Group Benefits and Employee Addictions

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Ten percent of the Canadian population report symptoms consistent with substance dependency. In the USA, the ratio is similar.

Source: Statistics Canada

Employers may watch for:

  • regular absence patterns
  • late for work
  • poor focus affecting production
  • confused about directives
  • appearing tired or stressed, or lazy
  • not collaborating well with other employees
  • a short temper
  • increased mistakes or wrong interpretations of duties

Have a policy for your employees who may suffer from substance abuse. Employers may have to find ways to approach, address, manage and/or get counsel for an addicted employee. The policy can also advise that your company suggest accessing an organization’s employee assistance program (EAP).

For an employee who suffers from an addiction to be eligible for group benefits, a group benefits plan may require that the employee disabled by addiction be introduced to a treatment program.


 

Group Critical Illness Insurance

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Group Critical Illness Insurance 

News of a critical illness can be very upsetting to a plan member. When you can offer them financial support during a difficult time with a Group Critical Illness Insurance plan, the employee can manage with the extra resources better.

Group Critical Illness Insurance Allows the critically ill to focus on recovery rather than worry about finances. It pays a lump sum amount when a plan member is diagnosed with a covered life-threatening illness.  The insurance benefit payment can be used as the plan member chooses. It is available to plan members and dependants.

Once a claim is approved for someone diagnosed with a covered illness, he or she is paid a lump sum. The money may be used however the person chooses, such as private nursing or medical care, modifications to a home or childcare costs, allowing the person to focus on recovery and managing the illness.

You can offer Group Critical Illness Insurance to plan members and their dependants while giving them an option to purchase additional coverage for themselves and their spouse. Benefits can be structured as either a flat amount (i.e. $25,000 to $100,000) or a multiple of the plan member’s salary.

Covered illnesses

Most standard plans cover these common major illnesses:

  • Heart attack
  • Stroke
  • Coronary artery bypass surgery
  • Cancer

Dependent on the plan, it may cover the illnesses above, plus:

  • Alzheimer’s disease
  • Aortic surgery
  • Benign brain tumour
  • Blindness
  • Coma
  • Deafness
  • Heart valve replacement
  • Kidney failure
  • Loss of independent existence
  • Loss of limbs
  • Loss of speech
  • Major organ transplants
  • Motor neuron disease
  • Multiple Sclerosis
  • Occupational HIV
  • Paralysis
  • Parkinson’s disease
  • Severe burns

Business employee retirement planning

Employee Retirement Plans incorporate the following:

• Analysis of available investment vehicles and associated yields
• Investment tracking and reinvestment alternatives
• Individual financial and investment consulting
• Establishment and management of individual registered and non-registered retirement savings plans such as self-directed RRSPs, group RRSPs, & RESPs with the following investment alternatives: investment funds, segregated funds, and labour-sponsored funds.

Group Retirement Options

When your employees retire or are approaching retirement, they will need help through this period of change. Professionals are available to educate your employees about all available retirement income vehicles.  We offer the expertise and services to ease the transition to retirement for your retirees:

• Retirement consulting
• Retirement income projections
• Establishment of retirement income vehicles such as RRSPs, RRIFs, LIRAs, LIFs, annuities

Individual Group Investment Products

Whether you are making investment contributions to save for future expenses or retirement, the Group Investment Program allows you to take control of your personal portfolio and achieve your financial goals with peace of mind.

• Lower investment management fees
• No front- or back-end sales charges
• No deferred sales charges
• No minimum investment
• Self-directed RRSPs
• No annual administration fees
• Consolidated statements

Group Retirement and Savings Plans

Group Retirement & Savings Plans  

We endeavour to deliver unparalleled service in group retirement and savings plans.

Canadian Defined Benefit Contribution plans and Group RRSPs have continued to play a growing role in Canada’s retirement landscape. We can help employers streamline and improve their retirement benefits for employees.

