What does a standard employer group benefit plan cover in Canada?

A standard Canadian employer group benefit plan typically has five components: (1) Extended Health Care (EHC) — prescription drugs, paramedical services (physiotherapy, massage, psychotherapy), vision care, medical equipment, and emergency out-of-country travel insurance; (2) Dental — preventive (cleanings, X-rays), basic restorative (fillings), and sometimes major restorative (crowns, bridges) and orthodontics; (3) Short-Term Disability (STD) — income replacement for 2–17 weeks when you cannot work due to illness or injury; (4) Long-Term Disability (LTD) — income replacement (typically 60–70% of salary) after the STD period ends, continuing to age 65 in many plans; (5) Life insurance — usually 1–2× your annual salary as a base, sometimes with optional top-up. Some plans also include an Employee Assistance Program (EAP) and possibly a Health Spending Account (HSA).

How do I evaluate a group benefit plan when comparing job offers?

When comparing group benefits across job offers, focus on: (1) Premium split — does the employer pay 100%, 75%, or 50%? Employee-paid premiums reduce your take-home pay. (2) LTD premium payer — if the employer pays LTD premiums, your benefits are taxable; if you pay, they are tax-free. This materially affects your net benefit. (3) Paramedical annual maximums — $500/year for physiotherapy looks good but often runs out quickly if you need regular treatment. (4) Prescription drug plan — formulary-based (list of covered drugs) vs drugs cost (percentage after deductible). (5) Dental major and orthodontic coverage — often capped at $1,000–$2,000/lifetime. (6) Waiting period — many plans require 3 months of employment before benefits begin; some begin on day 1. (7) Life insurance amount and imputed benefit — employer-paid life insurance over $50,000 creates a taxable benefit.

What is Extended Health Care (EHC) and what does it typically include?

Extended Health Care is the health benefits component beyond what provincial health insurance (OHIP, MSP, AHCIP, etc.) covers. Typical EHC inclusions: prescription drugs (usually 80–90% reimbursement after a deductible, up to an annual or lifetime maximum); paramedical services (physiotherapy: $300–$1,000/year; massage therapy: $300–$750/year; psychologist/psychotherapy: $500–$2,000/year; chiropractor: $300–$600/year); vision care (glasses/contacts: $150–$300 every 24 months); medical equipment (orthotics, hearing aids — often a separate dollar maximum); hospital upgrade (semi-private or private room premium over ward rate); and out-of-country emergency coverage (often $1M–$5M per trip for emergency only — pre-existing conditions exclusions apply).

What is the difference between Short-Term Disability and Long-Term Disability?

Short-Term Disability (STD) typically replaces 55–70% of your salary for a period of 2 to 17 weeks following an illness or injury that prevents you from working. The STD plan begins after a waiting period (usually 0–7 days for hospitalization, 7 days for illness). Long-Term Disability (LTD) begins after the STD period ends (typically at week 17 or week 26, depending on the plan) and continues until you can return to work or until age 65 — whichever comes first. LTD typically replaces 60–70% of your pre-disability earnings, subject to a monthly maximum (often $5,000–$10,000/month). The critical tax point: if your employer pays the LTD premium, LTD benefits are taxable income. If you pay the premium, LTD benefits are tax-free.

What happens to my group benefits when I leave my job?

Your group benefits typically terminate on your last day of employment (or end of the month of departure, depending on the plan). You have a portability window — usually 60–90 days — to convert or replace your coverage without a medical examination. Key options: (1) Convert group life insurance to an individual policy (within the portability window; no medical exam required). (2) Convert LTD to individual disability coverage if applicable. (3) Apply for individual extended health and dental coverage — subject to underwriting outside the portability window. (4) COBRA-style continuation does not exist in Canada — you cannot extend your group plan as a departing employee indefinitely. Cost reality: replacing group benefits individually is significantly more expensive; a comparable individual health and dental plan typically costs $150–$300/month per adult.

Group Benefit Plan Canada Guide 2026: What Your Employer Benefits Actually Cover

Overview: Standard Group Benefit Plan Components

Benefit	What It Is	Typical Coverage
Extended Health Care (EHC)	Prescription drugs, paramedical, vision, equipment, out-of-country	80–100% after deductible
Dental	Preventive, basic restorative; sometimes major and ortho	80–100% preventive; 50–80% major
Short-Term Disability (STD)	Income replacement weeks 1–17	55–70% of salary
Long-Term Disability (LTD)	Income replacement post-STD to age 65	60–70% of salary, monthly max
Group Life Insurance	Death benefit for beneficiaries	1–2× annual salary (base)
Employee Assistance Program (EAP)	Counselling, referral services	Free (employer-paid)
Health Spending Account (HSA)	Flex spending on eligible medical expenses	$250–$2,000/year employer credit
Employee Wellness Account (WSA/LSA)	Gym, wellness, ergonomics — often taxable	$250–$1,500/year employer credit

