Author Archive: The Benefits Consultant

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Group Health Insurance – Deductibles, Coinsurance and Out-of-Pocket Maximums

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.

How To Calculate Monthly Life Insurance Premium

Life insurance is expressed as a rate per $1,000 of insurance.  To calculate Life Insurance premium you take the benefit volume per $1,000 of coverage multiplied by the monthly rate.  For example, to calculate the monthly premium based on a 2x annual earnings (assume $40,000) schedule and a rate of $0.12 per $1,000 of coverage […]

Group Life Insurance

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.

Long Term Disability Insurance

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.

Underwriting: Prospectively Rated

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.

How To Calculate Monthly Long Term Disability Premium

Long Term Disability (LTD) is expressed per $100 of benefit volume.  To calculate monthly LTD premium you take the benefit volume multiplied by the rate per $100 of coverage.  For example, if you have monthly salary of $5,000, a 66.7% LTD benefit schedule, and a rate of $1.50 per $100, the calculation is as follows: […]

Group Health Insurance – Paramedical Practitioners

An overview of the second largest cost within a Group Health Insurance plan, paramedical practitioners account for between 15% to 25% of health claims. This article discusses the types of practitioners that are typically covered, the different coverage levels as well as common prevalence within Group Health Insurance plans.

Group Health Insurance – Prescription Drugs

A tutorial highlighting the key features of Prescription Drug coverage within an employer-sponsored Group Health Insurance plan. Topics include types of Prescription Drug plans, Drug Formularies, and the development of drug costs including dispensing fees

Human Rights

An overview of Canadian Human Rights Legislation at Federal and Provincial levels and applicability to Group Insurance and Employee Benefits

Group Health Insurance

An introduction to employer-sponsored health plans, the different features and types of services and supplies that are eligible for coverage under a public health services plan as defined by the Canada Revenue Agency (CRA) and the general categories within an employer-sponsored Health plan.