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Welcome to my Padlet. My name is Austin Gale, and the topic that I have chosen for this assignment is Health Insurance. You can expect to learn the different companies that offer health insurance, what it is, and why it is important.

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Health insurance is what covers you in case you need medical coverage for things that are not covered under each provinces medical coverage.
I chose this photo because it symbolizes the importance of health care in the eyes of the Canadian Government.

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This is one of many companies that offer Health insurance in Canada. Their purpose is to offer medical, dental, and other types of health insurance coverage to employees of many different companies within Canada.

I chose this company because I know what types of services they offer, and who they offer them to.

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This video gives a break down of the health care system in Canada. It is important to watch because it helps you understand exactly what you are covered for, both within Canada and while you are traveling to other countries. Some countries will cover you, only if you have travel insurance. Canada's health care system is one of the best in the world simply because of the affordability.
I chose this video to give an in depth explanation of what is covered under Canada's health care system.

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In Ontario, whatever is not covered under OHIP can be covered under health insurance. Dental, glasses, physio therapy, and many other things outside of going to see a doctor at a hospital are not covered under OHIP, so it is important to have medical coverage to assist you in paying for health care.
I selected this video to explain more in depth as to what OHIP covers and what it does not. It is important to know what is covered and what you need coverage for so that you can go out and look at buying insurance for any unexpected medical expenses that come your way.

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Understanding (OHIP,) Ontario health insurance plan for current residents and those new to Ontario.

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Blue Cross Canada is a good place to look at health insurance, because you can build the package that suits your needs. This company provides not only insurance that you can purchase, but it also is adapted by many companies to provide to their employees.
I chose this website because it is a very good, very popular insurance companies that people are with, because of how easy it is to obtain, how easy it is to submit a claim, and their willingness to provide for everyone.

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Frequently asked questions

1. What is Extended Health Care coverage?

Our provincial government health care plans, MSP and PharmaCare, cover only the basic medical needs such as a visit to your physician or hospital care. Extended health care coverage includes medical services and supplies NOT covered by our provincial health care plans.

2. Why is it important for me to have Extended Health Care coverage?

It is important for individuals and families to have access to extended health care over and above the provincial government plans. Pacific Blue Cross offers extended health coverage which provides coverage for prescription drugs, specialized health care, vision care, dental and much more.

3. When should I buy Extended Health and Dental coverage?

The ideal time to buy extended health care coverage is when you and/or your family are healthy. Since most extended health care plans exclude coverage for medical conditions you may already have, you need to obtain coverage prior to the occurrence of any future unforeseen accident or sickness.

4. Who is eligible for this coverage?

Our Individual Plans are available to all residents of British Columbia and the Yukon provided the resident is enrolled under the Medical Services Plan of BC, or the Health Care Insurance Plan of the Yukon. Coverage will be available for applicants who are awaiting provincial coverage to begin.

Policyholders must be at least 19 years of age. For people under age 19 who want to apply for coverage under one of our plans, an adult must be designated as the policyholder.

5. Where and how can I find more information on extended health coverage?

Pacific Blue Cross has available coverage for health, dental and emergency medical travel. Contact Pacific Blue Cross for more information or to speak with one of our Service Representatives:

Individual Plans Sales and Support
Telephone: 604 419 2000
Fax: 604 419 2199
Email: inhealth@pac.bluecross.ca

Toll-free Outside the Greater Vancouver Area:
1 800 USE BLUE (1 800 873 2583)

Mailing Address:
Pacific Blue Cross
Individual Plans
PO Box 7000
Vancouver, BC V6B 4E1

Connect with an expert

Call us

Monday to Friday 8:00am to 4:30pm (Pacific)
Excluding statutory holidays

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Personal Health Insurance | Pacific Blue Cross

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What is Extended Health Care coverage? Our provincial government health care plans, MSP and PharmaCare, cover only the basic medical needs such as a visit to your physician or hospital care. Extended health care coverage includes medical services and supplies NOT covered by our provincial health care plans.

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I learned the importance of Health Insurance coverage in Canada. Specifically Ontario, what is covered under OHIP and what you would need health insurance for.
I currently have a torn ACL, MCL, and medial meniscus. Canadian health care covers me for all of my MRI's, surgeon visits, and pain management medication. It does not cover me for my physio therapy, my $1,600 custom fitted knee brace that acts as my ACL/MCL. Thankfully, I have health insurance through my parents or else the physio and my knee brace would have been a very hefty unexpected expense.
I would pass on the importance of getting Health Insurance, to assist you with paying for health care that is not included in the Canadian Health Care system.

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Difference Between Individual and Group Health Insurance

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Difference Between Individual and Group Health Insurance

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This website goes into depth explaining the different types of health insurance in Canada. Individual insurance is a type of health insurance that you purchase yourself and it provides you with a certain amount of coverage based on the plan. You can change what you are covered for and what you do not need coverage for. Group health insurance is provided to you by an employer and there is limited modifications based on the coverage provided. Often times, companies deduct health insurance coverage from your pay to cover the price of the plan, but some companies do include this in your salary so you don't actually see it come off of your pay stub.
This website provides a detailed explanation regarding the difference between these two plans, and I learned a lot of information from it.

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In Canada, there are many methods of accessing healthcare - provincial health care plans, group insurance plans, and individual insurance plans, for a start.

Yet when it comes to individual and group health insurance, there are some key differences working Canadians should be aware of. Let's start with the definition of each:

Group Health Insurance

Group health insurance is provided to employees through their employer. Eligibility for employees under a group insurance plan is very straightforward. It is typically based on the number of hours worked and after meeting a waiting period. Employees who apply for group coverage as a late applicant may have a more difficult time, which is why applying for coverage on time is so important! These plans are also set up based on the average age of employees, the industry they work in, as well as the assumption that working employees are generally healthy.

