Group A&S

Group Accident and Sickness (Group A&S)

Health insurance is available to all Canadians through provincial health plans. The services vary and have limits. Group Accident & Sickness insurance provides additional coverage, the same goal as individual plans.


Extended Health Care

  • also called "Major Medical"
  • fills gaps in government health plans, e.g., by providing the same benefits as individual plans

Group Dental Plans

Vision Care

  • for purchase or replacement of glasses or contact lenses
  • maximum benefit per period of time (e.g., $200 every 24 months)

Employee Assistance Program (EAP)

  • an employee benefit, not an insurance product
  • employer paid
  • generally only in large companies
  • provide consultation to employees and their families for immediate support, education, access to resources for many employee needs, e.g.,
    • counseling for stress or drug addictions
    • financial counseling
    • legal advice (e.g., family law, bankruptcy, divorce)


  • group plans have deductibles and coinsurance, as with individual coverage

Coordination of Benefits (COB)

  • the CLHIA developing guidelines to coordinate health and dental benefits from all group plans which cover a person and their family
    • prevents the insured from profiting by submitting multiple claims for the same expenses
  • some group plans may not have Coordination of Benefits
  • the primary carrier pays first
    • a plan without Coordination of Benefits is the primary carrier
  • the secondary carrier pays a balance to the lesser of
    1. the amount it would have paid as the primary carrier
    2. 100% of the eligible expenses less the benefits payable for those expenses by the primary carrier

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