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Group Health Benefits
GMS Group Advantage® plans are group benefits specially designed for businesses with three to 49 employees. The advantage of Group Advantage comes from a winning combination of group health insurance, dental coverage, and life, disability, and critical illness insurance.
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Pooled product. Honest pricing.
When you choose GMS for group benefits, what you see is what you get: no surprises, no extreme price fluctuations, and everything you need to feel good before, during, and after your workday. Grouping our groups into what the insurance industry calls a “pool” helps us spread out any risk and keep price changes to a minimum.
The GMS Difference
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Comprehensive coverage. You and your team have access to a wide range of essential and bonus benefits like the GMS Care Network
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Convenient processes. Ease is everything. From applying to administering, we designed GMS Group Advantage so you can focus on your business, not your benefits.
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Help when you need it. Have a question about employee health benefits? Our Customer Care team is here to help.
Why buy?
A changing labour market means group health insurance isn’t just a nice to have – it's a must to attract, retain, and take care of your team. We make GMS Group Advantage work for your work.
Business owners choose Group Advantage for:
What’s Included?
GMS Group Advantage plans cover all the essential health and dental benefits – and then some.
GMS Group Advantage Health Plans
| Description | Silver | Gold | Platinum |
|---|---|---|---|
| Prescription Drug Coverage (coverage per person, per year) | 70% of lowest-cost-alternative up to $1,000 formulary & non-formulary drugs vaccines/immunizations | 80% of lowest-cost-alternative up to $3,000 formulary & non-formulary drugs vaccines/immunizations | 100% of lowest-cost-alternative up to $6,000 formulary & non-formulary drugs vaccines/immunizations |
| Health Practitioners
Coverage for acupuncture, massage therapy, chiro, physio, naturopath, speech therapist, chiropody/podiatry
| $250 combined | $350 combined | $400 per specialist per year |
| Counselling Services
Coverage for psychology, social work, psychotherapy, and clinical counselling.
| $250 | $350 | $400 |
| Eye Exams, Glasses, Contact Lenses & Surgery | $60 per 2 years (eye exams only) | $150 per 2 years | $300 per 2 years |
| GMS Care Network
An assistance program where employees can access online resources including virtual doctors, professional counselling, and other health-focused services and information.
| Unlimited short-term services | Unlimited short-term services | Unlimited short-term services |
| Travel Coverage |
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| Survivor Benefit
Coverage for eligible dependants after plan member's death
| 12 months | 12 months | 12 months |
| Diabetic Supplies & Equipment | $300 | $300 | $500 |
| Oxygen Equipment | $500 | $500 | $500 |
| Custom Foot Orthotics |
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| Ostomy Supplies | $300 | $300 | $300 |
| Ambulance | $1,500 | Unlimited | Unlimited |
| Air Ambulance | Unlimited | Unlimited | Unlimited |
| Casts & Crutches | Unlimited | Unlimited | Unlimited |
| Preferred Hospital Rooms | Unlimited | Unlimited | Unlimited |
| Private Duty Nursing | $2,500 | $2,500 | $5,000 |
| Accidental Injury to Natural Teeth | $2,000 per injury | $2,000 per injury | $2,000 per injury |
| Wheelchairs, Motorized Scooters & Hospital Beds | $500 per policy (every 5 years) | $500 per policy (every 5 years) | $500 per policy (every 5 years) |
| Artificial Limbs, Eyes & Larynx | $10,000 lifetime maximum | $10,000 lifetime maximum | $10,000 lifetime maximum |
| Patient Walkers | $200 per policy (every 3 years) | $200 per policy (every 3 years) | $200 per policy (every 3 years) |
| Breast Prosthesis | 1 (lateral) or 2 (bilateral) every 2 years | 1 (lateral) or 2 (bilateral) every 2 years | 1 (lateral) or 2 (bilateral) every 2 years |
| Health Supplies & Equipment
Covers things like wigs, splints, compressors, braces with metal parts, trusses, rib belts, sacroiliac corsets, embolic stockings, aero chambers, and more.
| $500 combined | $500 combined | $500 combined |
| Out-of-Province Referral (within Canada) | Not included | $50,000 lifetime | $50,000 lifetime |
| Hearing Aids | Not included | $500 (every 5 years) | $500 (every 3 years) |
| Therapeutic Shoes | Not included | $200 | $200 |
| Blood Pressure Monitor | Not included | Not included | 1 per policy per 5 years |
Coverage is per person. This is a summary of benefits only.
