2012 Workshop on Effective Benefit Plan Administration

We plan a workshop each year to teach our members how to effectively administer their benefit plans so that they are avoiding all possible legal issues. All benefit plan administrators are welcome.

Tuesday, November 27th, 2012
10:00am to 3:00pm
Westin Bristol Place Hotel Toronto Airport
950 Dixon Road Toronto ON M9W 5N4
There is no cost to attend.


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Agenda

10:00am: Beginner’s Introduction to How to Administer a Health Benefit Plan
11:00am: Advanced topics on Administering a Health Benefit Plan
12:30pm: Healthy Lunch
1:30pm: 2012 Trends in Healthcare Fraud, Prescription Drug Legislation, OHIP offloading, and more
2:30pm: Martin Walker from The Co-operators addresses plan member questions
3:00pm: Top 5 Stress-Busting Tips from Evelyne Mitskopoulos C.N.P., Beneplan’s Director of Wellness
3:30pm: Adjourn

RSVP to yafa @ beneplan.net or 1-800-387-1670 x252.

Please let me know if you have any allergies or food preferences.

See you there!

September Wellness Tip

Wellness Tip: Benefits of Juicing

Evelyne Mitskopoulos CNP is our staff nutritionist and Director of Wellness at Beneplan.

Fruits and vegetables are excellent sources of a wide range of vitamins, minerals and other nutrients, including phytochemcials – compounds that have been shown to combat cancer.  As more of the healthful substances are being found discovered in these foods all the time, no supplement can contain all these compounds.

It is recommended to consume two glasses of live juices a day for health maintenance.   Four glasses a day is recommended if you want to speed healing and recovery from illness.

Since fresh juices are made from raw fruits and vegetables, all of the components remain intact.  Vitamin C and other water-soluble vitamins can be damaged by overprocessing or overcooking.  Enzymes which are proteins needed for digestion and other important functions can also be damaged by cooking.

It is important to consume the juice right away as they can lose some of their nutrients if allowed to sit for long periods of time.

Three categories of juices:  Green juices, Vegetable Juices and Fruit juices.  Green juices are made from  variety of green vegetables and are great for cleansing the body of pollutants.  Vegetable juices are all other ones such as beet, carrots, garlic and celery that contain lots of antioxidants that fight cancer.  Fruit juices cleanse the body and nourish it with nutrients, including antioxidants.

Ageless Cocktail

4-5 carrots

3 sprigs fresh parsley

1 large handful spinach

1 large handful kale

1 beet, including tops

1 clove garlic, peeled

  1.  Thoroughly wash all vegetables, peeling the carrots and beet if they were not grown organically.  Cut the vegetables into pieces small enough to fit into the juicer.
  2. Process the vegetables in the juicer, and drink immediately.

Interview: Are Employee Assistance Programs Worth the Money? Featuring Sharlyn Lauby

Sharlyn Lauby, SPHR is author of the blog HR Bartender and president of ITM Group Inc. Her company focuses on developing training solutions that engage and retain talent in the workplace. She’s the author of Employee Motivation published by ASTD Press and a contributing author on workplace power to “The ASTD Management Development Handbook”. Her goal in life is to find the best cheeseburger on the planet.

In your experience, what sort of usage levels have you seen with Employee Assistance Programs?

I don’t have any data about how often Employee Assistance Programs (EAP) are used. But I do know from anecdotal experience that when employees need help, EAPs do get utilized. Even today as a consultant, I often remind employees that the benefit is available.

On some level, it reminds me of my AAA membership – I don’t think much about the roadside assistance service until I’m stuck on the side of the road with a flat tire. And then I’m really happy that I have it.

Keep reading →

[LEGAL] The 4 legal liabilities of benefit plans

How to avoid being sued over technicalities in your benefit plan

Business owners are often taken to court by their employees over tiny technicalities in their benefit plan. Here’s what can happen, and how to avoid an expensive settlement.

Liability #1: Employees who are “Not Actively At Work (NAAW)”.

All insurance contracts state that if an employee is Not Actively At Work, they are not eligible for coverage.

This is because of risk. Insurance companies don’t ask medical questions when a company
purchases benefits. They assume that people actively at work are healthy and pose no significant underwriting risk. Anyone falling outside of that presents new risks which were not agreed upon when the policy began.

Employees who take time off (apart from sick days, scheduled vacations and maternity leaves) are considered NAAW. Any grey area such as compassionate leave, leave of absence, sick leave, or unpaid vacation, could be construed as NAAW.

