GROUP BENEFITS

 
GROUP BENEFITS
SECOND OPINION SERVICE (SOS)

COMPETITIVE RATES


Taking your plan out to the market for quotes on a regular basis ensures that your carrier is staying competitive or identifies another carrier that may be better suited to your current requirements.




IMPROVED COMMUNICATION


Regular employee benefits sessions helps communicate things like what their plan covers and how to make a claim. This goes a long way to ensuring your employees maximize the use of the plan you’ve provided and give them a sense of appreciation for your efforts.




INCREASED FLEXIBILITY


Coordinating your employee benefits with a Health Spending Account (HSA) or Wellness Spending Account (WSA), possibly carving out certain benefits from your insured plan and having them picked up through a flexible HSA or WSA.





There are many reasons to invest in a benefits plan for your employees with Riverview Insurance Solutions. Chief among them, are the fact that they help you attract and retain good people, increase morale, maintain productivity, keep your employees healthy all while providing tax-efficient compensation.

As an employer, you believe you need to offer benefits to attract and retain quality staff:

  1. Why is being part of program good for you and your employees?

  2. What benefits are available?

  3. How does the pricing work?

  4. How can you get started or audit your existing program?

Why is being part of a program good for you and your employees?

There are three main reasons why a benefits plan is good for your employees.

  1. Access – your employees cannot generally get a comprehensive plan on their own at the same cost as group plan.

  2. Insurability – group coverage guarantees insurability for everyone – there are no medical questions or disclosures.

  3. Tax Efficiency – the premium an employer pays for extended health and dental benefits is not a taxable benefit to employees – it is non-cash compensation.  Without a plan, an individual will need $200 of gross earnings to get $120 of after-tax spending power, but with a benefit plan the expense is often covered entirely.

However, the main reason why a benefits plan is good for the employer is retention. It’s difficult and expensive to find and train new employees. It’s far better to have loyal people that are committed to coming to work. To get that, employers need to offer more than a competitive salary.

What benefits are available?

Benefits go beyond the standard health and dental most employees expect from their employer. Complete packages can be structured to make the company attractive and competitive in the marketplace by leveraging:

  • Life Insurance: A tax-free lump sum to the beneficiaries of the policy holder upon his or her death.  Many of your employees may not own separate insurance and this benefit is unfortunately all a family might receive.

  • Accidental Death & Dismemberment provides funds to help the beneficiaries of the policy holder if the death is accidental (often combined with and pays out in addition to life insurance).  Also provides funds to the insured if he or she is dismembered, such as the loss of limbs or vision.

  • Dependent Life Insurance: A lump sum provided to your employee if they lose a spouse or child.  This sum helps to ease the financial burden of final expenses and allow the employee to take off work to deal with things during this difficult time.

  • Long-term Disability: income replacement when an employee becomes sick or injured and can no longer work.  For example, it could take several years to recover from an accident or head trauma – and in some cases, a full recovery is not possible. Long-term disability payments replace a portion of the employee’s income when their disability prevents them from returning to work.

  • Critical Illness Insurance: A lump sum paid to the employee if they are diagnosed with a covered critical illness. The sum can be used in any way your employee sees fit – ultimately, it provides cash for the family when its needed most.  About 80 per cent of critical illness claims are for cancer, stroke and heart attacks.

  • Dental: Dental care in Canada is expensive. The only government coverage for dental care is for emergency treatment stemming from an accident – and even then, the focus is not cosmetic, so the individual is left to manage the additional expenses. Therefore, dental benefits are hugely sought after by employees.

  • Extended Health and Travel:  This covers prescription drugs, medical supplies, paramedical practitioners (chiropractors, physiotherapists, psychologists, naturopaths, massage therapy, etc), out of province travel insurance, medical supplies and more.

