Prescription drugs
Coverage can include eligible prescription medications, with plan-specific rules for formularies, generic substitution, dispensing fees and specialty drugs.
Group Health Benefits
Health benefits designed to balance coverage and cost.
Extended health benefits provide financial support for eligible healthcare expenses and can be tailored to an employer’s workforce and budget.
Drugs · Vision · Paramedical
Common health plan components
Shape coverage around what matters most to your workforce.
Prescription drugs
Paramedical services
Vision care
Hospital & medical
Travel emergency
Medical equipment
Independent market accessCompare leading Canadian insurers.
Plan-design flexibilityStructure benefits around workforce and budget.
Renewal analysisReview claims, pricing and plan performance.
Ongoing supportHelp with administration, claims and plan changes.
Why Health Benefits Matter
A valuable benefit employees rely on throughout the year.
Filling a prescription, visiting a physiotherapist or replacing glasses can make health coverage relevant in a tangible way. Help with those bills can make a meaningful difference to employees and their families.
What Health Coverage Can Include
Core protection with room to customize.
Available benefits and plan terms vary by insurer. The categories below are commonly evaluated when employers establish or reassess health coverage.
Paramedical services
Plans may cover services such as physiotherapy, massage therapy, chiropractic care, psychology and other eligible practitioners.
Vision care
Eye examinations, prescription glasses and contact lenses can be included, typically subject to frequency and dollar limits.
Hospital & medical services
Depending on the contract, coverage may include hospital accommodation, ambulance services, nursing, medical equipment and other eligible healthcare expenses.
Travel emergency coverage
Out-of-country or out-of-province emergency medical protection can help employees manage unexpected healthcare costs while travelling.
Flexible health benefits
Identify the expense requiring additional support before deciding whether an HSA, WSA or Cost Plus arrangement is appropriate.
Plan Design
Establish what the health plan needs to achieve.
Identify the expenses and financial risks the plan should address first. Clear priorities provide a basis for assessing a new arrangement or reviewing existing coverage.
Request a Plan Review01
Understand the workforce
Identify practical differences in employee circumstances that could affect coverage needs, such as family responsibilities, location and access to healthcare services.
02
Review how the plan is being used
Review aggregate claims over time to distinguish recurring patterns from isolated expenses before drawing conclusions about the coverage.
03
Compare contract details, not just premiums
Similar rates do not necessarily mean equivalent coverage; drug terms, benefit restrictions and insurer administration may vary considerably.
04
Build for sustainability
Assess whether the employer could maintain the proposed coverage if costs rise at renewal, rather than judging affordability only by the initial premium.
Independent Advice
Make sense of competing offers.
We explain the implications of competing proposals, identify points requiring clarification and help employers assess the trade-offs against their priorities.
Compare Health Benefit OptionsWhat we look at when comparing options
- Coverage levels and reimbursement percentages
- Drug-plan provisions and cost-management features
- Paramedical and vision maximums
- Travel and emergency-assistance provisions
- Administration and employee experience
- Renewal approach, pooling and overall cost structure
Managing Cost
Cost control does not have to mean simply cutting benefits.
Assess whether a proposed saving comes from better pricing, different reimbursement terms or changes in access to treatment. Each has different implications for employees.
Coverage and cost-sharing choices
Compare each proposed adjustment separately, showing the estimated premium effect alongside the change in employees’ out-of-pocket expenses.
CoinsuranceDeductiblesAnnual maximumsCombined limitsEmployer / employee sharing
Prescription drug cost-management
Review how each measure affects covered medications, claim approval and pharmacy reimbursement, including any steps employees must take to obtain coverage.
Generic substitutionDrug formulariesPrior authorizationDispensing-fee limitsPreferred provider programs
Health Benefits FAQs
Questions employers commonly ask.
These responses provide general guidance. The policy in force determines the actual benefits, conditions and restrictions.
What is usually included in group health benefits?
Common categories include prescription drugs, paramedical practitioners, vision care, hospital and medical services, medical supplies or equipment, and emergency travel coverage. The exact benefits and limits depend on the plan.
Can we improve health coverage without increasing every benefit?
Often, yes. Employers can enhance selected areas while making targeted adjustments elsewhere. The appropriate mix will depend on workforce needs, claims patterns and budget.
Why can health plans with similar costs provide different value?
The quoted cost is only one part of the comparison. Policy terms, drug-plan rules, benefit maximums, administration, pooling and renewal methodology can all affect how the plan performs over time.
Can we review our health plan without changing insurers?
Yes. Employers can assess how the plan is structured, funded and administered without initiating an insurer change. The review may confirm that retaining the current carrier is the strongest option.
How do prescription drug claims affect plan costs?
Drug utilization can be a significant component of extended health claims. The impact on rates is shaped by claim volume and cost, the insurer’s pricing approach and how higher-cost claims are pooled.
Get Started
Want to know whether your health benefits could work better?
We can review your current coverage, pricing and plan design—or help you build a new plan from the ground up.