Group Conversion Health and Dental

When your situation changes, we're here for you.

If the health and dental insurance coverage provided by your employer is about to end or has recently ended, we've designed a plan that offers you the opportunity to continue to receive the security you're used to.

Group Conversion lets you continue health and dental coverage without interruption so you and your family can enjoy the peace of mind that comes from knowing you're protected from the financial hardship of unexpected health costs.

Your group plan doesn't even need to have been provided by Blue Cross. Group Conversion is available for the initial transfer from any recognized Canadian group benefits plan within 60 days as long as you have been covered for at least 6 months under a group plan. And there's no need to complete a medical questionnaire, so there's no need to worry about prescription medications that you're already taking.

Group Conversion plan is the right option for:

  • Workers who are retiring
  • Employees who are moving from full-time to part-time and are no longer eligible for benefits
  • Workers who have been laid off
  • Workers who leave a group plan to pursue self-employment
  • Workers leaving employment who have existing medical concerns
  • Overage dependents that are no longer eligible for coverage under their parents group plan

What does Group Conversion provide?

Group Conversion is an individual plan. While coverage may not exactly match what you had with your group plan, it will give you peace of mind knowing you can continue to get the care similar to what you're used to at an affordable price.

Unlike other individual plans, Group Conversion covers pre-existing* conditions and allows you to bypass the medical questionnaire. We also waive the no claims waiting periods for dental and vision care benefits.

The plan covers 80% of eligible expenses up to a lifetime maximum of $250,000 per covered person.

*If you have no pre-existing condition(s), it may be more economical for you to opt for our standard Group Plan .

Plan Highlights

Group Conversion consists of a core health plan with prescription drug and dental coverage options so you can choose the coverage you need.

Core Health Plan

  • Vision Care
    Pacific Blue Cross covers the cost of prescription lenses, frames, contact lenses and laser eye surgery up to
    First 24 months 25-48 months 49 months +
    $75 per person $100 per person $250 per person
    $30 for optometrist $50 for optometrist $70 for optometrist
  • Registered Therapists and Health Practitioners
    Benefits are paid for visits to: naturopaths, massage therapists*, physiotherapists, chiropractors, speech pathologists, chiropodists/podiatrists, osteopaths, psychologists, audiologists, acupuncturists, and registered dieticians* up to:
    First 24 months 25-48 months 49 months +
    $300 per person per year $400 per person per year $500 per person per year
    $25 per visit $25 per visit $25 per visit
  • Hospital Accommodation
    Benefits cover costs for semi-private or private hospital rooms (no age restrictions).
  • Hospital Daily Cash Benefit
    If you are confined to a hospital, we will pay you $20 a day, for up to 90 days, from the 4th day of hospitalization, up to age 65.
  • Local Ambulance
    Benefits cover the cost of ambulance fees in emergencies, including air ambulance and Treat No Transport.

    Includes payment for Treat-No-Transport, charges for treatment when an ambulance is called to the scene of an accident or place of illness and transportation to hospital is not required.
  • Private Duty Care Nursing
    Benefits cover the cost for private duty care nursing in your home, provided the nurse is a Registered Nurse(RN) and care begins immediately following the discharge of an acutely ill bed patient from a hospital up to:
    First 24 months 25-48 months 49 months +
    $1,200 per person per year $2,500 per person per year $5,000 per person per year

    * Palliative care services and the services of an RN to assist with activities of daily living are not covered.

  • Out of Province, In-Canada Travel
    Benefits cover 100% of Out-of-Province and In-Canada medical emergency care.
  • Medical Services and Supplies
    Benefits cover supplies and services not covered by government plans up to:
    First 24 months 25-48 months 49 months +
    $1,200 per person per year $2,500 per person per year $5,000 per person per year
  • Accidental Dental
    Benefits cover up to $2,500 per person for accidental damage to natural teeth.
  • Accidental Death and Dismemberment
    Benefits cover the principal sum up to $25,000 (under the age of 70).
  • Final Expense Benefit
    Benefits cover up to $3,000 for each person.
  • Survivor Benefit
    Benefits begin 12 months following approval of application.

Enhanced Prescription Drug Option

The Enhanced drug option covers 80% of the cost of PharmaCare-eligible prescription drugs, plus prescriptions that are not eligible under the government PharmaCare plan. Drugs used for birth control are eligible.

First 24 months 25-48 months 49 months +
$1,000 per person per year $2,000 per person per year $5,000 per person per year

The Enhanced drug option includes a Direct Pay Drug card. With a Direct Pay Drug card, your pharmacist submits your claim electronically. PBC pays the pharmacy 80% of your prescription cost, and you pay the pharmacist the remaining 20%. There is no need to submit a paper claim.

Dental Options

Dental coverage can be purchased as an option to your Group Conversion plan: Both the Essential and Enhanced options provide a sliding scale for reimbursement. Like the prescription drug option on the extended health plan, the longer you have coverage, the more coverage you enjoy.
First 12 months 13-24 months 25 months +
Reimbursement percentage 70% Basic
*50% Major, Dentures & Orthodontics
80% Basic
*50% Major, Dentures & Orthodontics
80% Basic
*50% Major, Dentures & Orthodontics
Annual combined maximum $500 per person $750 per person $1000 per person

*applicable to Enhanced Dental Option only


Essential Dental Plan Option
The Essential dental plan covers eligible expenses up to a predetermined maximum. Eligible expenses include:
  • Diagnostic expenses (oral examinations, x-rays)
  • Preventive treatments (polishing, fluoride treatments)
  • Restorative treatments (fillings)
  • Periodontal cleaning (scaling and root planing)
  • Prosthodontic services (repairs & minor services only)
  • Oral surgery (routine extractions)

In addition, the plan covers emergency treatment of the above services while temporarily outside of BC or the Yukon. There is no financial limit on the amount that will be paid for the services covered over the lifetime of the plan.

Enhanced Dental Plan Option

The Enhanced dental plan covers all of the Essential dental benefits with the addition of endodontics and major restorative services, up to a combined predetermined maximum.

The plan covers 50% of eligible expenses. The maximum amount payable for major restorative, orthodontic and denture services is limited to $500 for each covered person per year.

Additional eligible expenses include:
  • Major Restorative services (crowns, bridges, inlays and onlays)
  • Endodontics (root canals)
  • Orthodontic coverage.(children only)
  • Complete or partial dentures