Extended Health Care — Typical Annual Limits

Service	Low-End Plan	Mid-Range Plan	Strong Plan
Prescription drugs	80%, $5,000/yr	85%, $10,000/yr	90%, unlimited
Physiotherapy	$300/yr	$600/yr	$1,000+/yr
Massage therapy	$0	$400/yr	$750/yr
Psychologist / psychotherapy	$0	$1,000/yr	$2,000+/yr
Chiropractor	$200/yr	$400/yr	$600/yr
Vision care	$150/24 months	$250/24 months	$300/24 months
Naturopath / acupuncture	$0	$300/yr	$500/yr
Hearing aids	$500/lifetime	$1,000/5 years	$2,000/5 years
Custom orthotics	$200/yr	$300/yr	$400/yr
Out-of-country emergency	$1M/trip	$2M/trip	$5M/trip
Deductible (annual)	$25–$50	$0–$25	$0

Dental Coverage — Typical Plan Structure

Coverage Class	What’s Included	Typical Plan %
Preventive (Class A)	Cleanings (2×/year), X-rays, exams, fluoride	80–100%
Basic Restorative (Class B)	Fillings, extractions, root canals, denture repairs	70–80%
Major Restorative (Class C)	Crowns, bridges, dentures, implants	50% (if covered; many plans exclude)
Orthodontics	Braces (children and sometimes adults)	50%; lifetime max $1,500–$3,000
Annual maximum	All dental combined	$1,000–$3,000/year

Disability Coverage Comparison

Feature	Short-Term Disability (STD)	Long-Term Disability (LTD)
When it starts	Day 1 (sometimes) or day 7	After STD ends (usually week 17–26)
Benefit amount	55–70% of gross weekly earnings	60–70% of pre-disability salary
Monthly maximum	Often none (short duration)	$5,000–$10,000/month typical
Duration	2–17 weeks typical	To age 65 (own-occupation definition varies)
Who pays premium	Employer often pays	Employer or employee — matters for tax
If employer pays premium	Benefits likely taxable income	Benefits are taxable income
If you pay premium	Benefits non-taxable	Benefits are tax-free

Group Life Insurance — Key Facts

Feature	Detail
Standard coverage	1–2× annual salary
Optional supplemental coverage	Up to 5–10× salary (employee paid)
Beneficiary designation	Must be named in writing; not automatic to estate
Taxable benefit	Employer-paid coverage over $50,000 assessed as taxable benefit on T4
Portability	60–90 day window after leaving to convert to individual policy without medical exam
Adequacy	Often insufficient — if you have dependants, review total life insurance need

What to Look For When Evaluating a Job Offer’s Benefits

Factor	What to Ask	Why It Matters
Premium cost split	What % does employer pay? What is my monthly premium?	Employer-paid 100% = full take-home value
LTD premium payer	Who pays the LTD premium?	Employer-paid LTD = taxable benefit when collecting
Paramedical limits	Annual maximums for physio, massage, psychotherapy?	Low limits (under $500) are nearly useless
Drug coverage type	Formulary (list of covered drugs) or open formulary?	Open is best; formulary = some drugs not covered
Dental major coverage	Is major restorative (crowns, bridges) included?	Major can cost $1,000+ per tooth; exclusion is a gap
Waiting period	When do benefits begin? Day 1 or after 3 months?	Impacts coverage if you become sick early
Out-of-country limit and conditions	Emergency only? Pre-existing exclusions?	Critical for travel; many plans have strict exclusions
Life insurance portability	Conversion right within how many days?	Important for estate planning on departure
HSA or WSA included?	How much? What’s eligible? Taxable?	Bonus value — HSA is non-taxable; WSA is taxable

Group Benefits vs Individual Coverage Cost Comparison

Benefit	Employer Group Plan	Equivalent Individual Plan
Extended health (1 adult)	$0–$100/month (employer subsidizes)	$80–$180/month
Dental (1 adult)	$0–$50/month	$50–$100/month
LTD (60% of $80K salary)	$0–$80/month (employer often pays)	$150–$300/month
Group life ($200K)	Included or $5–$20/month	$20–$60/month (term life equivalent)
Total (complete plan)	$0–$150/month	$300–$650/month

Group buying power and employer subsidy make employer benefits significantly cheaper than equivalent individual coverage. Benefits are a meaningful component of total compensation.