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  • Specialize in small | Small Biz Advisor
    succeed For you that s opportunity knocking Are you ready to answer Consider servicing the small group market Become better than the competition at SmallBizAdvisor ca The top 6 health benefits issues for 2013 Avoid trouble with clients by adopting this simple habit Why mandatory enrollment is so important Reduce your clients drug costs by teaching them about patient assistance programs Make renewals easier for clients by clearly explaining key

    Original URL path: http://www.smallbizadvisor.ca/partner-education/specialize-in-small-2054?Print (2016-04-26)
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  • Top 6 health benefits issues for 2013 | Small Biz Advisor
    create a strain on insurance companies and private industry Provincial programs like the Ontario government s Trillium Drug Program will help with the increasing costs over the years These programs provide coverage for some medicines when drug costs for a household are higher than a certain percentage of household net income Read The Trillium Drug Program Ontario s best kept secret 2 Mandatory generic drug use In 2012 SunLife and Great West Life introduced changes that required clients to start making generic drug use mandatory Overall mandatory drug use decreases costs in the long run Some providers such as Green Shield Canada still allow voluntary generic drug use Drawing on the assumption that providers think alike more insurance companies will evolve into ensuring clients implement mandatory plans 3 Extended Healthcare Policy Protection Plan EP3 On January 1 2013 Canada s 24 insurers will implement EP3 an industry wide solution to drug claims that are more than 25 000 per claim EP3 will give employer s more flexibility in moving to another carrier if the employer has one or more people on a high cost drug Gory says Read CLHIA shares details on new pooling framework and How high cost drugs led to the industry pool 3 Tighter out of country coverage Individual insurance plans have had limits on travel medical coverage for a long time and group plans are now following that lead Gory noticed that Desjardins Financial Security changed out of country insurance coverage for group plans in Dec 2011 and Manulife Financial did something similar in December 2012 stating that any diagnosed medical conditions have to be medically stable 90 days before travel Manulife defines medically stable very specifically I predict more companies will add new clauses about being in good health having no change in symptoms and

    Original URL path: http://www.smallbizadvisor.ca/news/top-6-health-benefits-issues-for-2013-1804 (2016-04-26)
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  • One simple strategy to avoid trouble with clients | Small Biz Advisor
    paid is 85 Or you might forget to mention that a client has to charge retail sales tax he says If a client bills an employee at 1 per 100 of LTD coverage instead of 1 08 the eight cents is for sales tax then the client may be liable according to Canada Revenue Agency LTD benefits paid by an employee are non taxable but those paid by an employer are taxable Meaning that eventually the advisor could be liable As with clients an advisor needs insurance for insurance in the form of adequate errors and omissions insurance Advisors should also always seek information from a provider when a client asks for an interpretation because an advisor should never place himself or herself in the position of an insurer Which brings us to the simple strategy to avoid mistakes and problems put everything in writing Including disclaimers Everything Political and philosophical conflicts You solve the non clerical mistakes case by case because they involve politics a possible policy change different interpretations or just plain disagreements Barszo tells the story of one employee an executive who called him in a panic because the exec had submitted claims 68 days after a

    Original URL path: http://www.smallbizadvisor.ca/your-business/the-easiest-way-to-avoid-trouble-with-clients-1763 (2016-04-26)
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  • Why mandatory enrolment is so important | Small Biz Advisor
    it takes a little more work at the launch of a plan Employers might says things like The employee doesn t want to pay for it and I don t want to make them I ve asked the employee five times and they refuse to complete the enrolment form oh well I guess it s their problem now The employee says that the insurer keeps asking for more medical information and it s too much of a pain to get so I m not going to Given that mandatory enrolment can protect an employer and employee these are not really acceptables options if an employer wants to minimize their liability and ensure that their staff obtains the benefits they are entitled to under the plan The cost of just one error could easily enter the millions of dollars Obviously that is a situation every employer should try very hard to avoid The following explanation is one provided to employees of our clients to help them better understand the issue Your employer has implemented a benefit plan because they think it is a good investment in maintaining a healthy workforce and it offers a degree of protection to their staff in the event of a major health life or disability claim If you opted out or failed to complete the necessary forms the plan could fail to protect you The costs you could incur could run into the millions of dollars In many cases these costs may have been covered by the plan As an example at times your employer or the insurer will require you to complete health questionnaires in order to obtain the proper life or LTD coverage that your income level dictates It is essential that you complete and return these forms immediately in order to obtain coverage

    Original URL path: http://www.smallbizadvisor.ca/group-benefits/why-%E2%80%9Cmandatory-enrolment%E2%80%9D-is-so-important-1045 (2016-04-26)
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  • Who is eligible for patient assistance programs? | Small Biz Advisor
    instead of the generic equivalent Pfizer has created a drug card that pharmacists can use to pay for the cost difference between the generic and Lipitor In the US these programs are often referred to as drug coupons and in Canada these are called Patient Assistance Programs PAP At first glance most employers will think that this is great as it will help their plans and employees without costing them anything more but if any of the below points apply to your clients current benefit plans they would unfortunately not be able to take full advantage of PAPs The plan reimburses brand name drugs The plan reimburses generic drugs unless the doctor notes no substitution The plan does not have a drug card If a plan reimburses brand name drugs or if a doctor indicates no substitution on the prescription the PAPs would not apply because the plan will pay for the brand name drug Ie Lipitor In fact if your client s plan pays for brand name drugs and an employees plan is coordinated with a spouse s plan your client s plan could be taking up a larger portion of the drug bill if the spouse s plan is mandatory generic drugs only To fully take advantage of the PAP drug plan design would have to be mandatory generic which means that even if a doctor writes no substitution the plan will only pay for the cost of the generic drug However it should be noted that there could still be reimbursement for single source drugs drugs that do not have a generic equivalent Discussions surrounding drug plan designs can be quite complex and there is no one fits all formula that will help contain rising drug costs A mandatory generic drug formulary may not appropriate for many