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Pensions in Canadian Retirement

Statistics Canada recently released some good information on retirement savings trends in our country.  For families in which the major income recipient was aged 55 to 64, 8 in 10 held either RRSPs or employer pension plans (EPPs). It is noteworthy that at each age level, median pension holdings were substantially higher, at $244,800, than those who only hold RRSPs.

A company that has a pension plan or assists employees to achieve their retirement is an employer of choice, particularly among high-quality seasoned and experienced employees.

We will work with you to develop the Group Retirement & Savings Plan best suited to your organisation’s needs.

Source: Statistics Canada

What are the benefits of an Employee Benefit Plan?

The following largely coincides with the guidance of the IRA’s information. The Information can change over time and your advisor and/or tax professional should be consulted.

Retirement can last a long time

  • Retirement can last for 30 years or more?
  • You might need up to 80% of your current annual income to retire comfortably?

Why should you set up a retirement plan, and what are some of the benefits?

A retirement plan has lots of benefits for you, your business and your employees. Retirement plans allow you to invest now for financial security when you and your employees retire. As a bonus, you and your employees get significant tax advantages and other incentives.

Business Benefits

  • Employer contributions are tax-deductible.
  • Assets in the plan grow tax-free.
  • Flexible plan options are available.
  • Tax credits and other incentives for starting a plan may reduce costs.
  • A retirement plan can attract and retain better employees, reducing new employee training costs.

Employee Benefits

  • Employee contributions can reduce current taxable income.
  • Contributions and investment gains are not taxed until distributed.
  • Contributions are easy to make through payroll deductions.
  • Compounding interest over time allows small regular contributions to grow to significant retirement savings.
  • Employee has an opportunity to improve financial security in retirement.

Examine the Future Retirement Income from potential savings in the following graph.

Source: Calculations by Adviceon

How do you set up a plan?

A good place to start is by contacting a tax professional familiar with retirement plans or an advisor and/or a financial institution that offers retirement plans.

Establishing your Employee Plan

You take the necessary steps to put your plan in place. Depending on the type of plan you choose, the administrative steps may include:

  • Adopting a written plan
  • Arranging a funding plan for the plan’s assets
  • Notify eligible employees about the terms of the plan
  • Developing a recordkeeping system.

Operating your Employee Plan

You want to operate your retirement plan so that the assets in the plan continue to grow and the tax-benefits of the plan are preserved. The ongoing steps you need to take to operate your plan may vary depending on the type of plan you establish. Your basic steps will include:

  • Covering eligible employees
  • Making contributions
  • keeping the plan up-to-date with retirement plan laws
  • managing the plan assets
  • providing information to employees participating in the plan

Drug Plan Management Solutions

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Drug Plan Management Solutions:  There is a wide range of drug plan options that can be fine-tuned to suit your organization’s needs, while allowing you to better manage the rising cost of prescription drugs. Yet you can still provide your plan members with the coverage they need. We can help you keep your drug plan affordable for both you and your plan members, by implementing drug plan cost management solutions.

Two-tiered plans:  A two-tiered drug plan design allows you to cover two formularies at two different levels of reimbursement. A tier-one managed formulary with a higher coinsurance can be supplemented by a more comprehensive formulary at a lower coinsurance level. This allows your plan to maintain broad drug coverage, while still lowering overall costs.

Managing your drug plan with formularies:  A formulary is a list of drugs the benefits plan will cover, out of the thousands of prescription and non-prescription drugs on the market today. There are many types of formularies, but the overall goal of each one is to control the eligibility of drugs, and therefore help manage drug costs by either: adding new drugs only after their therapeutic value and cost effectiveness have been proven, or allowing only generic drugs, or following the guidelines set by provincial governments.

Formularies may be designed such as:

Managing your drug plan with cost-containment options
We offer a number of plan design options to help you manage your healthcare plan costs. Let us help you determine which of these solutions fit your needs.

