Create a benefit plan that's right for your business
Blue Plus is a solid investment for small to medium sized employers. Blue Plus offers plan design flexibility that enables employers to manage their costs while providing health coverage relevant to their employee's needs. A benefit plan is significant to employee satisfaction since a well designed benefit plan provides them and their family coverage for many health care products and services where the provincial government health plan falls short.
We've made it easy for your business to provide a solid benefit plan with out compromising your budget. Blue Plus offers an affordable and flexible benefit package that will help you attract and retain the best employees for your business. And your employees can enjoy health coverage designed specifically with their needs in mind knowing they are protected by the world's most recognized and trusted name in health insurance.
Blue Plus is ideal for employers who want a benefit plan designed for their business. Employers start with core coverage, and then choose additional benefits to meet the needs of their workforce. It's complete, flexible and affordable.
Benefits for Employers:
- A solid and flexible benefit plan to help attract and retain the best employees
- Easy to understand plan administration kit and forms package
- Access to benefit knowledge and plan design consultation to help manage costs
- Convenient monthly payment plans with pre-authorized debit
- Access to our Business Support Program, offering exclusive discounts on key services for your organizations.
Benefit for Members:
- Convenient pay-direct drugs
- Direct deposit for claim reimbursement
- 24/7 access to claim and benefit information through CARESnet®, our easy to use self-service website
- Award winning call centre and walk-in customer service centre
- Up to 25% savings on medical and vision care products through our Blue Advantage program
- Individual conversion plans if group coverage ends
- Peace of mind knowing they have the most recognized health coverage in the world
Your solution for an affordable and flexible benefit plan
The success of any benefit plan depends on whether it meets the goals for which it was created. There are a lot of things to consider when designing a benefit plan that meets your business needs.
Employers start with core coverage that provides coverage for many health care products and services where the provincial government health plan falls short. Employers can then choose from several additional benefits to meet the unique needs of their workforce. Your costs depend on the core health plan and the additional benefits you select.
Blue Plus has flexibility built in; even the core coverage provides flexible options. There is no overall lifetime maximum* on the core extended health plan and employers can choose the length of the waiting period; the optional deductible and the percentage amount of co-insurance coverage for their plan.
*Certain benefits may include lifetime limits.
Core Benefit Plan
- Prescription Drugs:
Covers up to 100% of prescription drugs from your choice of formulary (Brand name, PharmaCare or Blue Cross formulary). An optional per prescription deductible can also be included on the plan to help contain costs.
- Pay-Direct Drug Card:
Your pharmacist submits your claim electronically. PBC pays the pharmacy your plan's percentage of the prescription cost. Your employees pay the pharmacist the remaining percentage. There is no need to submit a paper claim.
- Registered Therapists and Health Practitioners:
Covers visits to registered massage therapists, physiotherapists, chiropractors, naturopaths, chiropodists, podiatrists, osteopaths, speech pathologists, psychologists, registered dieticians and acupuncturists. You choose a calendar year maximum from $250 up to $500 with additional options to limit dollar amounts for each visit and/or the number of visits
- Hospital Accommodation:
Covers the cost for a semi-private or private hospital room up to $100 per day.
- Local Ambulance:
Coverage for the cost of ambulance. Includes air ambulance and payment for Treat No Transport charges (when an ambulance is called but transport to hospital is not required).
- Private Duty Care Nursing:
Covers private duty nursing care in your home with a Registered Nurse, following the discharge of an acutely ill patient from hospital up to $10,000 per person per calendar year. There is a $25,000 lifetime maximum on this benefit.
- Medical Services and Supplies:
Covers items like casts, crutches, oxygen and oxygen supplies, wheelchairs, hearing aids blood pressure monitors and more.
- Hearing Aids:
Benefit covers $500 per person per 5 calendar years.
Benefit covers custom made orthotics up to $300 per adult per 2 calendar years and $300 per child every calendar year.
- Employee and Family Assistance Program:
Benefit provides toll-free telephone access to confidential short-term counseling, advisory and information service provided by Shepell-fgi for a wide range of personal and work/life issues to employees and dependent family members 24hours a day/7 days a week.
- Second Opinion® Medical Consultation:
When diagnosed with a serious health condition, this benefit provides access to a second opinion from WorldCare International, Inc. WorldCare gives members and their treating physician access to leading specialists in North America’s top-ranked teaching and research hospitals – The WorldCare Consortium®
- Out-of-Country Referral
When a medical treatment is not available in the employee's province of residence, this benefit provides coverage over and above the amount covered by the government health plan for services and supplies on the referral of a Physician and/or Surgeon related to medically necessary treatment. Pacific Blue Cross must pre-approve any expense over $1,000 and the benefit has a $25,000 lifetime maximum.
- Survivor Benefit
A dependent whose coverage would otherwise cease because of the death of the employee will continue to be eligible for benefits without further payment of contributions provided the employee was covered for at least 12 months before death. Coverage continues until the earliest of:
- 24 months after the death of the employee
- The date the covered person ceases to be a dependent other than as the result of the employee's death
- The date the policy terminates
- Life Insurance:
The core benefit Life Insurance is provided to employees only. Benefits are paid to the employee's designated beneficiary. Options include the choice of a flat benefit amount of $25,000 to $100,000 or a multiple of annual salary to a maximum of $250,000 (groups with 4-24 employees) or $500,000 (groups with 10 or more employees).
