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Group Insurance Coverage


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Life Insurance


Group plan life insurance coverage may include the following:

  • Basic Life Insurance: Although each plan is unique, most offer life insurance providing for the payment of either a fixed amount or an amount equalling a multiple of the insured's earnings (e.g.: one or two times his or her wages).

  • Accidental Death or Dismemberment Insurance: This coverage provides for the payment of a lump sum over and above the amount supplied by basic insurance in the event of accidental death, as well as a percentage of the amount of basic life insurance in case of accidental dismemberment.

  • Supplementary Life Insurance: This coverage provides for the payment of either a fixed amount or an amount equalling a multiple of the insured's earnings (e.g.: one or two times his or her wages) above and beyond the sum provided by basic life insurance.

  • Dependent Life Insurance: This coverage generally provides for the payment of a fixed amount in the event of the death of a dependent.

Disability Insurance

  • Disability insurance is designed to help insureds cope with the loss of income resulting from an inability to work due to illness or injury.

  • This type of insurance may include the following types of coverage:


    • Short-Term Income Insurance: This coverage provides for the payment of a benefit equalling either a percentage of the insured's weekly earnings or a fixed amount.

    • Long-Term Income Insurance: This coverage provides for the payment of a benefit equalling a percentage of the insured's monthly earnings.


  • As a rule, individuals may choose from a range of insurance amounts, but the disability benefit is limited to a percentage of the insured's regular compensation (e.g.: 60%, 66 2/3% or 70%).

  • Such benefits are usually coordinated with private and public-plan benefits (e.g.: Quebec Pension Plan and Canada Pension Plan or workers' compensation benefits), meaning the amount of the benefit specified in the policy is the maximum the insured can collect.

Accident/Illness Insurance

  • Accident/illness insurance is meant to provide coverage in the event of an illness or accident, as well as during pregnancy.

  • Group-plan accident/illness insurance may include the various types of coverage below.  In practice, each type may be offered as an independent option-often the case for vision care and travel insurance, for example.

  • Hospital Expenses: Where the insured is hospitalized in Canada, the insurer will refund the attendant costs (e.g.:  private or semi-private room) not covered by the public healthcare system.

  • Prescription Drugs: The insurer generally refunds the cost of drugs prescribed by a physician or dental surgeon.  However, the kinds of drugs covered and terms and conditions of reimbursement may vary from one policy to another.

  • Medical and Paramedical  Expenses: This coverage applies to services rendered by healthcare professionals as well as services and equipment not paid for by public plans (e.g.: physiotherapy, rehabilitation therapy, orthopedic prostheses, wheelchairs, etc.).

  • Vision Care: This coverage pays for costs incurred to provide the insured with spectacles, contact lenses, and so on.

  • Travel Insurance: This type of insurance covers the costs incurred by Canadian residents because of an accident or illness occurring during a trip of less than three months outside their province of residence.

For each type of coverage mentioned above, the policy will stipulate exactly which costs are covered, the terms and conditions of reimbursement (e.g.: applicable limits), deductibles, and co-insurance percentages, where applicable.


Dental Insurance

  • Dental insurance is intended to protect insureds who incur expenses for therapeutic and preventive care.

  • Clauses providing for the payment of regular dental costs such as examinations and fillings, as well as special treatment such as crowns and prostheses, vary from plan to plan.

  • Most plans impose a maximum limit per calendar year per insured, for the lifetime of the insured.


Critical Illness Insurance

  • Critical illness insurance provides for the payment of a lump sum during the lifetime of the insured upon the diagnosis of one of the critical illnesses specified in the policy.

  • Critical illnesses and surgical treatments most often covered are heart attacks, strokes, heart surgery, cancer, kidney failure, organ transplants, paralysis, multiple sclerosis, blindness, deafness, coma, Parkinson's disease and Alzheimer's disease.


The above descriptions are general in nature and are intended for explanatory purposes only. Each type of coverage discussed here has its own specific features. Furthermore, only the group plans pertaining to these types of coverage contain all the relevant terms, conditions, restrictions and exclusions.


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