Group Benefit Plans

Group Benefit Plans

We offer a wide range of solutions, including fully insured plans, self-insured plans (ASO), health spending accounts (flex plans), and cost plus accounts.

1 ANALYZE COMPANY GOALS
2 IDENTIFY YOUR PLAN
3 FIND THE RIGHT SOLUTIONS
4 PREPARE EMPLOYEES
5 MONITOR THE PLAN
ANALYZE COMPANY GOALS

Before finding the right solution to fulfill your group benefit needs, we analyze your company goals and objectives, for the long and short term. Each company is unique, and therefore we don’t believe in a one size fits all solution for your company’s group benefits needs.

IDENTIFY YOUR PLAN

We complete a thorough analysis of your company’s group benefits experience for existing plans. We review the existing plan to ensure it has adequate coverage, affordability, and is the right solution for your company. Studying your company’s demographics allows us to propose the right solution for your group benefit needs.

FIND THE RIGHT SOLUTIONS

Propose plan specific options to align with company goals and budget. We offer a range of group benefits solutions, including:

  • Fully insured group insurance model (traditional model)
  • Self-insured group insurance model ( Administrative Services Only)
  • Health spending accounts (Flex plans)
  • Cost plus
PREPARE EMPLOYEES

Our advisors work with your company to educate employees on how to use their health insurance plans efficiently.

MONITOR THE PLAN

Our advisors regularly monitor your company’s group benefits plan to ensure your plan is aligned with the company’s needs. Conduct market studies every 2-3 years depending on renewal rates.

Fully Insured Plans

Also known as the traditional group insurance model. Insured benefits and experience-rated benefits are both wholly insured through an insurance company. Large volumes allow us to negotiate competitive premiums for our clients.

Our advisors Conduct market studies every 2-3 years, depending on renewal rates received from insurers.

Self Insured Plans – ASO (Administrative Services Only)

A health plan is divided into two parts:

Total Cost of your Group Plan
Benefits(%)

Experience Rated Benefits

80

Insured Benefits

20


INSURED BENEFITS

  • Life Insurance
  • Long-term disability
  • Travel health coverage
  • Accidental death and dismemberment (AD & D)
  • Stop Loss

How are insured benefits managed?

Our advisors’ role is to find you competitive rates with major insurance companies. We also offer reinsurance (stop-loss) option which places a ceiling on the costs that may accrue due to major health problems.

How are experience rated benefits managed?

With the right resources, the volume of claims tends to remain relatively stable when monitored over time. The ASO model allows you to budget for these types of expenses. With the ASO model, our clients save an average of 22% per year compared to the traditional group insurance model.

Employers only pay for the benefits they use. They set an annual budget, and if they claim less than that amount, any surplus in premium is returned to the company. Employers have the option to retain the surplus in cash, bank it for the following year to reduce future rates, or invest in additional benefits or services.

Administration fees are lower and paid ONLY on the claims that are made.

Health spending accounts (Flex Plans)

A global health care plan may not meet all employee needs. That’s where the health spending account (FLEX plan) comes into play – it gives employees a predetermined amount to spend on any health expense.

How does it work?

There are no limits on prescription drugs, paramedic services, or hospitalization services. All other health care services have a predetermined amount to spend, these services include:

  • Vision care

    • Glasses
    • Contact lenses
    • Laser eye surgery

  • Medications excluded on Health Care plans

    • Fertility drugs
    • Erectile dysfunction drugs

  • Paramedical practitioners

    • Psychologists
    • Optometrists
    • Acupuncturists

  • Medical expenses that qualify under the Canada Revenue Agency

    • In the case an employee does not claim the maximum amount, the remaining balance that was not used at the end of the year will automatically be carried forward to the following year and will remain available for 12 months. If the credit amount carried forward is not used by the end of the next plan year, this amount is forfeited.

    Cost plus

    This plan is mostly for senior management, executives, or company owners.

    When an individual covered under the present group insurance policy exceeds his coverage limits, one can claim the exceeding amount through their Cost Plus account. Any medical or dental claims made using a Cost Plus account become a non-taxable benefit.