Individual Health Insurance

Individual health insurance is purchased by an individual who requires health coverage above and beyond what the government will cover. These plans are set up based on the individual person's age, medical condition(s), family medical history, and other lifestyle circumstances. As such, you may be required to submit medical evidence.

What's Different?

Here, we'll highlight the most important differences between group health insurance and individual health insurance.

Eligibility and Medical Evidence

With group insurance, individuals do not have to supply medical evidence and are automatically eligible for coverage, provided they work the minimum number of hours and satisfy the waiting period. This makes group insurance very accessible.

Individual health insurance will often require applicants to submit medical evidence and other information prior to approving the coverage (though not all plans). Based on the supplied medical evidence, there is potential for coverage to be denied, whereas this is not the case with group insurance.

Coverage for Pre-existing Conditions

When applying for individual health insurance, the Insurer may deny coverage for any pre-existing conditions (or deny coverage altogether), based on the supplied medical evidence. Individuals with previously documented health conditions, such as diabetes or cancers, may be able to get health insurance, but likely not for those pre-existing conditions. A person's age and smoking status can also impact coverage and even the cost of coverage.

However, group insurance coverage is available to all eligible employees, regardless of pre-existing conditions. Importantly, this does not necessarily mean that a group plan will offer coverage for all pre-existing conditions, as there may be specific pre-existing condition clauses within group insurance.

For example, travel insurance generally requires that a person is in stable condition for a certain number of days prior to departure. This is usually somewhere between 30-90 days.

What is Travel Insurance and What Do I Need to Know Before Travelling?

Another example of this is Disability Insurance. Claims may be denied for a condition that was treated within a certain time frame prior to coverage, and for which is claimed within a certain period of time after coverage commences. For example, if a person was treated for chronic back pain within 3 months of their coverage effective date, and then made a claim within 12 months, they may be denied. However, if they make their claim after the 12 months, this would not be an issue. These time frames vary by policy, always check with your insurer or plan administrator to confirm these details.

8 Common Group Insurance Myths and Misconceptions, Debunked

Cost Differences Between Group and Individual Health Insurance

As a general rule, group insurance will cost a person less than individual insurance for the same or comparable coverage. This is the case for three reasons.

One - in group insurance, the risk of a claim is spread out across a large number of persons who are considered healthy (employees in a workplace). This is known as risk pooling.

Two - in group insurance, employers are required to pay a minimum of 50% of the premiums for most benefits. Special consideration is made for Disability Insurance, as there are tax implications depending on who pays the premium. More on that below.

Three - the cost of group insurance benefits is taken from an employee's before-tax paycheque. With individual health insurance, you'll pay premiums with after-tax dollars.

With individual insurance, the entirety of the premium cost is on the individual without employer cost-sharing. Additionally, premiums are paid with after-tax dollars rather than before-tax income. All of this is added to the fact that individual insurance premiums are typically quite expensive for robust coverage.

Everything Employers Need to Know About Group Insurance Underwriting

Policy Termination

For group insurance, insurance coverage is tied to the covered person's employment. This means that coverage begins after they have satisfied a waiting period, and coverage will cease if that person leaves their job for any reason. Coverage may be extended (such as for a retiring employee or as part of a severance package), but only for so long, and it is still dependent on the last day of employment of the individual. For employees who are losing their group coverage, they have the option to convert their benefits to individual coverage. In this case, the medical evidence that would normally be required is waived.

Employment does not affect the termination of individual health insurance policies as they are purchased separately by a person who requires the coverage. This is not to say that their job might not be a factor in what type of coverage they need or are able to receive. For example, sports athletes require different coverage than an office worker, and the price for coverage may also vary.

Continuation of Benefits for Leaves of Absence, Layoffs, and Retirees

Tax Implications: Group Health Insurance vs. Individual

Premiums

For group insurance, the employer is able to add the premiums they pay for their employees coverage to their business expenses. In other words, it is a tax write-off. For Life, AD&D, Disability, and Critical Illness benefits, the amount of premiums the employer pays is considered taxable income for the employee. Extended Health Care, Dental, and EAP premiums are exempt from this and are not added as taxable income for the employee.

Shared premium costs are deducted directly from the employee's pay, which means they are using pre-tax dollars to pay for their premiums.

For individuals purchasing individual insurance, they would be using post-tax dollars. These premium amounts can be claimed as a medical expense on the individual's personal income tax return.

Benefits

When it comes to claiming the benefits, there are also tax implications. For medical and dental expenses that are covered, these cannot be claimed as individual medical expenses, as the employee has been reimbursed. The amount that is reimbursed to the claimant should also not be added as income to the individual tax return.

For Life and AD&D benefits, the benefit received by a beneficiary is non-taxable. This is not dependent on who paid the premiums for the insurance coverage.

Disability insurance is slightly different. If an employer pays the premiums, the benefit amount received by the claimant is taxable. If the employee pays the premiums, the benefit amount is non-taxable. For this reason, many group disability plan premiums are paid 100% by the employees. Again, because the employee is using pre-tax dollars to pay the premiums, savings are still realized over an individual plan.

While there are reasons to have both types of coverage, generally speaking, if your employer has group coverage, it is advantageous to enroll. In some cases, enrollment may even be mandatory (this is especially true for small to medium sized businesses). Plus, if you do end up leaving the specific company under which benefits are provided, they are responsible to advise employees of their conversion options for continued coverage.

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Individual vs. Group Health Insurance: What are the Major Differences?

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In Canada, there are many methods of accessing healthcare - provincial health care plans, group insurance plans, and individual insurance plans, for a start. Yet when it comes to individual and group health insurance, there are some key differences working Canadians should be aware of.