  • Employee Assistance Program: Not all ailments are physical. When it comes to mental health issues, addiction recovery, work stress, and emotional wellbeing, therapy is a great option. The Employee Assistance Program is a benefit that gives employees discreet short-term access to counselling. If additional therapy is needed after the sessions, the councillor can help to arrange longer-term care.

  • Virtual Healthcare options: in a time where our healthcare system is pressured to its limit with excessive wait times and access to care being minimal or non existent, this benefit is an option that could  provide your employees with a valuable option to getting the care they deserve in a timely, easy to use method – their phone.

  • Flex Dollars/Health Spending Accounts: Chances are that one employee will require sports massage while another needs dental benefits more. Flex dollars allow your employees to allocate funds to the benefits they need the most. It removes the one-size-fits-all benefit plan and really gives your employees the customization they need.

  • WI (Weekly Indemnity)/Short Term Disability (STD): WI, or STD, benefits provide a weekly short-term payout to help replace income when the employee cannot work due to a short-term disability.  This benefit is more commonly added for higher earning employees as Canadians already pay for short term disability through their EI deductions and if you do offer this benefit you get a credit to your EI premiums.

In these challenging economic times, businesses are constantly looking for ways to control their costs. Your employee benefit plan could be a source of savings. That’s why we offer our free of charge Second Opinion Service. We will review your existing plan and make recommendations on ways to optimize your offering.

 

A review of your existing plan could return benefits such as:

HOW DOES THE PRICING WORK?

Pricing for NEW Group Plans


Initial pricing is based on the demographic (census data) of your employees with a layer of estimation. Initially it is a bit of a guessing game, as small groups are not actuarially credible. There is just not enough lives to make an accurate mathematical estimate of the group’s utilization, so the underwriter makes a “best guess” until there are a years worth of claims to get a better idea on what you companies claims look like.

  • Insured Benefits (life, AD&D, dependent life, long term disability, weekly indemnity, critical illness) are priced based on demographic and occupation category.
  • Experience Rated Benefits (dental & extended health) are simply a “best guess” for the first year until a pattern can be established through annual renewals.




Pricing for EXISTING Group Plans


Pricing a new group is based on the demographic (census data) of your employees and your group’s utilization experience. Not many underwriters will offer an existing group new low rates without finding out what they are getting themselves into. They simply do not want a group paying $25,000 in annual premium and making $50How ,000 in claims.

  • Insured Benefits (life, AD&D, dependent life, long term disability, weekly indemnity, critical illness) are priced based on demographic and occupation category.
  • Experience Rated Benefits (dental & extended health) are a little tougher for existing groups. The underwriter needs to look at the type of claims and expense factors and make an educated estimate of future experience (this explanation over-simplifies the process. Contact us for a more information).





Calculating the Annual Renewal

Group plans are renewed annually. It is common for the plan’s premiums to increase to keep pace with claims, group makeup (census data), and plan usage. Below we will explore some factors that go into the annual review.

  • Target Loss Ratio (TLR): The TLR is the percentage of the plan premium that is used to pay claims. Remember, each plan has expenses in excess of claims, such as administration, taxes, and commissions. When the expenses are deducted from the premium, the remaining percentage, or the TLR, is the pool from which the claims will be paid. The TLR percentage is generally set by the size of the group.

  • Trends Factors (Inflation): The cost of extended health, prescription drugs and dental procedures go up every year.  The insurance company must factor higher future costs into each annual renewal.  Some companies use inflation as a profit center, but an experienced benefits specialist will help negotiate this part of your renewal.

  • IMS Reserve (IBNR): Not every employee submits a claim in a timely manner, and if a plan sponsor (the employer) cancels or switches carriers, some claims may remain eligible in the interim.  This can affect the carrier’s ability to play claims. To prevent defaulting on these types of claims, the carrier has an “incurred but not reported,” or IBNR buffer – a percentage of the premiums that is held in reserve.

