physiotherapy, Podiatrist/Chiropodist, Psychologist etc.|
|Dental Coverage||80% covered ($1000/per year coverage)
Minor Restorative: Teeth cleanings, fillings, x rays, pit and fissure sealants etc.