A guide to workplace healthcare benefits
By Brittany Stuckless
Posted on November 22, 2021
Canadians have access to free healthcare. That being said, there are some additional healthcare perks and benefits that many Canadian workplaces offer their employees. Let’s look into how newcomers can find a job with these benefits and understand how extended health insurance coverage works.
What types of jobs have benefits?
Many jobs offer workplace benefits to their employees. Sometimes, you will have to go through a probationary period before having access to benefits. However, it is worth the wait and usually isn’t too long. To know if a job has healthcare benefits, be sure to check the job listing or ask your employer.
Many companies have healthcare benefits packages, especially larger companies with more employees. New, smaller businesses may not be able to provide benefits to their employees. However, some may in the future. It is helpful to know what jobs and companies offer benefits. Here are a handful of examples:
- Canadian food retailers, such as Loblaws
- Liquor Control Board of Ontario (LCBO)
- Large restaurant chains may offer benefits to managers
- Clothing stores, such as Gap Inc.
- Large chain companies, such as Walmart
- Most Canadian banks
- Teachers and other school employees
- Information Technology (IT) jobs
- Most marketing jobs
- Government jobs
- Many entry-level positions after graduating from university
Canadian insurance companies
Many Canadian insurance companies provide employees and employers with extended healthcare plans. Some major insurance companies in Canada include:
- Manulife
- Canada Life
- GreenShield Canada
- Sunlife Financial
- Desjardins
- SSQ
- Empire Life
- Johnson Inc.
Understanding insurance coverage
Benefit cards
If you have healthcare benefits at work, you will be given a benefits card. This Telus Health Guide shows what information is on a benefit card, using Manulife as an example. Most benefit cards will have a policy number (also known as a plan contract number) and a member certificate number (also known as a member ID).
What does workplace insurance cover?
Your workplace benefits give you access to extra healthcare not covered by your provincial healthcare plan. This benefits plan will usually cover a certain percentage of the cost of an appointment. They will also cover a certain percentage of any prescriptions you need. Here are some services you have access to with additional workplace coverage:
- Prescriptions
- Dental care
- Physiotherapy
- Chiropractic care
- Massage therapy
- Vision care
How much coverage do I have?
Your insurance company will grant you a certain amount of coverage per service. For example, let’s say you receive dental treatment, and the cost is $115. Your insurance company may cover the entire appointment, or a portion, depending on the plan. This means your insurance company will reimburse either the full cost or a portion of the cost after submitting your claim.
Your benefits plan will also give you a certain amount of coverage per year, for each service. When you reach your maximum coverage for a service, your insurance company will alert you after you submit a claim. For instance, after a certain amount of dental appointments, you may not be eligible for coverage anymore until your insurance resets. You may also want to use your coverage once a year for check-ups without having to worry about reaching the maximum.
It’s important to check how much coverage you have for each service, especially if you need some more than others. For example, if you have $500 for physiotherapy until your insurance resets, you should keep track of how many appointments you can afford to book per year.
How do I use my coverage?
To use your coverage, you can submit a claim to your insurance company after paying in full for your services. Many insurance companies have apps you can install on your smartphone. You can submit your claim with the detailed receipt given to you after an appointment. For example, if you attend a physiotherapy appointment, your receipt will have:
- Your physiotherapist’s signature
- Your physiotherapist’s license number
- The exact cost of the appointment
- Other detailed information about the clinic
Some clinics can directly bill your insurance company for you. This means that they can submit a claim for the insurance company to pay the clinic instead of you. You will only have to pay for a portion of the appointment, or none at all, if they can accommodate this.
The amount you pay will depend on how much coverage you’re eligible for each visit. If the clinic cannot offer direct billing, they may submit a claim on your behalf. This saves you some extra paperwork, but you will have to pay upfront for your services. It usually only takes a few business days to get your money back from your insurance company.