Recent history in Ontario has underlined the importance of staying on top of your employer group benefit coverage. In particular, prescription drug coverage for Ontarians under 25 has seen two significant changes in just the past 6 months.
The first change was the introduction in January 2018 of OHIP Plus, whereby prescription drug coverage was provided to Ontarians under 25 for the approximately 4,400 drugs that make up the Ontario Drug Benefit program (ODB).
One of the first moves of the new Ontario provincial government has been to amend the program for people covered under group benefit plans. The employer group plan will be the first payer, with the government as the second payer only once group coverage is used up. The effective date of these changes has yet to be announced, but this has clearly been identified as a government priority.
If you are someone covered by an employer group plan, do you know your benefits? Are there limitations as to how much the plan will pay or deductibles that apply? Where couples are involved with both people having group coverage, it will be particularly important to be aware of how to coordinate benefits between plans.
Being knowledgeable regarding your group benefits is not only important in regards to those under 25. If there are limitations to your group coverage it may be that supplemental individual coverage should be investigated. These limitations could be in relation to any component of the group plan.