Who can participate in a group benefits plan?
Different insurers have varying minimum requirements for both the company and employees to be considered eligible for group coverage.
Generally, when a firm applies for benefits all employees must participate unless coverage is supplied elsewhere. For example, an employee may already be covered by a spousal benefit package for Extended Health and Dental.
Some insurers will offer group coverage to Not-for-Profit organizations, firms with a combination of contractors, owner operators, and seasonal businesses. Minimum number of hours per week can vary starting at 20 hours.
What will it cost?
There are many different factors that can effect the cost of Life Insurance or Group Benefit Plans.
Some of the factors that effect cost of life insurance policies are:
Smoker/ non smoker
Face value of policy
The policy type ( whole life, term )
Factors effecting premiums for group insurance may include:
# of lives insured
Type of benefits selected
Single, couple or family coverage
Whether rates are experience rated or pooled
Volume of income
When are Premiums paid?
Premiums are usually due on the 1st of the month.
What is the difference between experience rated and pooled plans?
A group insurance program can consist of pooled benefits and/or experience rated benefits.
Commonly, Group Benefit plans are experience rated for health and dental. This means the insurer sets group premiums based on actual claims made by the companies employees, along with other factors. This may be a risky option for smaller companies as one employees accident or illness could effect premiums in following years. Rates are revised yearly.
Pooled rate plans, such as those made available through Chambers group plan and Manitoba Blue Cross can protect smaller groups from that risk. The costs of benefits are driven by an average of employee demographics: age, gender and the volume of insurance held by each employee. Claims made generally do not effect the premium costs and can provide more stable and predictable premiums.
When will coverage start?
Generally new coverage comes into effect on the first of the month. For new employees there may be a 3 month waiting period before they are eligible to enroll in the group benefits.
Can an employee opt out of coverage?
An employee can opt out of health and dental coverage when they are enrolled under a spousal plan. Proof of other coverage is required.
Can employees convert group health and dental benefits to individual plans if they cease to be employed?
Yes, there are a number of options for employees to convert their health and dental benefits to individual plans. Most group insurers offer an option to convert Life Insurance and AD&D to a personal policy.
Contact Theresa – firstname.lastname@example.org for information on coverage requirements.