Understanding the new federal EI sickness benefit program
The federal government has confirmed that it will be extending the EI sickness benefit program from 15 weeks to 26 weeks, effective December 18, 2022.
What this means for employers:
- Plan sponsors are under no legal obligation to change their plans to align with Bill C-30
- If your STD (Short-Term Disability) benefit is registered with the EI Premium Reduction Program (PRP), the government hasn’t yet provided any details about the new qualification criteria for the PRP or the transition period. However, they will introduce a legacy clause to give plan sponsors enough time to make the necessary changes to their plans to ensure they remain eligible for it.
The change from 15 to 26 weeks may provide an incentive for some groups to make changes to their STD and/or LTD plan design depending on:
- The type of STD benefit they offer
- The length of their maximum STD benefit payment period
- The length of their LTD waiting period
Contact a member of the Bridgewell team if you have questions about the new EI sickness benefit changes, or to review your group benefits plans.
The Canada Dental Benefit is open—but it won’t impact your group benefits coverage
The federal government has committed to providing dental care in the form of the Canada Dental Benefit for uninsured Canadians with adjusted net family income of less than $90,000 annually.
While a positive development for families across Canada that lack dental coverage, it’s important to note that the Canada Dental Benefit is intended to serve only the lowest-income households. Private paid dental plans are still a vital tool for employee attraction and retention tool—and will not be replaced by the basic coverage the federal government is providing. Furthermore, offering a robust dental plan will help position your organization as an employer of choice. For that reason alone, it’s worth maintaining and continually enhancing dental coverage within your group benefits package.
What you need to know about the Canada Dental Benefit
The program will provide eligible parents or guardians with direct, up-front tax-free payments to cover dental expenses starting with children younger than 12-years-old in 2022. Under the new benefit:
- $650 would be provided for each eligible child if the family’s adjusted net income is under $70,000
- $390 would be provided for each eligible child if the family’s adjusted net income is between $70,000 and $79,999
- $260 would be provided for each eligible child if the family’s adjusted net income is between $80,000 and $89,999
To access the Canada Dental Benefit, parents or guardians of eligible children would need to apply through the Canada Revenue Agency website. In addition, they would need to attest that:
- Their child does not have access to private dental care coverage
- They will have out of pocket dental care expenses for which they will use the Benefit
- They understand they will need to provide documentation to verify out of pocket expenses occurred (e.g. show receipts), if required
The Canada Dental Benefit would not reduce other federal income-tested benefits such as the Canada Workers Benefit, the Canada Child Benefit, and the Goods and Services Tax Credit.
Travel reminder as we head into the holiday season
Are your employees planning to travel outside of Canada this holiday season?
Your group plan’s out-of-country coverage is designed to provide benefits during a medical emergency while you or your dependents are temporarily outside Canada for business, education or vacation. The definition of an out-of-country medical emergency will depend on the specific terms of each group plan. These are some examples of what might be considered a medical emergency:
- A sudden, unexpected injury
- An acute episode of a medical condition that was not identified or being treated prior to departure from Canada
- An unexpected and unforeseen acute episode of a previously identified medical condition that was stable and controlled at the time of departure from Canada
In assessing whether a previously identified medical condition is stable and controlled at the time of departure, the insurer may consider whether, within three months prior to your departure:
- You’ve had any new medications or changes in dose
- Your doctor has prescribed or recommended any medical, surgical or diagnostic procedures for you
- Your medical condition has worsened
Out-of-country coverage generally covers expenses associated with the initial treatment of a medical emergency, such as doctor fees, lab fees and hospital fees. Here are some examples of out-of-country expenses that may not be covered:
- Non-emergency care or follow-up care after the initial emergency treatment
- Expenses related to pregnancy or delivery after the 34th week of pregnancy or at any time prior to the 34th week if the patient’s Canadian physician considers the pregnancy to be high-risk
- Continued medical care following an emergency outside Canada if the patient’s medical condition permits a return to Canada for treatment
How out-of-country coverage differs from travel assistance
Out-of-country coverage is sometimes confused with travel assistance. These are two separate types of coverage. Out-of-country coverage provides benefits for the medical costs associated with a medical emergency, such as doctor, hospital and lab fees.
Meanwhile, your plan’s travel assistance coverage includes such services as 24-hour-a-day, seven-day-a-week access to coordinators who can direct you to an appropriate healthcare facility or assist with travel arrangements following a medical emergency. Most plans do not include coverage for trip cancellation, trip interruption or loss or damage of baggage.
In case of a medical emergency
If you experience a medical emergency while outside Canada, call the number on your travel assistance card (if your group plan provides travel assistance service). The assistance company will help arrange for appropriate medical care, verify your insurance coverage and provide necessary assistance, such as flight, hotel accommodation and vehicle return.
For more information on our group benefits solutions, contact a member of the Bridgewell team.