GMS Group Advantage Dental Plans
Choose between $500, $1,000, $1,500, or $2,000 combined coverage maximums for preventative, basic, and major dental services.
| Benefit | Silver | Gold | Platinum |
|---|---|---|---|
| Preventative Services
Covers things such as cleaning, polishing, topical fluoride treatment, and more.
| 80% coverage
| 100% coverage
| 100% coverage
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| Basic Services
Covers things such as exams, x-rays, root canals, denture repair, and more.
| 80% coverage
| 100% coverage
| 100% coverage
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| Major Services
Covers things such as bridges, crowns, full or partial dentures, inlay and onlays, and more.
| Not included | 50% coverage
| 80% coverage
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| Orthodontic Services (for children under 18 years of age) | Not included | Not included | 50% coverage ($1,500 lifetime maximum) |
Coverage is per person. This is a summary of benefits only.
GMS Group Advantage Plus
Give your business an even bigger advantage with optional coverage through Group Advantage Plus.
| Benefit | Coverage Options |
|---|---|
| Life Insurance and Accidental Death and Dismemberment (AD&D) | Choose from $10,000, $25,000, $50,000, or 1 x annual salary (varies by salary) |
| Dependant Life Insurance | Choose between $5,000 (spouse) and $2,500 (dependants) or $10,000 (spouse) and $5,000 (dependants) |
| Traditional Critical Illness | Comprehensive coverage for up to 25 critical illnesses including heart attack, kidney failure, or benign brain tumour Choose between $10,000 or $25,000 (only available to groups of six – 49). |
| Dependant Traditional Critical Illness | Choose between $5,000 (spouse) and $2,500 (dependants) or $10,000 (spouse) and $5,000 (dependants) |
| High Severity Critical Illness | Coverage for up to 9 critical illnesses including critical strokes, late-stage cancer, or severe dementia Choose between $10,000 or $25,000 (only available to groups of six – 49) |
| Dependant High Severity Critical Illness | Choose between $5,000 (spouse) and $2,500 (dependants) or $10,000 (spouse) and $5,000 (dependants) |
| Short-Term Disability |
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| Long-Term Disability |
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| Second Medical Opinion | Available to employees, spouses, and dependants. Access a Canada-wide network of second medical opinion specialists to review patient files, verify diagnoses according to up-to-date practice guidelines, and confirm or propose modifications to the suggested treatment plan as required. |
This is a summary of benefits only. Please refer to the policy for complete details. GMS Group Advantage Plus Life & Disability options underwritten by Assumption Life.
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Set a new standard for a healthy work-life balance.
We make buying group benefits easy – honestly. Fill out our GMS Group Advantage quote form and someone from our Group Sales team will get you a quote within two business days.
Frequently Asked Questions (FAQs)
- Is GMS Group Advantage open to companies of any size?
Right now, we only offer GMS Group Advantage benefit plans to companies with three to 49 employees.
- Can I choose which benefits I include in my group health plan?
We designed GMS Group Advantage with a focus on consistent, reliable rates and comprehensive coverage. Most of the benefits are pre-selected, but you can choose between our Silver, Gold, and Platinum plans based on what you think you and your team need. You can also decide to add life, disability, critical illness benefits, and more.
- How do Health Care Spending Accounts (HCSA) work?
As an employer, you choose the HCSA amount your employees get each year, from a minimum of $250 per employee all the way up to $15,000. You can even set different amounts for different employee groups (managers versus staff, for example). Once you’ve set up your HCSA, employees can send claims for reimbursement just like they would any other benefits. We’ll make sure those claims are eligible, reimburse the employee, and send you a monthly invoice for the total cost of claims plus a 10% administration fee and any applicable taxes.
- What kinds of medical expenses are non-taxable?
We’re glad you asked. The Canada Revenue Agency keeps a list of expenses eligible for HCSA coverage. Common examples include things like prescription eyeglasses, prescription drugs, and dental services.
- Can my employees submit claims online?
You bet. Encourage your employees to sign up for a My GMS account; once they do, they can submit claims, track claim payments, sign up for direct deposit, and get more information about a claim through their Explanation of Benefits.
Don’t see your question here? Check out our full list of group health insurance FAQs or contact us and we’ll get you an answer.
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Looking for a resource?
Check out the GMS Resource Hub for forms and other helpful information about group health insurance and group benefits.