Additional Life coverage options to cover spouse and dependents are available. (see Life Insurance Options below)
- Accidental death and dismemberment:
Coverage options include the choice of a flat benefit amount of $25,000 to $100,000 or a multiple of annual salary to a maximum of $250,000 (groups with 4-24 employees) or $500,000 (groups with 10 or more employees)
Extended Health Care Options
Vision Care. Choose a maximum up to $300 every two calendar years. Option to include eye exams and/or laser eye surgery under the Vision Care maximum. If eye exams are a separate benefit, choose a maximum from $50 up to $100 every two calendar years.
Dental Plan Options
Blue Plus offers complete flexibility. You can select any or all three categories of dental coverage from Basic, Major and/or Orthodontic services. You also choose your own deductible.
Basic Preventative and Restorative Services Option
The Basic Dental Option covers services for the basic care and maintenance of teeth including procedures to restore teeth to natural and normal function. Eligible expenses include:
- Recall Examinations (several options available)
- Diagnostic expenses
- Preventive treatments
- Restorative treatments
- Periodontal cleaning
- Prosthodontic services
- Oral surgery
You can choose from a range of co-insurance percentages. You also can also choose to include unlimited coverage or a calendar year maximum up to $2,000.
Major Restorative Services Option
The Major Dental Option covers major restorations or replacement of missing teeth, or the reconstruction of teeth where basic restorative methods cannot be used satisfactorily (includes crowns, bridges and dentures). Various coinsurance percentages and plan maximums can be applied depending on the size of your group.
Orthodontic Services Option
The Orthodontic Services Option covers all eligible expenses up to 50%. Eligible expenses include ortho-exams, x-rays, diagnostic radiographs, casts, braces and retainers.
- For groups with 4-9 employees, coverage is available for children only and you choose a $1,000 to $2,000 lifetime maximum.
- For groups with 10 or more employees, coverage is can be selected for children only or for children and adults with a lifetime maximum up to $3,000.
Life Insurance Options
Dependent Life Insurance Option
Dependent Life Insurance can be added as an option to cover your employee's spouse and dependents. Dependent Life is designed to pay for final expenses such as funeral costs. Coverage options are available up to $10,000 for spouse and $5,000 per dependent child depending on your group size.
Optional Life Insurance
Groups with 10 or more employees can offer the opportunity for employees to add additional Life Insurance coverage in units of $10,000 to a maximum of $250,000.
Critical Illness Option
When diagnosed with a life threatening illness, unexpected expenses such as special equipment, private nursing or even childcare can add pressures making it difficult to focus on recovery. You can help employees through a difficult time by providing financial security through a critical illness plan. When it life take a catastrophic turn, the Critical Illness Option provides a lump sum cash payment that can be used to cover private nursing costs, home modifications, childcare costs, or whatever else the employee chooses so the focus can be on recovery.
Coverage options are available up to $50,000 for the employee, $10,000 for spouse and $5,000 per dependent child depending on your group size.
Disability Plan Options
Short Term Disability
Short Term Disability benefits are paid to an employee who, as a result of a non-occupational injury or illness becomes disabled and is unable to perform their job. The benefit provides income replacement up to 75% of salary depending on if the benefit is implemented as a non-taxable or taxable benefit. Several options are available to choose for benefit maximums, qualifying periods and benefit duration.
Long Term Disability
This benefit provides a monthly income (usually to age 65) for employees who become totally disabled due to accident or sickness and are unable to work. The benefit provides income replacement up to 75% of salary depending on if the benefit is implemented as a non-taxable or taxable benefit. Several options are available to choose for benefit maximums, and qualifying periods.
Eligibility / Enrollment Requirements
- Your business must have been operating for at least one year.
- The proportion of employees that are related to each other should not exceed 50%.
- A minimum of four participating employees.
- For 4 to 9 lives, 100% enrollment is required
- For 10 to 24 lives, 90% enrollment is required.
- Employees must work a minimum of 20 hours per week to be eligible for benefits.
- Retirees and individuals employed on a part time, seasonal, casual or contract basis are not eligible.
- Eligibility for coverage is on the first of the month following your choice of waiting period.
- For 4 to 9 employees, 3 to 6 months
- For 10 or more employees, 1 to 6 months
Exceptional Service is included
With a Blue Cross health plan, you're covered by the world's most recognized and trusted health insurance brand. Our people are committed to delivering the Blue Cross service standard that is expected by our members.
We continually look for ways to improve service. Whether it's in person, on the phone or online self-service via CARESnet, our member self-service portal, we deliver service you can be proud of.
Blue Cross members have an advantage
The Blue Advantage® program allows Blue Cross members to save on medical, vision care and many other products and services offered by participating providers across Canada.
The program is unique because it provides savings at point of sale on the total cost of products and services from participating providers, regardless if the item is covered under your benefit plan. Simply present your Blue Cross identification card to the participating provider and mention the Blue Advantage program. Know more. Save more.