  • Experience Weighting: At renewal, the underwriter has discretion to give a certain weighting to the current year utilization experience.  For example:  a group that has been with a carrier for three years might have 50 per cent weighting from the current years experience and 25 per cent for each of the previous two years.  (the underwriter’s goal is to price the renewal on the average known experience).

You may have been visited or contacted by a salesperson offering big savings on group plans. Beware! Using marketing dollars, such agents can offer very attractive rates – that lasts for the first year only. Once that year is up, all the above factors come into play and the premium spikes. It takes time, effort and money to properly set up an employee benefits plan, but the result is a stable, realistic plan with manageable renewals based on actual plan usage and census data.

Your business is unique, so your employee benefits plan needs to be unique, too. That also means there is no one-size-fits-all when it comes to pricing out the plan. Benefits Consultants and Advisors use the following methods to manage employee benefits plans:

Health Spending Account Option


A health spending account, or HSA, is a popular option for small or solo-run businesses, but companies can also use an HSA as its benefit plan or to top up benefits coverage.

HSAs are trust accounts regulated by Canada Revenue Agency. Gross income (pre-tax) dollars are put into the account and the money is used for healthcare expenses. With this setup, it’s easy to see why entrepreneurs like this type of account. However, employers can set up a company HSA, or contribute to employee’s HSA accounts.

This is a good option for companies that want to avoid the traditional insurance route, but it does come with a couple of drawbacks. If an employee needs expensive medical treatment or has ongoing healthcare expenses (like dental work), frequent contributions to the HSA can be financially difficult. Additionally, the only expenses that can be reimbursed are treatments from a licensed medical practitioner, or medications dispensed by a licensed medical practitioner or a pharmacist. This excludes non-traditional treatments.

HSA’s are regulated by CRA, but for companies looking to control costs, they can be a suitable alternative to a full blown, standard benefits plan.





 

Getting Started with your Employee Benefit Plan

Putting a group plan in place is not difficult.

  • The plan sponsor fills out a data sheet with the demographic details of the group.

  • Companies with an existing plan must also provide, benefit booklet, most recent monthly billing and the most recent annual renewal.

  • Next, the advisor will present the plan details and benefits available and plan design will be chosen.

  • Finally, the paperwork. The sponsor (employer) distributes an enrollment form to each employee with their basic contact details, dependents and beneficiaries.

With the paperwork complete, it takes roughly three weeks for the plan to roll out – plan booklets and drug cards must be printed.  New plans generally start on the 1st of the month.

Employee Benefits are Part of Your Company’s Success

No matter if your company is solo-run, a thriving corporation, or a multi employer union trust – there is a benefit plan that can be customized just for you.

Contact Riverview Insurance Solutions today to learn how your company can get started with a tailor-made benefits solution for you and your team.

 

Benefits Plans

We are employee benefit plan consultants and do things a little differently than most.   We’ve created a buying advantage for our customers.

Our promise is to clearly explain and educate our clients on how benefits are priced and lower your premium in a sustainable way without compromising the benefits levels or service your employees deserve.

Our goal is to allow you to maintain our quality employee benefit plan but to have it with a sustainable cost and helpful friendly service. The bottom line is to provide you with the best bang for your hard-earned dollar.

Small and medium sized companies benefit from our volume buying programs.  Setting up a new plan or fixing an existing program, has never been easier.  Enjoy the benefits of our strong carrier relationships and bulk buying, purchasing power.

The rising cost of employee benefits plans is alarming

A company with fewer than 50 employees means the insurance company will charge more to operate your benefit plan.

Target Loss Ratio (TLR) is an important pricing factor that tells you the administrative load on your benefit plan – the TLR can be as low as 65% for small groups.

A 65% TLR means there is 35% overhead to operate your plan… or $.65 per dollar goes to your staff as dental and extended health benefits and $.35 goes to program overhead.

Basically, as one small company you pay ‘full retail price’ for your program.

WE CAN PROVIDE VOLUME DISCOUNTS TO OBTAIN LOWER RATES… AND YOU SAVE.