Keep reading →

How do drug cards really work?


What is stopping Canadians from choosing cheaper generic substitutes over brand name drugs?

Drug plan costs are on the rise, and generic drugs can provide huge savings for sponsors, group insurers and plan members.  Generic drug prices are declining, and it’s important to understand generics so that you can take advantage of benefit plan savings.

Brand name prescriptions are almost three times more expensive than generics, priced on average at $73.76 and $24.05 respectively, according to IMS Health Canada. Furthermore, a 1% increase in the utilization of generic drugs would provide more than $260 million in savings across Canada.

What is stopping Canadians from choosing generics? There is still a large stigma with patients with choosing generic drugs – it’s often perceived to be a weaker alternative to the ‘superior’ brand name drug.

 

Keep reading →

Major Insurance Carriers Jump on the Generic Substitution Bandwagon

Market leading insurance companies such as Sun Life Financial and the Co-operators Life Insurance Co are transitioning to generic substitution in an effort to ensure long-term drug plan sustainability. As of recently, all new business to their pay direct and pay deferred drug plans will be set up with mandatory generic substitution.

What this means for new clients

  • When a doctor writes “no substitution” on the prescription, the patient is reimbursed only for the lowest price equivalent (where existing clients would be covered for the higher priced brand name drug). An exception to this rule occurs when the customer can provide medical evidence that there is no appropriate substitute.

What this means for existing clients

  • No changes have been made to benefit plans unless otherwise requested by the client.

Will generics drive brand name drugs out of the business for good?

Currently, the average claim for a brand-name drug is $72, whereas generics are only $27 on average. Generics are growing in popularity, and only time will tell what companies will do next when it comes to generic substitution.

   

Lowest cost group benefit provider in Ontario

Lowest cost group benefit provider in Ontario

The Beneplan Co-operative is the lowest cost group benefit provider in Ontario and Canada for groups with less than 500 lives.

Mark-up to administer benefits is lowest

For groups with under 50 lives, the all-inclusive administration fee is 15%. This includes:

• 8% Admin Fee to Beneplan
• 5.5% Fee to the underwriting insurance company to process claims
• 2% Federal premium tax

For groups with 50 or more lives, the all-inclusive administration fee is 12%. This includes:

• 5.5% Admin Fee to Beneplan
• 5% Fee to the underwriting insurance company to process claims
• 2% Federal premium tax

Plus, there is the opportunity for a refund on your health, dental and life insurance premiums if your employees spend less than claims plus fees.

Lowest stop-loss rates in the country

Our rates for stop-loss insurance are $1.97 per single per month and $4.97 per family per month for groups with drug-caps. For groups with unlimited drug plans, the rates are higher by a few dollars, depending upon the risk. These rates are equivalent to what an enterprise-sized firm would pay, yet they are available to small & medium businesses through Beneplan.

A Non-Profit Insurance Co-operative

The Beneplan Co-operative is a fully non-profit entity. Aside from the admin fee which Beneplan Inc makes to run the co-operative, 100% of the surplus which is generated by the Co-operative is fully refunded back to members. A reserve must be set aside from the surplus, which is mandated at 10% of the surplus to a max of 5% of last year’s claims.

Call 1.800.387.1670 or click here to find out how you can join the Beneplan Co-operative.

 

Best benefits broker in Toronto by customer service

Best benefits broker in Toronto by customer service

The Beneplan Co-operative provides the best customer service out of any benefits broker in Toronto . Here’s why:

• Multiple 1-800#s available for employees to call in with questions
• A personal benefits consultant is assigned to each employer
• Your benefits consultant can be reached by cell phone any time
• Employers have access to the same world-class consulting as the large firms, but with no additional cost

Beneplan provides expertise on the following issues:

• How to avoid lawsuits regarding benefits
• How to take advantage of the EI Premium Reduction Program
• How to avoid paying for benefits indefinitely with someone on disability
• How to avoid over-insuring your long term disability
• How to structure benefit plans to save money without cutting benefits
• How to take advantage of the Ontario Trillium Drug Program
• How to negotiate with dentists, pharmacists and other providers
• How to deal with benefits around layoffs and severance
• How to provide coverage to expatriates
• How to have a claim paid even though the insurance company rejects it
• How to handle benefits which are taxable to employees
• How to navigate the bureaucracy of insurance companies
• What to do if an employee tells you they have Cancer
• How to avoid pay below-retail pricing for benefits
• How to deal with tough Human Resource situations

Call 1.800.387.1670 or click here to find out how you can join the Beneplan Co-operative.