A discussion of how a claim is defined by benefit category – Life Insurance, Accidental Death and Dismemberment Insurance, Critical Illness, Short Term Disability, Long Term Disability, Health and Dental – who it applies to, and general commentary surrounding market prevalence
Read the full story »A discussion of Group Insurance, typical Group Insurance coverage in the Canadian marketplace, the advantages of providing a Group insurance plan and the conditions and elements needed to arrange a Group Insurance policy
A benefits consultant is an important intermediary in the group insurance and employee benefits marketplace. If you want to get a better understanding of what a benefits consultant is, how they can help manage your employee benefits plan, the services they provide, and how to go about choosing one, then check out this article.
Fully pooled is a fully insured underwriting method typically used for smaller groups as well as those benefits that have a low incidence of claim but a high claim amount irrespective of size. Typical for out-of-country and accidental death and dismemberment benefits as well as Basic Life and Long Term Disability for smaller employer groups.
Almost all group insurance health plans provide coverage for medical supplies and services to assist employees recovering/living with a disability due to illness or injury. These benefits provide coverage for the purchase, rental and repair for devices such as wheelchairs, crutches, elastic stockings and orthopedic shoes. These benefits are included under the provisions of a health care plan and are typically subject to any applicable deductible or coinsurance provisions.
Group health insurance plans cover most of the basic hospital and surgical expenses in Canada that any resident incurs during a period of hospital confinement, including accommodation at the ward level, the services of a doctor/surgeon, diagnostic procedures and drugs. Employer-sponsored hospital benefits plans cover only the additional cost of preferred accommodation such as semi-private or private, during hospital treatment in Canada
A description of the out-of-country coverage typically provided within a group health insurance plan, covering employees for limited travel either outside of their province of residence, or out of the country. Coverage typically includes protection for both personal and business travel for 60, 90, or 120 days up to a one million in coverage (lifetime) per covered individual.
Vision benefits, coverage for eye exams, lenses, frames and contacts, typically account for between 5% and 7% of a group health insurance program. Vision benefits typically have a very high perceived value to employees, usually higher than the actual cost of providing vision benefits. More recently, group health insurance plans have expanded provisions to include coverage for laser eye surgery, which has become more common place as technology has advanced and pricing has decreased.
Drug reform has swept across Canada with 5 provinces making changes in 2010 and 2011 to the way generic drugs are regulated in Ontario, Alberta, British Columbia, Quebec and Nova Scotia. The proposed changes drastically change the drug landscape and the delivery of drug benefits, both from the public’s perspective through government-funded programs, and from the private perspective and employer-provided group health insurance programs.
A group that uses the refund accounting underwriting arrangement to fund it’s plan is essentially prospectively rated however choosing to share in the financial results of the program through an annual accounting of surplus/deficit completed by the insurer.
A tutorial highlighting the coinsurance, deductibles and out-of-pocket maximums that are used within Group Health Insurance plans as strategic levers in limiting utilization and sharing program costs with employees.
A tutorial highlighting the types of group life Insurance, rate determination, and insurance provisions applicable to each. Includes basic life, optional life, dependent life, paid-up life and retiree life.
A tutorial covering long term disability benefits including provisions such as qualifying period, definition of disability, recurrent disability, offsets, maximums, subrogation, COLA, conversion and taxability.
Prospective rating is similar to fully pooled in all aspects except premium renewal rating. The key difference lies in that prospectively rated groups have a either a portion or all of their claims experience used in determining premium rates. Renewal rates are determined by reviewing historical claims experience and then applying the rate adjustment prospectively or to future policy periods.
An overview of Canadian Human Rights Legislation at Federal and Provincial levels and applicability to Group Insurance and Employee Benefits
A discussion of Group Insurance, typical Group Insurance coverage in the Canadian marketplace, the advantages of providing a Group insurance plan and the conditions and elements needed to arrange a Group Insurance policy
Drug reform has swept across Canada with 5 provinces making changes in 2010 and 2011 to the way generic drugs are regulated in Ontario, Alberta, British Columbia, Quebec and Nova Scotia. The proposed changes drastically change the drug landscape and the delivery of drug benefits, both from the public’s perspective through government-funded programs, and from the private perspective and employer-provided group health insurance programs.
A benefits consultant is an important intermediary in the group insurance and employee benefits marketplace. If you want to get a better understanding of what a benefits consultant is, how they can help manage your employee benefits plan, the services they provide, and how to go about choosing one, then check out this article.
Fully pooled is a fully insured underwriting method typically used for smaller groups as well as those benefits that have a low incidence of claim but a high claim amount irrespective of size. Typical for out-of-country and accidental death and dismemberment benefits as well as Basic Life and Long Term Disability for smaller employer groups.