Our buying program lowers the normal operating cost of a benefits plan. With our offering we can provide a TLR of 80% (20% operating cost) and you get better service with similar benefits and coverage.

Your Company is seen as a part of our large group benefit program and priced accordingly with smaller margins.

With our volume buying program, the insurance carrier takes less margin on the larger group and everyone benefits. The savings are significant.

Compare with no obligation to change

Our group benefit advisors will review your existing plan with no obligation or expected commitment.

We’ll either reinforce the advice you’re currently receiving, and your diligence will be complete – or you may see that buying better will save your company a lot of money.

Ensuring more of your premiums are go to your people and creating premium stability for years to come.

 

Same benefit levels - Lower premiums 

Our employee benefits plan value proposition is simple:

  • Experience – hundreds of employee benefit plans and growing.

  • Lower Price – with volume savings, up to 25% less for the same employee benefits plan.

  • Service – We have highly trained administrative staff to assist you with all questions.

Employee benefits consulting and management services:

  • Quarterly and Annual review of benefits relative to industry trends.

  • Independent Audit of your existing plan.

  • Contractual negotiation with insurers and tendering of group insurance contracts.

  • Cost containment strategies and alternative funding methods.

  • Employee educational seminars.

  • Plan administration support.

  • Full second opinion service

Call us Toll Free at 1.877.342.4822 to get started!

 
 

HEALTH SPENDING ACCOUNTS

Health Spending Account Option


A health spending account, or HSA, is a popular option for small or solo-run businesses, but companies can also use an HSA as its benefit plan or to top up benefits coverage.

HSAs are trust accounts regulated by Canada Revenue Agency. Gross income (pre-tax) dollars are put into the account and the money is used for healthcare expenses. With this setup, it’s easy to see why entrepreneurs like this type of account. However, employers can set up a company HSA, or contribute to employee’s HSA accounts.

This is a good option for companies that want to avoid the traditional insurance route, but it does come with a couple of drawbacks. If an employee needs expensive medical treatment or has ongoing healthcare expenses (like dental work), frequent contributions to the HSA can be financially difficult. Additionally, the only expenses that can be reimbursed are treatments from a licensed medical practitioner, or medications dispensed by a licensed medical practitioner or a pharmacist. This excludes non-traditional treatments.

HSA’s are regulated by CRA, but for companies looking to control costs, they can be a suitable alternative to a full blown, standard benefits plan.





 

RETIREMENT PROGRAMS

Pricing for NEW Group Plans


Initial pricing is based on the demographic (census data) of your employees with a layer of estimation. Initially it is a bit of a guessing game, as small groups are not actuarially credible. There is just not enough lives to make an accurate mathematical estimate of the group’s utilization, so the underwriter makes a “best guess” until there are a years worth of claims to get a better idea on what you companies claims look like.

  • Insured Benefits (life, AD&D, dependent life, long term disability, weekly indemnity, critical illness) are priced based on demographic and occupation category.
  • Experience Rated Benefits (dental & extended health) are simply a “best guess” for the first year until a pattern can be established through annual renewals.




Pricing for EXISTING Group Plans


Pricing a new group is based on the demographic (census data) of your employees and your group’s utilization experience. Not many underwriters will offer an existing group new low rates without finding out what they are getting themselves into. They simply do not want a group paying $25,000 in annual premium and making $50How ,000 in claims.

  • Insured Benefits (life, AD&D, dependent life, long term disability, weekly indemnity, critical illness) are priced based on demographic and occupation category.
  • Experience Rated Benefits (dental & extended health) are a little tougher for existing groups. The underwriter needs to look at the type of claims and expense factors and make an educated estimate of future experience (this explanation over-simplifies the process. Contact us for a more information).





contact us

RED DEER

Unit #9, 7887 - 50 Ave

Red Deer, AB T4P 1M8

​​Tel: 403-342-4822

Fax: 403-342-4827​

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