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Tag Archive: Health

  1. Three reasons why group benefits are so costly — and how you can address them

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    Group benefit costs continue to rise, but that’s not something you don’t already know. What you might not realize is why.

    Naturally, there are many varying reasons for general rate adjustments, and we don’t need to discuss the various justifications for why health and dental costs are on the rise. But it is worth reviewing the deeper-seeded components that factor in to plan costs — especially because, as an employer, you have some measure of control over these costs.

    Let’s take a look at three of them:

    Plan Design. This could be the greatest factor in why your costs are going up. If your plan is above industry norms, you will be attracting more claims from employees but also from their dependents, as under coordination of benefits (where a couple both have coverage), you will pay what other plans wouldn’t. Have you safeguarded against abuse and over-utilization in your plan? We are living in changing times, so if your group plan hasn’t changed, you are going to have more financial pressure than you can may be able afford. The changes we are talking about are not the typical benefit cutbacks, but rather a more forensic approach to benefit design that explores what your employees truly need. This type of review will reinforce the sustainability of your group plan.

    Claims Usage. The cost of your plan is directly correlated to claims paid. This requires us to focus on specific benefits, such as your health and dental, as these typically represent 60% of your total group benefit budget. And while this ties directly into the plan design you offer, it is also impacted by the mindset of your employees. Some employees will treat their group plan as an entitlement, with little regard for how the plan is used as it is company money, not their own. For this reason, engaging employees in the relationship between claims and costs and arming them with knowledge about why it is in their best interest to always be an aware consumer, even when it concerns their benefits, is critical to improving the results of your group plan. Corporate culture can have a significant bearing on your ability to partner with your employees and impact your bottom line.

    Carrier Costs. Have you noticed how complicated group benefits are getting? This confusion can frustrate employers and encourage rash decision-making over detailed analysis. However, a carrier’s costs can absolutely be an important factor in the group benefit cost conundrum, and avoiding it can quickly exacerbate the costs. Only through in-depth analysis by a group insurance expert/advisor can you confirm if you are paying too much for your plan. You can always market your group plan to test for competitiveness, but unless your advisor knows how the pricing of a plan works, you are likely boomeranging back to the same scenario, with a bad first renewal. So scrutiny of all the components of your plan’s costs is required to ensure you are obtaining real savings and can avoid the costly process of switching carriers cyclically.

    If you would like to explore the unique tools we use to address these key group benefit factors, please contact Steve Marsh at Business Insurance Services or 905.777.9990, ext. 200, today.

  2. Virtual Doctor Services: Are You Ready to Offer This Benefit to Your Employees?

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    We’re living in an era where things change fast! We’ve seen it as technological advances are made in so many areas, from home appliances and automobiles to communications. Medical services are no exception, as we’re currently seeing the emergence of virtual doctor services.

    The concept is just as you’d surmise, given the name. Where offered, an employee has access to a doctor, via video, on their phone or using their computer. Some insurance carriers have aligned themselves with a specific provider, but where a carrier does not offer this option, it can be purchased direct from a provider of virtual doctor services. There are many different options, and pricing for this new benefit can be just as varied, ranging from $3.00 to $15.00 per employee, per month.

    Ultimately, the level of service and attention to detail will differentiate one virtual provider from another. However, when looking to add this new benefit to your plan, the key is knowing what services a provider offers and how they impact an employee’s current medical provider. Only private virtual doctor services work outside of the Ontario Health Insurance Plan (OHIP) and as a result, virtual visits to a doctor have no impact on the employee’s family doctor OHIP billing. This type of provider is more costly, but also seems to provide the highest level of service.

    With hospital emergency room wait times ballooning and some geographical regions having wait lists for family doctors, it’s no wonder this benefit evolution has occurred. One provider’s experience shows 40-50% of employees with this benefit will use a virtual doctor app on their phone. Those who have used the service love its convenience and found the level of care excellent. They found it easy, timely and efficient to get an answer, and appreciated the convenience of having their prescriptions sent right to their local pharmacy for quick pick-up. In many cases, easily resolvable health issues that previously required taking time off work and a longer duration of suffering were quickly addressed and remedied. The service is quick to refer employees when situations require more direct medical attention, but many needs can be addressed using this application.

    This kind of virtual service will have a profound impact where family doctors are not readily available and should also reduce employee absenteeism and improve productivity. Some employers even look at this as a hiring benefit to attract new talent. The key is to fully understand the services offered to your employees to ensure the cost/benefit analysis is aligned with your corporate philosophy. For more information on what your options are, contact Rosemary Marsh at Business Insurance Services today.

  3. If you have travel coverage in your group plan, do you need to buy individual travel coverage for your trip?

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    Travel coverage has evolved of late. This is in part due to the world becoming a smaller place and many of us travelling more frequently. We are often asked whether employees should buy individual travel coverage or rely on the group plan’s travel coverage. All plans differ and so the key is to know what your plan provides and what the stability clause is in any travel plan.

    Stability Clause: This terminology refers to what criteria a carrier uses to access if an employee is medically safe to travel. The most common stability clause requires that an employee must be medically stable for the 90 days prior to travelling. This sometimes means no substantial change in medication, no unconfirmed test results, no health conditions not yet fully diagnosed. If an employee cannot meet the carrier’s definition of medically stable, he or she will not pass the stability clause and will not have travel coverage for any pre-existing condition.

    For the above reason, there is no straight answer to the travel question, Should you or shouldn’t you buy extra coverage? It all depends on your medical situation and the restrictions within your group travel policy.

