Traditional health benefit plans are the most familiar option for many Edmonton businesses when they think about employee health insurance. With these plans, an insurance carrier provides a defined set of coverages at a predictable monthly cost, making budgeting and long-term planning easier for employers.
Traditional benefit plans typically offer broad coverage, including prescription drugs, dental care, vision benefits, paramedical services, and extended health services. These plans often become more cost-effective as the size of the employee group increases, making them a strong solution for growing businesses in Edmonton and across Alberta. Depending on the insurance carrier and group size, traditional health benefit plans may be structured as experience rated or pooled arrangements, each with different cost and renewal considerations. All traditional plans renew annually, allowing businesses to review coverage, pricing, and plan performance on a regular basis.
At Summit Benefits, traditional benefit plans can be custom quoted based on the size and needs of your organization. Employers can choose from a range of plan designs and coverage options offered by leading carriers, ensuring the plan aligns with both employee expectations and business objectives.
Micro Business products for groups under 10 employees typically come as pre-built options. These plans can be taken with little to no customization and service as a good starting point for benefits.
If your company is small and new to business, Pre-Built Plans can serve as a good starting point.
To help clients get a better sense of the types of plans available, Summit has prepared 3 standard plan options based on the company size. These plan designs can help provide a launching off point for a business looking for benefits between 5-25 staff. By standardizing the plan designs to what we see across hundreds of small business, we hope to find the most competitive offerings in the market.
For larger business of 10 or more staff, we can help tailor the benefits plan to you. We can craft customizable plans to meet your organizations need, quoting the plan design you want, and the coverage you need.
With benefits we can customize many aspects of the plan, to align with the benefits you want to provide to the staff.
Traditional Style Plans fall on a spectrum of pooled vs experience rated regarding the rate structure.
Pooled plans tend to be more stable for small groups, with lower increases at renewal.
Pooled Plans tend to be the most expensive plans when signing up for benefits.
Unlike Experience Plans, Pooled Plans work blind, where experience or claims is not known. Instead the carrier bases the renewal based on the performance of the pool, or all the Firms on the plan.
These plans tend to be more stable then experience rated plans, as the law of large numbers should normalize any claims irregularities.
Pooled plans work similar to Auto or Home insurance.
Partial Pooled Plans are a balance between Experience Rated and Pooled Plans.
Carriers put the firms into buckets based on the experience and then apply the renewal adjustments to the whole bucket.
Partial Pooled Plans tend to be more stable then Experience Rated groups, but don’t provide the stability when a firm has catastrophic claims.
Pooled plans are relatively new to the market compared with Experience Rated Plans and Pooled Plans.
Experience Rated plans are sometimes called Traditional Plans.
At Renewal the Carrier looks at the groups Claims and Premiums and compares it to their breakeven.
Based on where the group falls on their experience, will dictate how the rates are changed renewal.
Experience Rated plans tend to fare better for larger groups, as they have a larger spread of risk, and are able to balance their claims over a long period of time.
Many business owners are looking for something customizable to their needs and predictable with costs.
Health Spending, and Wellness/ Lifestyle spending accounts provide an option for business as either a standalone or add-on option.
Health Spending Accounts can be used to write off eligible medical expenses through the corporation for the employees.
Employees have to be given a maximum amount for a period, which they either lose at the end of the period or can carry forward for one year.
Eligible Expenses are defined by CRA with the Medical Expense Tax Credit or METC being a good rule of thumb for what is included.
Similar to Health Spending, Lifestyle or Wellness Spending is a set dollar amount for employees to use.
Where Health Spending is defined by CRA, wellness is not. Wellness has a much broader definition, including gym memberships, sports fees, etc.
Unlike Health, Wellness is taxable to the employees but it is still a write off for the business with the list of benefits completely customizable.
With Spending Accounts, the third option is the combination of Health and Wellness.
Under a Flex account, employees have to choose each period (year) what amount they want to allocate to Health and what to Wellness. Employees are locked into this allocation for the year, but will able to reallocate new funds at the beginning of the next period.
Flex accounts provide the ultimate flexibility to members.
Over the years we have worked with many businesses setting up group health benefit plans and have encountered many of the same questions. For your convenience, we have listed below a few that we hear most often. If you have other questions, please feel free to reach out to us and we’d be more than happy to answer them for you.
A traditional group benefit plan is an employer sponsored health insurance plan that provides defined coverage for employees such as prescription drugs, dental care, vision benefits, and extended health services at a predictable monthly cost.
The cost of a traditional group benefit plan depends on factors such as group size, employee demographics, plan design, and coverage levels. In general, larger groups tend to receive more competitive pricing due to shared risk.
Traditional group benefit plans commonly include prescription drugs, dental care, vision coverage, paramedical services, hospital coverage, and employee assistance programs. Coverage can be customized based on employer needs.
Experience rated plans are priced based on a company’s claims history, while pooled plans spread risk across multiple employers. The best option depends on group size, claims stability, and long term cost objectives.
Yes. Many insurance carriers offer traditional group benefit plans specifically designed for small and mid sized businesses in Edmonton, with flexible plan designs and cost sharing options.
Yes. Employers can customize coverage levels, cost sharing, and optional benefits to align with business goals, employee needs, and budget considerations.
Summit Benefits works with Edmonton businesses to compare carriers, design tailored benefit plans, manage renewals, and ensure long term value for both employers and employees.
Alberta Blue Cross is the largest carrier for Individual Products in Alberta
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A Health Spending Account (HSA) lets incorporated small business owners pay for personal health and dental expenses using pre-tax business dollars.
It works like a health expense reimbursement plan—your corporation pays for eligible medical expenses, and the cost becomes a tax-deductible business expense. The reimbursement is tax-free to you.
100% tax-deductible to your business
Tax-free benefits for you
More flexible than traditional insurance
No monthly premiums
To setup a Health Spending Account, you need to either have a Corporation which you are an employee (drawing T4 or taxable income), or be a Sole Proprietor with at least one arms length employee. This would be an employee who is not related to you.
