F.A.Q.

What is it going to cost?

This is probably the number one question we get asked.  That answer is that depends.  Here are the factors that go into setting your rate:

Demographics:

Age, Gender, amount of insurance can all greatly affect coverage such as Life Insurance, Disability and Critical Illness products.  What industry you are in is also a factor as well as your individual turnover.

In addition, the number of people covered with is also a factor.  Single coverage is for the employee only.  Family and Couple coverage assumes two or more to be covered. Corresponding rates reflect the number of insured’s.

Benefits (Plan Design):

The ‘plan design’ are those options chosen by the decision maker in your company.  Think of it as going to a restaurant and ordering a meal.  Plan designs are similar to that.  You pick and choose the ones that are important to your group.  The two most popular selections for employees are Extended Health and Dental.

Extended Health Coverage (EHC): What’s driving the cost of EHC is prescription drug coverage.  Drugs tend to comprise the majority of claims your employees will make. Paramedical coverage use is on the rise as well, as employees make use of coverage for things like Chiropractic Treatments and Massage Therapy.

Dental: Dental coverage is divided into three increasing levels of coverage.  The first step is Basic, secondly Major and lastly Orthodontic Services (usually straightening of children’s teeth). Basic covers maintenance and restoration of existing teeth.  Major coverage is for more in depth work such as crowns and bridges. Orthodontics can be limited to dependent children only or be inclusive of adults.

Other:

Underlying Limits: An example of underlying limits would be paramedical coverage.  All programs set limits anywhere from $300 to $500 per practitioner per year. Another common example would be Dental coverage.  Here limits vary from $1,000 to $2,000 per year in coverage.

Deductibles: When a deductible is used the employee pays that amount before their reimbursement commences.   A common one is $25 for single and $50 per family.

Co- Insurance:   A common use of co-insurance would be with Pharmaceutical Coverage.  Many plans cover 80% of prescription drugs with the employee paying 20% of any claim.

So in short, a definitive premium is difficult to give.  However, with the number of variables and cost control items available it is very likely that you can design something to meet your coverage and cost needs.

 

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How quickly are claims paid?

Have you waited for weeks to receive payment on health and dental claims? Long waiting periods are a common complaint when individuals are asked about their group benefit plan. GBL’s carriers offer fast turnaround and great payment alternatives (like claims paid directly to employee bank accounts).

Better plans will offer you a solid payment track record and payment alternatives. Consider the value of good service and rest assured that we will recommend a plan that works best for you.

 

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Package Plan or customize-able convenience?

Some plans are packaged for you. You can take them or leave them – you just can’t change them! While this may make the buying process easier, it can also be more expensive. When considering package plans, are you paying for benefits you don’t want? Are you missing coverage you need?

“Value” is as important as price for most companies, so give serious consideration to a custom benefit plan. You are more likely to use and appreciate coverage that you choose!

 

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What is a Pooled Plan and are there any benefits to selecting one?

Traditionally, benefit plans are “experience rated” or un-pooled.   That means the insurance companies set individual group premiums based on actual claims made by that firm’s employees – plus additional charges for expenses, inflation, and other changes like government health cutbacks. In these kinds of plans the insurance company has the right to increase your premiums without limit. This is especially risky for small companies – consider if just one employee has a serious accident or sudden illness how your health claims skyrocket!

To protect your company from this uncertainty, look for a pooled plan, like the Chambers Plan or Manitoba Blue Cross. Pooled plan prices are set for a large number of employers under one umbrella, so they can offer more stable, predictable premiums.

 

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I hear companies talk about guarantees in their plans. What are they, and what is their value?

When you look at benefit options, you want a maximum number of guarantees. Some plans are particularly hard on small firms: rejecting many industry types, companies less than a year old, and firms with too few employees.

Such plans are unlikely to offer guaranteed renewable coverage and seldom offer basic levels of benefits without medical questionnaires or tests.

Solid product features, like reasonable entry requirements and coverage guarantees, not only make coverage more valuable to you, they tell you a lot about the organization you are dealing with. When you compare the cost of various plans, take into account the value of the plan rules and guarantees.

 

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How valuable is a comprehensive Group Benefits Package?

North American employers strive to turn a profit in an increasingly challenging market – volatile economic conditions, rapid change and an aging work force are key factors that must be considered.

With these trends top of mind, finding and retaining valuable employees becomes an important priority. What can employers do to add value to their employee offerings? Fair wages, comfortable working conditions and, where applicable, flexible working arrangements such as job–sharing and alternate hours of work are standard in today’s workplace.

Comprehensive group benefits packages are another way to add value to both prospective and current employees, and these can help to both attract new talent and to retain invaluable mature leaders and anchors. Group benefits offer cost effective universal appeal and are easily accessible.

Employers who seek to retain the staffing “edge” should consult with their group benefits provider on an annual basis to learn about new offerings, and ensure that they maintain the best possible coverage for their unique work force.

 

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Can each employee get different options?

Coverage can vary between classes of employee’s only.  For example there may be a management of sales group that gets vision care or some other plan variation.  For flexibility on an individual basis, take a look at the question regarding health spending accounts.

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What happens if some employees don’t want coverage?

The most common reason employees do not want benefits is because they have them through another source such as a spouse.  An employee would only be required to take coverage not provided by their spouses plan, such as life insurance or disability.

Not participating in any part of the plan is another issue entirely.  Most companies have participation requirements.  They range from 75% to 100% depending on the size of the group.

 

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What is a private health spending account? 

(Version of this include a Cost Plus or Health Spending Account.)  

A Health Spending Account is a group benefit that provides reimbursement to employees from the company for a wide range of health-related expenses, either in place of a group benefits plan or over and above a regular benefit plans.   This can provide the type of flexibility that a lot of companies are looking for as employees can self-select what they choose to use their allotment for.

They can be designed in a multitude of ways, but all plans have limits.  These limits can be set for each benefit, such at $1,000 for dental or overall by employee such as $1,000 per employee or both.

HSA’s must be administered in accordance with Canada Revenue Agency guidelines.   These guidelines indicate what is reimbursable as well as how the HSA’s are to be structured.

We do not recommend that this option be used for coverage that can produce high claims such as Life Insurance, Long Term Disability or Travel.

 

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