What to consider when workplace benefits are disappearing
Workplace health and dental benefits don’t get as much love as they should.
To borrow a line from a 1980s hair band lyric – you don’t know what you’ve got, till it’s gone.
Or nearly gone.
Such is the case from a reader lately (I’ve changed the names) about their health and dental benefits. See their questions and concerns summarized below.
My husband (Bob) and I are retiring from full-time work within the next six (6) months at age 55. We can’t wait!!
However, when we retire from work, our workplace benefits (drug, dental and other healthcare coverage benefits such as long-term disability) as part of our group healthcare benefits will cease to exist. This is a scary thought. We’re considering various options now including health insurance using medical underwriting plans or going with a group conversion plan but we really don’t understand what all this means in terms of coverage or benefits. Can you help?
Thanks so much for your site and blog.
No doubt thousands of Canadians when they retire are in the same boat.
I have full confidence some passionate readers might also be able to provide some guidance based on what they have done.
Since I’m versed although not a pro in this area, I decided to reach out to someone who is. Enter Brian So, a fan of this site, a life insurance agent who runs his own site, and helps Canadians with these insurance needs and more every day.
- Brian – what options should Bob and Tisha consider now that they are stranded without any healthcare plan?
That’s a great question Mark. It can be scary relying on group benefits your entire working life and then suddenly losing them. Fortunately, they have several options.
If they are still in relatively good health, they can purchase a medically underwritten plan. This will give them the most choice in terms of the level of coverage they want. They would have to complete a medical questionnaire and any existing medical conditions will be reviewed by the insurance company to verify if they will be covered. And because the plan is medically underwritten, it will have the lowest premium out of all their options.
If their health has deteriorated, they can opt for a group conversion plan. This lets them get coverage without completing a medical questionnaire or exam. But they must apply within 60 days of the end of employment to qualify.
If they pass the 60-day deadline (associated with the group conversion plan), and they have chronic health issues making them ineligible for the medically underwritten plan, they would have to settle for a guaranteed acceptance plan. This is the least preferred choice with the most limited coverage and higher premiums. (They should try and avoid this type of plan if they can in my opinion.)
- Brian – is there an option to ‘opt-in’ to any healthcare coverage without any medical exam? Say, within 30 or 60 days of workplace benefits coverage eliminated? What are the pros and cons of this? Also, should our readers be concerned with the underwriting process in that they were covered under many healthcare benefits from their group plan but now, might not be?
Mark, (and for Bob and Tisha), this would fall under the group conversion plan described above.
The advantage of this plan is it gives them guaranteed coverage without a medical questionnaire or exam – same as when you joined your place of employment.
Treatment related to existing medical conditions is covered since they don’t have to answer any medical questions. Plus, they can also start using the plan immediately, instead of having to satisfy a waiting period like with the medically underwritten plan.
The downside of the group conversion plan is you have to apply quickly since there’s a deadline of 60 days after employment ends. The premium is also higher than the medically underwritten plan.
- Brian – I’ve assumed Bob and Tisha want to travel a bit or enjoy new experiences in their 50s and 60s during their “GO-GO” retirement years as some people call this phase. Is there specific coverage they should be looking at?
Because provincial health insurance only covers a tiny portion of health care costs while they are outside their province, they should strongly consider travel insurance from a private insurer. This can be an add-on to their existing healthcare plan or it can be a standalone coverage.
For our new 50-something retirees, I would suggest they get an annual multi-trip plan that covers them for an unlimited number of trips out of the country for the year. Such a plan will cover medical emergencies with a limit of $5,000,000 or $10,000,000.
Insurance companies will have a choice of maximum trip length for multi-trip plans, so they should match it up to their longest expected trip – say 15-days or 21-days, and so on. If their longest trip exceeds the maximum trip length of their plan, they can always buy a single trip policy to extend their coverage.
For example, if they choose a 15-day multi-trip annual plan and they take a 3-week vacation, they can top-up their coverage with a 6-day single trip policy.
- Brian – let’s talk money. What might the typical cost for a healthcare plan be? Let’s assume both Bob and Tisha are non-smokers, in good health. Should they be concerned their premiums might rise over time?
I ran some quick numbers for them.
For a 55-year-old couple:
- A medically underwritten plan will cost $264/month.
- A group conversion plan will cost $410/month.
(Both of these quotes are from Pacific Blue Cross, just for an example. (No affiliation by My Own Advisor.) There are many other carriers.)
The healthcare plans cover:
- 80% of the cost of prescription drugs up to a maximum of $5,000 per person per year.
- 80% of basic dental services up to a maximum of $1,200 per person per year with 2 recall visits per year.
- 50% of major restorative services.
- 50% of orthodontics.
- $300 per person every 2 years for vision care.
- $500 per person per year for registered therapists and health practitioners (physiotherapists, chiropractors, etc.).
- $5,000 per person per year for medical services and supplies not covered by government plans.
- Miscellaneous benefits such as private duty nursing care, accidental death & dismemberment, etc.
Some of these limits begin at a lower amount in the first year and gradually increases to reach the maximum after 4 years.
For the second part of the question, while the premium isn’t guaranteed and can increase every year, they shouldn’t worry about a substantial increase in premium. It usually goes up only a few dollars per year and everybody in their age group is affected so they don’t have to worry about being singled out for using their plan excessively.
- Brian – I always like to provide readers with insight on where they can learn more – for free. Any websites (no affiliation) that offer great comparison quotes for personal healthcare plans for retirees? Any particular companies that you feel, personally, offer a good bang-for-buck? Again, no affiliation?
All good Mark, re: no affiliation.
I like to use Kanetix.ca for my research since it searches several insurance companies and has a user-friendly interface. The list isn’t comprehensive though, so I always check the individual insurance company’s website (and use my own software) for a more thorough list.
As for the second part of your question, I believe Pacific Blue Cross offers the best bang for your healthcare buck (again, no affiliation – just an example). It gives you the choice of either basic or enhanced coverage for dental and prescription drugs and it offers the most competitive premium amongst all providers. Plus, it’s a not-for-profit organization so all the profits are reinvested back into the business for the benefit of its members.
- Brian – should prospective retirees consider working with an insurance broker (at no cost to them) to find the best personal healthcare plan? Why or why not?
Great question Mark.
Really, there are 2 types of people: those who like to do the research themselves to make sure they have the right plan, and those who would rather save some time and work with an insurance broker to find them the right coverage.
The right answer to your question depends on what type of person you are.
I suspect many readers of your blog are the DIY-type or they want to be the DIY-type so they would enjoy doing the research. But even if they are, they should still check with an insurance broker to see if they are getting the best plan. And whether they go through an insurance broker or buy it themselves, it still costs the same, so it doesn’t hurt to have a second opinion. Besides, an insurance broker can provide ongoing service related to the healthcare plan or other insurance products.
Great stuff Brian and I think this post will help many retirees in this situation.
If you have questions for Brian, he’ll be happy to answer them below on this site and keep the conversation going. Alternatively, if you have a specific set of questions for him – don’t hesitate to reach out.
Brian So is a life insurance agent based in beautiful Vancouver, British Columbia. He runs Brian So Insurance (no affiliation) and is committed to helping his clients find the best coverage for their needs. He takes a holistic approach to insurance, implementing life, disability, critical illness, healthcare and long-term care insurance into his clients’ risk management plan to provide comprehensive coverage for their families.
How are you navigating your loss of workplace benefits? What is that costing you? Did you factor that into your retirement budget and plans? Let me know and share in a comment below.