Extended Health Care Benefits in Group Insurance Plans

December 29, 2016

As we mentioned in previous article, many corporations offer competitive packages, and that’s even a strategy in hiring and retaining employees. These competitive packages include group insurance to plans that provide individual retirement accounts or traditional registered pension plans, etc. In this article, we will discuss fundamental principles of group insurance.

Group Insurance exists for the benefit of the complete group and therefore the individual member is not required to submit medical information. In this article, we will discuss the extended health care benefits in group insurance plan.

Extended health care is a benefit that picks up where basic health plan leave off. It provides an extension for some benefits and provides other benefits not available through the basic plans. The benefits is a supplement of the basic plan benefits until the basic benefit has reached it maximum payout. the core benefits of extended health care plan includes

a) Semi-private or private room accommodation in a hospital.
b) Prescription drugs
c) Private duty nursing
d) Ambulance services and paramedical services
e) Eye and hearing care
f) Dental care such as preventative care, major restoration and orthodontics

Both Health and Dental Care plans may have a deductible of $25 to $50 and /or co insurance factor of 80% reimbursed by the insurance company. Deductible are applied against the first claim of the calender year and co-insurance is applied against each claim. Extended health care may includes a limiting clause resulting in a lower premium being charged for the benefit.

Dental care normally has a maximum benefits that can be charged for each calendar year by each insured member and their dependents, such as $2000. Sometimes there is a different maximum for different levels of care. Please read details in your plan.

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