    Please note, should an employee have a pre-existing condition that disallows his/her group travel coverage, there is an individual travel policy where stability is measured in the 7 days prior to travel. So be sure to inquire by contacting your travel carrier to better understand your plan’s medical limitations, should you be concerned. Better to know up front what you are and are not covered for to allow you to explore your travel coverage options.

    If you’d like more information on options to consider when you have a pre-existing condition, please contact Steve Marsh at smarsh@bisinc.ca or 905-777-9990, ext. 200

  4. What you need to know about cannabis

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    There is so much updated information to share about cannabis. With this in mind, the following is a short summary of the most important things you need to know.

    In most organizations, human resource professionals are adding cannabis to their policies and procedures. It falls in line with other procedures already established under substance abuse. For the most part, pundits suggest little will change in recreational cannabis usage after legalization, but only time will tell.

    Understanding more about cannabis is important to developing your policy. Cannabis has more than 85 molecules or active ingredients, but the two most popular and talked about are THC and CBD. THC (tetrahydrocannabinol) is the molecule within cannabis that provides the hallucinogenic properties or what is referred to as the high. CBD (cannabidiol) does not contain hallucinogenic properties, which is why someone can medically be using cannabis and still be fit to drive.

    Cannabis does not yet have a Drug Identification Number (DIN) or Natural Product Number (NPN). As a result, it is not regularly included under a carrier’s formulary group drug plan. A few carriers have added a cannabis benefit that will allow an employer to add cannabis to their healthcare plan. To date those carriers are Sun Life, Green Shield and Manulife; Great West Life and GroupHEALTH have announced they will add this benefit in January 2019. A cannabis benefit could range between $1,500 and $6,000 per person, per year and requires a prescription to be eligible, but only for certain, specific medical conditions as defined by each carrier. By restricting this benefit to only certain medical conditions, the carrier is preventing the plan from reimbursing for recreational cannabis use.

    For those employers who have a Healthcare Spending Account (HCSA), the Canada Revenue Agency does allow cannabis and cannabis seeds to be reimbursed as an eligible expense, when prescribed by a doctor.

    With this new cannabis industry erupting, we will continue to see things evolving in this arena. For this reason, please note the above summary reflects information as at October 15, 2018. For more updates or advice on how to engineer your organization’s response to this upcoming change, please contact Steve Marsh at smarsh@bisinc.ca or 905.777.9990, ext. 200.

  5. What you need to know about cannabis

    Comments Off

    TAG1 Blog photo

    There is so much updated information to share about cannabis. With this in mind, the following is a short summary of the most important things you need to know.

    In most organizations, human resource professionals are adding cannabis to their policies and procedures. It falls in line with other procedures already established under substance abuse. For the most part, pundits suggest little will change in recreational cannabis usage after legalization, but only time will tell.

    Understanding more about cannabis is important to developing your policy. Cannabis has more than 85 molecules or active ingredients, but the two most popular and talked about are THC and CBD. THC (tetrahydrocannabinol) is the molecule within cannabis that provides the hallucinogenic properties or what is referred to as the high. CBD (cannabidiol) does not contain hallucinogenic properties, which is why someone can medically be using cannabis and still be fit to drive.

    Cannabis does not yet have a Drug Identification Number (DIN) or Natural Product Number (NPN). As a result, it is not regularly included under a carrier’s formulary group drug plan. A few carriers have added a cannabis benefit that will allow an employer to add cannabis to their healthcare plan. To date those carriers are Sun Life, Green Shield and Manulife; Great West Life and GroupHEALTH have announced they will add this benefit in January 2019. A cannabis benefit could range between $1,500 and $6,000 per person, per year and requires a prescription to be eligible, but only for certain, specific medical conditions as defined by each carrier. By restricting this benefit to only certain medical conditions, the carrier is preventing the plan from reimbursing for recreational cannabis use.

    For those employers who have a Healthcare Spending Account (HCSA), the Canada Revenue Agency does allow cannabis and cannabis seeds to be reimbursed as an eligible expense, when prescribed by a doctor.

    With this new cannabis industry erupting, we will continue to see things evolving in this arena. For this reason, please note the above summary reflects information as at October 15, 2018. For more updates or advice on how to engineer your organization’s response to this upcoming change, please contact Steve Marsh at smarsh@bisinc.ca or 905.777.9990, ext. 200.

  6. Mental Health

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    It is estimated that 1 in 5 people will experience mental health problems in any given year. The remaining 4 will have a friend, family member or colleague who will be challenged with mental health issues. In Canada, There are 500,000 Canadians absent from work every day. Mental Health is the number one cause of disability in Canada, accounting for nearly 30 of disability claims and 70 of total claims. Approximately 20 of people with a mental disorder have a co-occurring substance use problem. The estimated cost to the Canadian economy in terms of health care and lost productivity is $51 billion or $34 billion is the cost to the Ontario economy. According to the World Health Organization, depression will be the single biggest medical burden on health by 2020.

    In spite of the numbers affected, there is still a stigma associated to mental health. Only 50 of Canadians would tell friends or coworkers that they have a family member with a mental illness, compared to 72 who would discuss a diagnoses of cancer.

    Employers can assist by training their front line managers to recognize mental health issues and offer solutions for building a mentally healthy workplace culture, such as providing an Employee Assistance Program (EAP) which offers a large array of tools, information and support. This kind of benefit can educate and arm your managers on how to be more effective in addressing those situations and help to reduce the stigma surrounding mental illness.

    Employers should check their Employee Benefits provider websites as many insurance companies provide online information on their websites, as well as offer materials and webinars available for managers. Should you have difficulty locating resources, contact BIS for assistance.



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231 Main Street West, Main Floor
Hamilton, ON
L8P 1J4
Phone: (905) 777-9990
Email: rmarsh@bisinc.ca