Using Generic Substitution
Cost reimbursement is established to the value of the generic equivalent of a drug, regardless of what has been prescribed, unless the physician indicates ‘no substitution’ on the prescription

Per-prescription deductibles:  This is the amount the plan member must pay for each prescription drug claimed. It can be set to a specific amount, or equal to the dispensing fee portion of the drug.

Coinsurance:  Coinsurance is the determined percentage amount that the plan will pay for eligible prescriptions after any deductibles have been met.

Dispensing fee limits:  This is the plan’s coverage up to the maximum amount of the fee pharmacies charge to cover their business expenses.

Drug maximums:  This is the maximum amount the plan will reimburse for prescription drug coverage per person, per calendar year; maximums can be set at a specified amount per year, or can be unlimited.

Note: Plan Sponsors in Quebec: The Quebec government has a public drug plan that covers anyone who is not eligible for coverage under a private plan. This plan is administered by the Régie de l’Assurance Maladie du Québec (RAMQ). The law in Quebec also requires private drug plans to provide equivalent or better coverage than the public plan. Plan sponsors in Quebec are limited in how much they can alter their drug coverage, since they must ensure it conforms to RAMQ.

Note: Plans and coverage vary depending on the carrier used.

Dental Care Benefits

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Dental Care Benefits

Whether you and your plan members require basic maintenance or major procedures, group dental care benefits help cover the cost of dental services and supplies offered by licensed dentists. Employees significantly value dental care benefits. Many coverage options are available, and electronic “real-time” claims filing directly from the dentist’s office can save time. Your organization can specify coverage percentages and/or apply a fixed dollar amount per year.

Dental care covers such options as:

  • Ongoing care and maintenance of teeth, roots and gums
  • Diagnostic services – exams, radiographs, X-rays and tests
  • Preventative treatment – polishing, scaling, oral hygiene instruction, it and fissure sealants, and space maintainers
  • Minor restorations – fillings, prefab crowns for primary teeth, and other services completed in conjunction with minor restorations
  • Endodontics – root canal therapy
  • Periodontics – treatment of gums
  • Denture maintenance – relines and rebases
  • Oral surgery – removal of teeth
  • Adjunctive services – anaesthesia, medications and pain relief

Major coverage includes work such as:

  • Crowns and Onlays
  • Dentures and bridges
  • Related items such as posts, pins and denture-related surgery
  • Replacements when the existing appliance is five or more years old
  • Appliance maintenance – denture relines and rebases, denture or bridgework repair

Orthodontic coverage includes work (with limitations) such as:

  • Ortho-exams, X-rays, diagnostic radiographs and casts
  • Braces and retainers (usually limited to children between certain ages)

Note: Plans and coverage vary depending on the carrier used.

Prescription Drug Benefits

Prescription Drug Benefits 

Drug plans are one of the main attractions in a benefit package for a plan member and is one of the most highly used benefits by two thirds of plan members. A range of drug plan and drug formularies can be tailored to suit your organization’s needs; allowing you to better manage your prescription drug benefits versus costs while still providing your plan members with coverage they value.

You may choose from plan designs offering a range of coverage, including the following managed drug plan:

Prescription drug plan:  Prescription drugs are a fast-rising cost component of group healthcare claims due to cut-backs in government-sponsored plans, Canada’s aging population and the introduction of new, more expensive drugs. The plans provide coverage for drugs that require a prescription for dispensing or for sale; which includes some life-sustaining drugs which may be available without a prescription; or may include or exclude over-the-counter drugs.

Claims Payment Options:  You can choose the method of claims payment your plan members will use for their drug purchases.

Reimbursement: This is the traditional payment option where plan members pay for their prescriptions at the time of purchase and submit their claims on paper for later reimbursement.

Pay-Direct Drug Card: This system allows for on-the-spot claims processing of prescription drugs at almost any pharmacy in Canada. A plan member presents his or her card to the pharmacist, who submits the claim electronically. The plan member’s eligibility and drug coverage is confirmed and he or she pays only the portion not covered by the plan.

