Worked Costs and Plan Checklists
Losing group health benefits in Canada: conversion plans, deadlines and your options
What to do when employer health and dental benefits end after a job loss, layoff or retirement in Canada: conversion deadlines, guaranteed-issue plans, Quebec RAMQ and a cost comparison.
When you leave a job, are laid off or retire in Canada, group health and dental benefits usually end on your last day of work or at the end of that month, unless your employment contract, severance arrangement or provincial employment standards require them to continue for a notice period. Your most important deadline is the insurer's conversion window: many group plans let you buy an individual plan without medical questions if you apply within a set period after group coverage ends, often 60 days, sometimes 90. Miss it, and you may need to pass a health questionnaire. Your other options are an underwritten individual plan, a spouse's group plan, provincial drug programs, the Canadian Dental Care Plan, or paying yourself. In Quebec, you must register with the RAMQ public drug plan if you have no other group access.
This guide is part of the plan choice checklist guide. Figures are illustrative.
First 7 days: find out the dates
- Ask human resources or the plan administrator, in writing, for the date your health, dental and drug benefits end.
- Ask whether benefits continue during a statutory notice period. Under provincial employment standards laws (for example Ontario's Employment Standards Act, 2000), employers must generally continue benefit plan contributions during the statutory notice period; severance or contractual terms may add more.
- Ask for the conversion option details: insurer, deadline, plans offered, premiums.
- Use your benefits before they end for anything already scheduled, such as a dental appointment or prescription refill, if it is clinically appropriate.
Your options compared
| Option | Medical questions? | Pros | Cons |
|---|---|---|---|
| Conversion plan from the group insurer | No, if you apply in time | Covers existing conditions; continuity | Lower maximums, especially drugs; premiums can be high for the benefit |
| Other insurer's guaranteed-issue plan | No, if you apply within its window after losing group coverage | Choice of designs | Same limits as conversion plans |
| Medically underwritten individual plan | Yes | Higher maximums for the premium | Exclusions for existing conditions; can be declined |
| Spouse's group plan | Usually no, if added within the plan's deadline after losing your coverage | Often the cheapest | Must apply quickly; check late-entrant rules |
| Provincial programs | No | Seniors, income-based drug programs, CDCP | Eligibility rules; formulary limits |
| Self-funding | — | No premium | No protection against large bills |
Worked example: a 60-year-old who retires
Situation (illustrative): retiring at 60 in British Columbia, with two regular medications costing $160 a month combined ($1,920 a year), dental $1,200 a year and physiotherapy $500 a year. Net family income in retirement $55,000.
Option A: conversion plan at $185 a month ($2,220 a year). Pays 80% of drugs up to $1,500, 70% of dental up to $1,000, 80% physio to $300.
- Drugs: 80% x $1,920 = $1,536, capped at $1,500
- Dental: 70% x $1,200 = $840
- Physio: 80% x $500 = $400, capped at $300
- Plan pays $2,640. Total cost: $2,220 + ($3,620 - $2,640) = $3,200.
Option B: underwritten plan at $150 a month ($1,800), excluding both conditions for drug coverage. Pays dental 80% to $1,000 ($960) and physio 80% to $500 ($400). Plan pays $1,360. Total cost: $1,800 + $2,260 = $4,060.
Option C: no plan plus BC Fair PharmaCare. Drug costs count toward the household's income-based deductible; after it is reached, PharmaCare pays a share of eligible costs up to a family maximum. Total cost depends on the deductible for $55,000 of net income, and on these numbers the household would pay all $1,700 of dental and physio and most or all of the $1,920 drug bill: up to about $3,620, less whatever PharmaCare pays, with Fair PharmaCare limiting the downside if drug costs grow.
The conversion plan is the cheapest in this example and protects existing conditions, but only if applied for in time. At 65, provincial seniors' drug coverage (in many provinces) may change the calculation again; review it then.
Job loss in Quebec
If you lose group drug coverage in Quebec and have no access to another group plan (for example, through a spouse), you must register with the RAMQ public prescription drug insurance plan. Do it quickly to avoid a gap. You can still buy an individual plan for dental, vision and paramedical care. See Quebec's mandatory drug insurance.
Check the Canadian Dental Care Plan
Once you no longer have access to dental coverage through work, a pension or a spouse, you may become eligible for the Canadian Dental Care Plan, if adjusted family net income is under $90,000. A conversion plan that includes dental would make you ineligible, so consider a health-only conversion option if CDCP would cover your dental care.
Other benefits that end
Group life insurance and long-term disability insurance often end too, and life insurance commonly has its own conversion right with a short deadline (often 31 days). These are outside this site's scope, but do not miss them.
Mistakes to avoid
- Waiting until you need care to look at conversion; the window may have passed.
- Assuming COBRA-style continuation exists. Canada has no general equivalent; continuation depends on your contract, notice period and the insurer's conversion offer.
- Cancelling a conversion plan to buy an underwritten one before it is approved.
- Forgetting to add yourself to your spouse's plan within the deadline.
Frequently asked questions
Do I get my benefits during severance?
During the statutory notice period, employment standards laws usually require benefit contributions to continue. Contractual or common-law severance beyond that depends on your agreement; check with an employment lawyer if unsure.
Can I keep my group plan by paying the premium myself?
Some employers allow this for a short time, for example during a leave; for terminated employees it is uncommon. Ask the administrator.
Is a conversion plan the same as my group plan?
No. It is a new individual contract, usually with lower maximums.
Sources
- Canadian Life and Health Insurance Association — leaving a group plan
- Government of Ontario — Employment Standards Act, 2000, benefits during notice
- Government of British Columbia — Fair PharmaCare
- Régie de l'assurance maladie du Québec — registering for the public drug plan
- Canadian Dental Care Plan on Canada.ca — eligibility after losing coverage
