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Group Health Benefits
GMS Group Advantage® plans are group benefits specially designed for small and medium-sized companies with 3–49 employees. The value of Group Advantage come from its comprehensive combination of group health insurance, travel insurance, dental coverage, life and disability benefits and critical illness protection.
Our customizable plans are designed with flexible options to suit every need. You can choose from three levels of health, dental, and drug coverage and flexible maximums in our pre-designed plans. Also add life, disability, and popular Health Spending Accounts (HCSA) to your plan.
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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 customers into what the insurance industry calls a “pool” helps us spread risk and keep price changes to a minimum.
Pooled plans help keep costs predictable. Investing in the health and well-being of employees is one of the best decisions a business can make. With hassle-free enrollment and claims processing, you can keep things running smoothly. And with Group Advantage’s off-the-shelf plan design, setup is quick and easy.
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:
Three benefits tiers designed to fit your needs
You can choose from three pre-built Health & Dental plans: Silver, Gold, and Platinum, designed for small and medium-sized businesses. You also have the option to upgrade to Group Advantage Plus to include Life and Disability Insurance, giving you and your employees added security and peace of mind.
Choose from three plan types:
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 Formulary & Non-Formulary Drugs (coverage per person, per year) | 70% of lowest-cost-alternative up to $1,000 | 80% of lowest-cost-alternative up to: Gold 1 - 80% up to $3,000 Gold 2 - 80% up to $10,000 Gold 3 - 80% up to $20,000 | 100% of lowest-cost-alternative up to: Platinum 1 - 100% up to $6,000 Platinum 2 - 100% up to $10,000 Platinum 3 - 100% up to $20,000 |
| Health Practitioners (massage therapist, chiropractor, physiotherapist and more) | $250 combined at 80% | $350 per practitioner at 80% | $500 per practitioner at 80% |
| Mental Health Practitioner (includes clinical psychologists, clinical counsellors, registered social workers and psychotherapists) | $250 combined | $350 combined | $500 combined |
| 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 (air and ground) | $1,500 | Unlimited | Unlimited |
| Casts & Crutches | Unlimited | Unlimited | Unlimited |
| Semi-Private 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) |
| Prosthetic Appliances | $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, 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) |
| Orthopedic Shoes | $50 | $150 | $250 |
| 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
With Group Advantage, you have the flexibility to tailor your dental coverage to what your team needs most. Choose from $500, $1,000, $1,500, or $2,000 in combined annual coverage for preventative, basic, and major dental services. This means your employees can access routine cleanings, exams, fillings, extractions, crowns, and other essential dental treatments with confidence, knowing they’re protected by a plan designed to support both everyday care and more complex procedures.
Choose from three plan types:
What’s Included?
GMS Group Advantage Dental Plans cover all the essential health and dental benefits – and then some.
| 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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GMS Care Network: Around-the-clock care
GMS Care Network is our assistance program available to all Personal Health, Replacement Health, and Group Advantage customers. It's a network of virtual secure services available to you any time, day or night.
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.
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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.
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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Replacement Health Insurance; additional support for Group benefits
If an employee is transitioning off your group benefits plan, Replacement Health Insurance ensures they can maintain similar coverage without interruption. It provides a smooth transition for retirees, departing employees, or anyone taking time away from the workforce.