What might a group plan include?

Depending on the insurer and design, a plan may include health, prescription drug, dental, vision, life, disability, critical illness and wellness coverage. Every benefit has its own terms, limits and eligibility rules.

Common funding approaches

Fully insured group coverage transfers insured claims risk to an insurer. Pooled structures can spread some claims experience across a larger group. A health spending account sets a defined employer budget for eligible expenses. Administrative services only arrangements let employers fund eligible claims while using an administrator. The right mix depends on the employer and the plan design.

Questions to ask before choosing

  • Which needs matter most to your employees?
  • What will the employer and employees each pay?
  • How will renewals be reviewed?
  • What support will employees receive during setup and claims?
  • What happens as the team grows or changes?

How Ecotone helps

We start with discovery, compare available options, explain tradeoffs, recommend a design and support implementation and renewal.

A health spending account needs proper design. The Canada Revenue Agency explains private health services plan requirements.