Provincial plan replacement (PPR) coverage

Who should read this article?

HR Admins

Certain rules apply to providing benefits to employees from a country outside of Canada. These employees may be:

• New Canadian residents

• Canadian citizens returning to Canada

• Foreign workers temporarily living in Canada

To enroll these employees in your benefits plan, they may need to be covered by either:

• The provincial healthcare plan for the province they live in

• A provincial plan replacement program (PPR)

Note: Some insurance carriers need the employee to enroll in their group plan before they can enroll in the PPR program.

Each province decides when individuals become eligible for provincial health coverage. Usually, there is a 3-month waiting period from the date of arrival in Canada.

During this waiting period, you can buy PPR coverage for your employees and their dependents, or employees can purchase PPR coverage themselves. This ensures they have health coverage in the case of illness or medical emergency.

PPR coverage replaces provincial plan coverage, such as doctor's fees and hospital care. PPR coverage is sometimes called Inpatriate Health Plans.

PPR products:

• Can be purchased from several private insurance carriers including Manulife, Canada Life, Sun Life, and Desjardins.

• Have no evidence of insurability requirements (if the application is received within 31 days of being eligible).

• Doesn’t require the disclosure of pre-existing conditions.

PPR plans usually have a lifetime maximum for all covered expenses (for example, a $1,000,000 maximum for all expenses).

PPR coverage lasts for 3 months. This aligns with the 3-month waiting period for provincial coverage. Foreign workers who aren't eligible for provincial coverage can apply to extend their PPR coverage.

How do plan administrators buy PPR coverage for their employees?

PPR application forms are available online from private insurance companies. Contact your insurance carrier to see if they provide PPR coverage.