Group Insurance

Employee Life can be designed to provide for flat amounts of coverage or for multiples of annual earnings. The latter option relates the coverage to the need and continually updates the coverage for changes in earnings. There can be one or more classes with different levels of coverage and non-evidence limits are available.

Dependent Life insures the dependent spouse and children of the Plan Member under the group plan.

Optional Life offers cost effective supplemental coverage to be elected by Plan Members according to their needs and budget. Optional Life is usually offered in units of $5,000 with premiums related to the insured's age, gender and smoker status. Programs can include Optional Life for spouses and dependent children of Plan Members.

Accidental Death & Dismemberment (AD&D) is a cost-effective supplement to the Plan Member's Basic Life coverage. It insures the Plan Member under the group plan providing for an additional payment, generally equal to the Basic Life coverage, in the event of death caused by an accident. Benefits are paid for injuries and losses due to accidents.

Optional AD&D offers cost effective supplemental coverage to be elected by Plan Members according to their needs and budget. Optional AD&D is offered in units of $5,000. Programs can include Optional AD&D for spouses and dependent children of Plan Members.

Long-Term Disability provides monthly benefit coverage for extended disabilities. Coverage can be tailored to co-ordinate with payments received under a Short-Term Disability plan. The Plan Sponsor chooses from a selection of taxable or non-taxable plans, elimination periods, maximum benefit duration, percentage of monthly earnings to be reimbursed and the maximum monthly benefit payable. The benefit formula may be arranged on a graded scale and can be designed to include Cost of Living adjustments. The LTD benefit amount is integrated with all income sources.

Wawanesa Life's Long-Term Disability benefit plan includes a rehabilitation provision which are intended to assist the Plan Member in the return to work process.

Short-Term Disability covers short absences from work due to accident or sickness. The Plan Sponsor chooses from a selection of taxable or non-taxable plans, elimination periods, maximum benefit duration, percentage of weekly earnings to be reimbursed and the maximum weekly benefit payable. Plans will be tailored at the Plan Sponsors request to qualify for the Employment Insurance premium reduction. The benefit formula may be arranged on a graded scale.

Accident and Serious Illness Disability provides access to long duration disability coverage for the Plan Member during extended absences from work due to a covered condition.

Accident and Serious Illness Disability is structured in a similar fashion to full Long-Term Disability (LTD) plans but provide more limited coverage. Eligible claims under the Accident and Serious Illness Disability program are the result of a Plan Member becoming disabled due to an Accident or one of the 33 Covered Conditions.

Hybrid Disability is a combination of a full Long-Term Disability Program which transitions to the Accident and Serious Illness Disability Program after two years.

Hybrid Disability provides income protection for the Plan Member during extended absences from work due to injury or illness, for a two-year period. After this time, coverage is limited to the covered benefits under the Accident and Serious Illness Disability Program.

Critical Illness provides protection to Plan Members and their families if faced with a life-threatening illness. Our standard Critical Illness coverage will include coverage for 29 conditions for the Plan Member and spouse and 16 covered conditions for dependent children. Provisions include partial payments for some serious conditions that are not life-threatening, multiple event coverage that allows for continued coverage and benefits in the event a second illness occurs at a future point and cancer reoccurrence providing individuals diagnosed with life-threatening cancer a second time to make another claim provided it has been 5 years since their diagnosis and they have not received treatment related to the cancer within the previous 60 months.

Optional Critical Illness offers cost effective supplemental coverage to be elected by Plan Members according to their needs and budget. Optional Critical Illness is offered in units of $5,000 with premium related to the insured's age, gender and smoker status. Programs can include Optional Critical Illness for spouses and dependent children of Plan Members.

Wawanesa Life understands the Plan Sponsor's challenge of controlling health care costs while meeting the Plan Member's needs for services. Health benefits are designed to supplement the basic health care coverage provided under provincial government programs. Through claim audits, claims management and adjudication practices, active fraud/abuse detection and prevention practices, Wawanesa Life takes an active role in assisting the Plan Sponsor in designing plans that encourage healthy choices and keep benefits effective and affordable.