Deferred drug card: This system is similar to on-the-spot processing of prescription drugs submitted electronically by the pharmacist at the point of sale. The plan member pays for his or her prescriptions and is reimbursed by cheque once a dollar-amount or time-period threshold is reached.

Note: Plans and coverage will also vary depending on the carrier used.

Group Benefits Overview

Group Benefits Overview 

We understand that your business is unique; whether you have ten or thousands of people working for you. Group Benefits typically include life, disability, health, and dental insurance coverage and many include other benefits such as Accidental Death and Critical Illness insurance, Health Spending Accounts and wellness programs. The advantage to the employer is that these benefits attract and retain quality employees. When corporations aim to acquire top employee talent they often are drawn to provide a superior employee benefits package.

What are the benefits for your business? A well-designed group insurance plan tailored to your employees adds exceptional value to your total compensation package. Often the best employees view their benefit plan as a major reason why they stay with their current employer.

 Comprehensive group insurance plan can help you to:

  • Attract high-quality employees
  • Imparts trust that your company cares about family values and health
  • Maximizes loyalty and reduces turnover
  • Encourages a healthy work environment
  • Improves productivity while it reduces absenteeism
  • Pays compensation in a tax-effective manner
  • Sets you apart from your competitors

Benefits for your employees:  Group insurance plans can offer financial and health solutions to your employees and their families in many areas including:

  • Prescription drug care
  • Dental care
  • Supplementary medical services
  • Life Insurance
  • Accidental death and dismemberment insurance
  • Disability – Income Replacement Plans
  • Critical Illness Plans
  • Hospitalization

Every group has unique requirements. Group benefit plans vary depending on the size of the group, your business objectives and financial budget. Once assessed, we will recommend a plan that makes the most sense for your business. You can also address any challenges you’ve had with your current group insurance carrier as we work with them to help resolve any issues. Prior to your policy’s renewal date, we ensure that your policy continues to meet your company’s and employees’ needs while you continue to receive coverage, service and pricing from your carrier.

Let us evaluate the market for you. We will submit a request-for-proposal to all potential insurance carriers to obtain the best plan at the most affordable price. Once you decide to move to another carrier, we will help you transition as we become your new benefits consultant. You will receive personal assistance during the entire transition. We will keep in touch with you on a regular basis to stay up-to-date on what’s important to your business and employees and act as your liaison with your carrier when necessary.  We work for you and in your best interest.

Keeping cost to a minimum. You can choose to fully cover the cost of insurance or share it with your employees. Moreover, you can offer your employees the opportunity to purchase individual life, disability and critical illness coverage. Individual insurance provides enhanced life and health coverage where long-term ownership via portability is valued by certain employees.  We will help you determine a plan that minimizes the cost impact on your company and will continue to advocate for you each time your plan is renewed, to ensure you still receive the best rates possible.

Note: Plans and coverage vary depending on the carrier used.

Extended Health Care

Extended Health Care
Extended Health Care benefits, also referred to as major medical benefits, are designed to supplement existing provincial hospital and medical insurance plans. The benefit provides for reimbursement of expenses and services not covered by existing government plans. Extended Health Care benefits can be divided into several categories which include:

  • Hospital coverage
  • Drug coverage
  • Medical supplies and equipment
  • Paramedical services
  • Out-of-province coverage
  • Other health care benefits

The plan may include a deductible and/or a coinsurance factor (e.g. 75% reimbursement for prescription drugs), and maximums (e.g. $500 per calendar year for chiropractor).

Vision Care

Vision care is not a fairly common feature of many benefit plans. This optional benefit provides coverage for eye examinations, eyeglasses, contact lenses and laser eye surgery, whereas safety glasses and prescription sunglasses are generally excluded. Vision care can be included in most benefit plans just by inquiring through your benefits broker.