It's more important than ever to have competitive health benefits that provide your employees with the coverage and services they want and need. That's why we offer Equitable EZBenefits: a unique benefits solution for organizations with 2-25 employees.
Cost controls keep your plan's pricing stable so you can provide employee benefits for years to come
Equitable EZBenefits offers a range of plan design options - Bronze, Silver, Gold and Platinum - for every need and budget.*
Our plan design options include a mix of Life, Health and Dental coverage.**
You can also add any of these benefits if it makes sense for your employees:
We want to provide your employees with added support for both their physical and mental wellbeing.
We've designed EZBenefits to provide long-term pricing stability for health and dental benefits. We've considered the impact that small fluctuations in claims experience can have on rates, to help maintain price stability.
We work hard to control costs so that your plan stays affordable and sustainable.
We want to take the heavy lifting out of common human resources tasks and provide you with extra HR advice and support.
With EZBenefits, you get HR support tools and services through our partnership with Citation Canada® (formerly HRdownloads), including:
As a mutual insurance company, you'll find we aren't like other group benefit providers.
Our only focus is our clients – not shareholders. That means we can provide you and your plan members with a better benefits experience.
‡2022 NMG Group Benefits Study.
| BENEFIT | BRONZE | SILVER | GOLD | PLATINUM |
| Deductible | No deductible | |||
| Coinsurance | 70% | 70% | 80% | 100% |
| DRUGS | ||||
| Formulary | Standard Mandatory Generic Formulary (TELUS Plan 88 GA). Reimbursement is limited to the amount of the lowest cost alternative medication, typically a generic drug. |
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| Dispensing fee cap | $8 | No dispensing fee cap | ||
| Annual drug maximum | $5,000/ year | $25,000/ year | $100,000/ year | $100,000/ year |
| OUT-OF-PROVINCE/COUNTRY COVERAGE | ||||
| Coverage limits | 100% coverage of eligible emergency medical expenses up to a lifetime maximum of $5 million |
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| Trip limit | 90 days | |||
| PROFESSIONAL SERVICES | ||||
| Paramedical practitioners (e.g. physiotherapists, massage therapists, chiropractors, etc.) | No coverage | $300/ practitioner/ year | $500/ practitioner/ year | $500/ practitioner/ year |
| Mental health practitioners* | $500/ year | $800/ year | $1,000/ year | |
| MEDICAL SUPPLIES | ||||
| Surgical stockings | No coverage | $250/ calendar year for eligible expenses | ||
| Orthotics/ orthopaedic shoes | $350/ calendar year for combined eligible expenses | |||
| Hearing aids | $500 for each consecutive 60-month period | |||
| Other standard inclusions | E.g. prosthesis, wigs and hairpieces, wheelchairs, colostomy supplies, etc. |
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| MAJOR SERVICES | ||||
| Private-duty nursing | No coverage | $10,000 per calendar year | ||
| Ambulance | Based on reasonable and customary costs for region where services are obtained |
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| Convalescent home services | $40 per day for a maximum of 180 days per disability | |||
| VISION | ||||
| Eye exams | No coverage | Once every two years | ||
| Lenses/ Frames/ Contacts | No coverage | $200/ year | $250/ year | |
| HOSPITAL | ||||
| Hospital accommodation | No coverage | 100% coverage for semi-private accommodation | ||
Extended health care benefits include two years of coverage for eligible surviving dependents. Benefits terminate at age 70. All claims are subject to Equitable Life’s reasonable and customary amounts for the necessary services, supplies, products and appropriate treatments being claimed.
* Maximum is combined for all mental health practitioners
| BENEFIT | BRONZE | SILVER | GOLD | PLATINUM |
| BASIC AND RESTORATIVE (e.g. dental exams and fillings) | ||||
| Deductible | No coverage | No deductible | ||
| Coinsurance | 70% | 80% | 90% | |
| Annual maximum | $1,500/ year/ patient | $2,000/ year/ patient combined with Major Restorative | $2,500/ year/ patient combined with Major Restorative | |
| Recall exams | Every 9 months | Every 6 months | Every 6 months | |
| Scaling (i.e. cleaning) | 8 units/ year | 8 units/ year | 10 units/ year | |
| Fee guide | Current | |||
| MAJOR RESTORATIVE (e.g. bridges and crowns) | ||||
| Coinsurance | No coverage | 50% | 50% | |
| Maximum | No coverage | $2,000/ year/ patient combined with Basic and Restorative | $2,500/ year/ patient combined with Basic and Restorative | |
Dental benefits include two years of coverage for eligible surviving dependents. Benefits terminate at age 70.
| BENEFIT | BRONZE | SILVER | GOLD | PLATINUM |
| Basic Life/AD&D | $25,000 | $50,000 | $75,000 | |
| Optional Life | Coverage available in units of $10,000 up to a max of $250,000 | |||
| Dependent Life | $5,000/ $2,500 from live birth |
$10,000/ $5,000 from live birth |
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Basic Life and AD&D benefits reduce to 50% at age 65. No medical questionnaire is required for Basic and Dependent Life benefits. All Life and AD&D benefits terminate at age 70 and include Waiver of Premium (the plan member’s life insurance premiums are waived if they become disabled).
| BENEFIT | BRONZE | SILVER | GOLD | PLATINUM |
| Graded schedule | 67% for the first $3,750 of monthly earnings, 50% of the remainder up to a maximum of $7,500 | |||
| Waiting period | 17 weeks | |||
| Tax status | Non-taxable | |||
| Non-evidence limit | $5,000 | |||
| Definition of disability | 2-year own occupation | |||
LTD benefits include Waiver of Premium and terminate at age 65.
| BENEFIT | BRONZE | SILVER | GOLD | PLATINUM |
| Allocation amounts | Plan Sponsor choice | |||
| Type | Use it or lose it | |||
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One Westmount Road North
P.O. Box 1603, Stn Waterloo
Waterloo, Ontario N2J 4C7
Phone: 519.886.5110
Toll Free: 1.800.722.6615
www.equitable.ca
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