The Group Operation offers plans which allow the Plan Sponsor to include coverage for prescription drugs, professional services, medical supplies, ambulance services, accidental dental, hospital and convalescent hospital coverage, emergency out of country coverage, travel assistance program, and vision care. Reimbursement is based on a range of selected coinsurances, deductibles and maximums that may apply to certain eligible expenses.

Additional expertise and services are provided in the areas of Pay Direct Drug Cards and Travel Assistance Benefits through two strategic partners.

To cover the cost of dental work, The Group Operation allows the Plan Sponsor maximum flexibility in its choice of deductibles, co-insurance, recall options, annual benefit maximums and coverage levels.

The core benefit – Level 1, Basic Dental, provides for preventative and routine restorative procedures and includes treatment for gum disease, root canal therapy and some denture services (relining and rebasing). Level 2, Major Restorative, services can be added. Major Restorative provides for removable dentures, fixed bridgework and crowns. Level 3, Orthodontia, is usually for dependent children under the age of 19 but the plan can be designed to provide coverage for adults.

Health Spending Accounts (HSA) are an effective method for Plan Sponsors to provide Plan Members with a high level of involvement and flexibility in their benefit plan. Health Spending Accounts are individual accounts established for each Plan Member. The Plan Sponsor deposits an amount for each Plan Member. The Plan Member can draw on the account by submitting qualifying expenses that are not insured under Health or Dental benefits.

The eligibility of expenses is controlled by the Income Tax Act. Types of expenses can include, but are not limited to: deductibles and coinsurance amounts, expenses that exceed group insurance plan maximums, eye glasses, contact lenses and laser eye surgery, medications, vaccines over the counter and lifestyle drugs, and dental work such as implants, dentures, or orthodontics.

Health Spending Accounts can be a cost-effective way to fund medical and dental expenses that can be anticipated to recur each year. The Plan Sponsor’s contribution to the account is not taxable to the Plan Member but is deductible by the Plan Sponsor, making it tax-effective.

Personal Spending Accounts (PSA) give Plan Members the flexibility to decide how to invest in their wellness. A Personal Spending Account is a spending account funded by the Plan Sponsor that Plan Members can use to pay for a range of personal wellness related expenses not covered by their group benefits plan or provincial health plan.

Following are examples of eligible coverage categories under a Personal Spending Account:

• Coordination of traditional benefits
• Educational and personal development
• Environmental household products
• Family care
• Fitness equipment
• Fitness/ sports fees
• Insurance premiums
• Non-Health professional services
• Transportation
• Wellness services

Expenses claimed under a Personal Spending Account are subject to income tax as outlined by the Canada Revenue Agency.

Additional Expense Benefit (AEB) is a “cost plus” benefit that provides top-up coverage for most Health, Dental and Vision expenses not covered under the standard contract but Canada Revenue Agency approved. AEB allows the Plan Sponsor to strengthen the coverage offered while providing valuable tax savings. AEB can be used to provide enhanced coverage to key employees in a way that is more tax-efficient than salary increases.

Wawanesa Life has partnered with Teladoc Health to provide Plan Sponsors with an optional program to provide quick, convenient access to quality Telemedicine services.

Telemedicine services allow Plan Members and their eligible Dependents to visit with a physician by phone or video for a broad array of episodic healthcare issues. During the visit they can receive a diagnosis, treatment recommendation, and even be prescribed medicine when necessary.

Telemedicine is available to select Wawanesa Life plans.

Wawanesa Life has partnered with Teladoc Health to provide Plan Sponsors with an optional program to provide quick, convenient access to Expert Medical Services.

Having any health complication is stressful and navigating the healthcare system can seem overwhelming. The Expert Medical Services program offers a number of unique features to ensure Plan Members and their eligible Dependents are able to get the right diagnosis, treatment, or information about their condition.

Expert Medical Services is available to select Wawanesa Life plans.