Comparing group benefits quotes: what should an employer look at?

The premium appears first on most proposals because it is easy to compare. The harder question is what the employer and employees receive for that premium, both at the start of the plan and after the first renewal.

A sound comparison starts by asking insurers to price the same group and the same requested coverage. Where a proposed insurer cannot match a feature, show the difference openly. That makes it possible to see whether the price reflects a different insurer, a different plan or both.

Gather the details needed for a quote

For a new plan, outline which employees would participate, where they work, the benefits you want quoted, the employer’s proposed share of the cost and when coverage should begin. If you already have a plan, also include current plan documents, rates, renewal details and available claims information. An insurer may request more information before quoting.

Compare what each proposal includes

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Area to compare	What to review
Routine health and dental claims	Drug rules, dental fee guides, reimbursement percentages, visit limits and annual maximums.
Major coverage and claims	Disability definitions and waiting periods, life insurance amounts, exclusions, high-cost drug provisions and applicable pooling terms.
Who can participate	Hours-of-work rules, employee classes, waiting periods and dependant eligibility.
Administration and support	Enrolment tools, billing, reporting, employee communications and help with difficult claims.
Future pricing and charges	Rate guarantees, renewal approach, experience reporting and charges that may change separately from the base premium.

Use these comparison points as a starting place; not every item will be relevant to every plan. Give the most attention to terms that could change the protection or everyday coverage your employees receive.

Example: a lower premium with different coverage terms

The example below compares two hypothetical proposals for the same employee group. The prices and plan terms are invented to show how a review might work; they are not typical quotations.

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Feature	Proposal A	Proposal B
Total monthly plan premium	$1,000	$1,120
Drug plan substitution rule	Generic substitution	Mandatory generic substitution
Example annual paramedical maximum	$500 per covered person	$750 per covered person
Drug dispensing fee cap	$7 per eligible prescription	No separate dispensing fee cap
Dental recall examination schedule	One recall examination every 9 months	One recall examination every 6 months
Initial rate guarantee	12 months	24 months
LTD non-evidence maximum	$5,000 per month	$3,800 per month

The disability figures are monthly non-evidence maximums—the amount of LTD coverage available without medical evidence—not a monthly payment every employee would receive.

In this example, the two drug rules differ in how brand-name prescriptions are reimbursed when a generic is available and what exceptions may apply. Confirm the actual rules in each proposal.

At the stated total premiums, Proposal A costs $120 less per month, or $1,440 over 12 months if the quoted rates and group remain unchanged. It also has a higher LTD non-evidence maximum. Proposal B offers a higher paramedical maximum, a six-month dental recall schedule and a longer initial rate guarantee. Compare how those differences and the drug plan terms would affect this group. Proposal B’s lack of a separate dispensing fee cap does not promise full reimbursement, and its longer rate guarantee alone does not establish which plan offers better value. Confirm which rates and charges each guarantee covers and when each can change.

Give each comparison point a simple status: matches the request, acceptable difference, material concern or awaiting insurer confirmation. This keeps attention on the issues that could affect the final choice.

Check the transition before changing insurers

Before choosing a replacement insurer, ask the current and proposed insurers what would happen to employees away from work, claims still in progress and coverage connected to an ongoing disability. Confirm the applicable contract terms and who will handle each issue. CLHIA Guideline G3 addresses insurer changes and continuation of certain life and disability coverage for disabled members; the answer for a particular employee depends on the plan terms and circumstances.

What the comparison should make clear

Ask for a one-page decision summary showing the shortlisted proposals, the differences that matter most, any terms awaiting insurer confirmation and the reason for the recommended direction. It should make coverage changes and uncertainties about future pricing clear.

To get started: Outline who would participate and the two or three priorities the plan must serve. If you already have coverage, have your current plan documents ready.

Primary reference for insurer transitions: CLHIA Guideline G3 — Group Life and Group Health Insurance.

Review your options with us

Tell us what you need the plan to do. We can help you compare available proposals against those priorities.