Vancity Member Health Benefits Plan

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Exclusively
for

small businesses and
the self-employed

Entrepreneurs, self-employed and small businesses increasingly drive British Columbia’s economy. Yet, more often than not, they have to go with less health coverage than their corporate counterparts. The Vancity Member Health Benefits Plan was designed to offer robust quality health benefits at competitive prices to fill this gap.

Membership

Membership and so much more

Becoming a member of Pacific Blue Cross, BC's only dedicated not-for-profit health society, means more than just being able to easily file a claim.

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A network of connected health providers

Pacific Blue Cross has the largest network of providers in the province who directly bill us so you don't even have to submit a claim or worry about paying up front.

I loved the way that I could customize my plan to suit my own needs."

Silvia — Ess Design Inc.

Investing into your health & wellbeing

Large organizations know the value of keeping their teams and leaders healthy. We believe it shouldn't be any different for entrepreneurs, small businesses, and the self-employed.

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Benefits in your pocket

Every member gets access to our leading mobile application to review coverage on the go, submit claims with a photo, or find in network providers near you.

Download the App

The Plan

A plan designed by the worker for the worker

We worked closely with our community of entrepreneurs and small businesses to build a modular and flexible plan that can be custom built to meet your needs.

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Life and Accidental Death & Dismemberment (AD&D)

This module is always included and helps ensure that you, your business, your employees and your family are prepared for the unexpected.

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  • Basic Life$25,000
  • AD&DPrincipal Amount $25,000

Conditions

  1. Coverage reduces at age 65 to 25% of the face value and terminates at age 75 or retirement, whichever comes earlier.
  2. Waiver of premium for Life and AD&D
  3. If someone is disabled, entire module premium is waived. Basic employee life will continue in effect after group policy is terminated. However, AD&D benefit will terminate at group policy termination. The waiver is “6 months to age 65; any occupation.”
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Extended Health Care

We have four different extended health care modules to choose from. Starting at basic drugs up to robust coverage for massage and other benefits.

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Health expenses

Your EHC benefits include coverage for health expenses not covered by government MSP. This includes 80% coverage for items such as medical supplies and equipment, hospitalization, and at higher levels massage therapy and vision care.

Drugs

Your prescription drug coverage includes a pay-direct drug card to make life easy. Reimbursement is for drugs that fall under a Pacific Blue Cross managed list of drugs (Pacific Blue Cross Rx formulary). Certain drug claims will require prior authorization from Pacific Blue Cross or special authorization from BC PharmaCare. Lifestyle drugs for fertility, smoking cessation, anti-obesity and erectile dysfunction are not covered.

Your options

Customize your plan by selecting one of the below Health options.

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Health2
Health3
Health4

Notes

  1. Oral contraceptives require a prescription and are included as part of the drug benefit. Therefore, they are not specifically mentioned.
  2. As per our standard Pacific Blue Cross contract terms, chiropractic x-rays are included. Also, out-of-country referral ($25,000 lifetime maximum) is included but terminates at age 65.
  3. All plans include a lifetime maximum coverage of $5 million. There are no deductibles.
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Dental Care

Dental options cover 80% of basic services which include regular cleanings and check-ups. Higher coverage is available to cover major work such as bridges or crowns.

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Maximum amounts shown below are per person, per year, unless otherwise noted.

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  • Basic work max.Combined Basic & Major $1500
  • Major work max.Combined Basic & Major $1500
  • Recall Frequency6 months

Notes

  1. Endodontic & periodontal services are included under major restorative.
  2. Scaling, root planning and gingival curettage will be combined and limited to a dollar maximum equivalent to 6 units.
  3. Fluoride is covered for dependents 18 and under.
  4. Oral hygiene instructions excluded.
  5. Major work attached to implants are not included, however certain dentures and crowns may be eligible.
  6. Eligible services under PBC standard dental fee schedule 3.
  7. Waiting period for Basic is 3 months and 12 months for Major.
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Critical Illness

Critical Illness Coverage is a $25,000 lump sum payment that can help you and your employees financially if diagnosed with one of the 23 covered critical conditions.

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This benefit provides a lump sum, tax-free cash payment. The payment can help with everyday living expenses or additional expenses associated with recovering from a critical condition:

  • Mortgages or Rent
  • Additional Child care costs
  • Loss or reduction in income
  • Alternative treatments and experimental drugs
  • Bank or Car loans
  • Home health care services
  • Adaptive equipment or modifications
  • Travel and accommodations for treatments

Any sickness, injury or symptoms existing in the 24 months before coverage are not covered within the first 24 months.

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Long Term Disability

Income Support provides financial assistance when a disability renders you unable to work in your own occupation.

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  1. There is a 12 month waiting period. Employees must be under age 65 to enroll. The benefit terminates at age 65.
  2. Pre-existing clause: If you become disabled within the first 12 months of coverage, we will go back six months prior to the date of coverage (not hire) to check if the condition existed prior to claiming.
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Health Spending Account (HSA)

Available to businesses with 2 or more employees, a Health Spending Account provides reimbursement for unpaid balances or expenses not covered under your health plan. You can claim any item or service allowed under the Income Tax Act of Canada as a medical expense.

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  • HSA1$250
  • HSA2$500
  • HSA3$1,000

HSA credits are deposited annually and must be spent in the year they are allocated.

Get a price now

We know you're busy. That's why we made it as quick as possible to get you a quote online. In about 5 minutes we can have everything needed to get you covered.

Talk to an Expert

Kenny is your dedicated program specialist and can help you with any questions you have along the way.


Contact Kenny

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