    Original URL path: http://www.smallbizadvisor.ca/news/when-patient-assistance-programs-can-save-money-1875 (2016-04-26)
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  • Why does an IBNR matter in a renewal? | Small Biz Advisor
    has adequate funds to cover claims yet to be submitted for reimbursement says Brent Delveaux benefits consultant TRG Group Benefits Pensions Inc in Vancouver They are meant to provide financial protection to clients to ensure that the insurance company has the financial ability to pay for outstanding claims he says Especially if there were issues of financial solvency for the insurance company With these types of claims the insurer doesn t know the exact amount nor the extent of the claim says Claude Ferguson director actuarial services Medavie Blue Cross in Montreal IBNRs reserves are meant to make sure the insurer has the resources to pay for claims for which the amount is unknown he says They are set using assumptions about the future for a portion or the entire insurance portfolio using statistical models and averages based on previous overall claim experiences for the insurer Most insurers have actuaries and accountants responsible for ensuring IBNRs meet acceptable actuarial and accounting standards IBNR Renewals Some insurance companies use billed premium in the calculation of their IBNRs for client renewals and others use paid claims says Delveaux Ultimately most insurance companies use premium as the basis of the calculation when determining adequate IBNR requirements for their entire block of business he says IBNRs are very important for clients to be aware of and we would always ask for IBNR factors and calculations as they will come into play in determining renewal adjustments Insurers must keep their level of reserves well above the level required by the Office of the Superintendent of Financial Institutions says Ferguson Small businesses should make sure their insurer has IBNRs in place and at an appropriate level to ensure their employee s claim can always be paid regardless of a spike in claims either from one company

    Original URL path: http://www.smallbizadvisor.ca/group-benefits/why-does-an-ibnr-matter-in-a-renewal-1787 (2016-04-26)
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  • After the divorce: What to explain to clients and their employees | Small Biz Advisor
    of separation and divorce you may at some point have more than one person qualify as a spouse However each insurance carrier is different says Steven Goldman lawyer and partner with Goldman Hine LLP He notes that with at least one insurance carrier as soon as an employee is separated the soon to be ex spouse s eligibility for coverage is gone In cases like this it s the employee s responsibility to remove their ex from their plan right away Coverage doesn t terminate automatically That s why it s important to read your contract If a person doesn t qualify for coverage their claims won t be reimbursed says Gauthier In other cases it s often best to wait until the divorce is finalized to avoid situations like the one Pamela Glendinning of Glendinning Insurance Services described in Part 1 Goldman says that knowing the terms of coverage can also help the employee as they re negotiating their divorce agreement Before you negotiate you d better know what s contained in your policy Some of those policies have an automatic termination provision so you can t contract to keep your spouse covered under the policy That doesn t mean that you can t negotiate separate private coverage but again that usually ends up being costly Updating your beneficiary information As with benefits coverage employees are responsible for notifying the insurance carrier of any changes to their beneficiary information under their group life insurance policy Unlike benefits coverage however there s never a requirement to revoke an ex spouse s beneficiary designation In fact there are a few good reasons to keep an ex as a beneficiary for example if the ex spouse is the primary caregiver to the employee s children Says Gauthier If your ex gets alimony

    Original URL path: http://www.smallbizadvisor.ca/group-benefits/after-the-divorce-what-to-explain-to-clients-and-their-employees-1063 (2016-04-26)
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  • The moral argument for more life insurance | Small Biz Advisor
    to increase the amount of life insurance coverage offered to their employees for three key reasons The majority of Canadians are underinsured it may be a small amount but in the event of death it can make a tremendous difference Employees can be uninsurable and this is the only life insurance they will ever be eligible for The cost of the life insurance should be paid by the employee to ensure it is a non taxable benefit How small group life works Offering life insurance coverage is mandatory for small employers and typically consists of the minimum coverage of 25 000 per employee or commonly referred to as a flat 25 000 The employer has the option to design the amount of coverage they wish for their employees to have For example they can increase the flat amount to 50 000 or 100 000 or make the benefits a multiple of the employee s income Premium is determined by the average age of the employees and the claims history of the entire insurer s block of business A small or medium size employer could have one two or three employees make a claim on the pooled benefits and it would not affect their rates as the claims are fully pooled Employees automatically qualify for life coverage regardless of their health history up the non evidence maximum of the group Non evidence maximum is the maximum amount of life insurance coverage you can obtain without providing medical evidence A 10 employee group can have 200 000 life insurance benefit for each employee without having to provide medical evidence Moral obligation Does an employer have a legal obligation to offer a higher life insurance benefit than the mandatory 25 000 No but perhaps a moral one exists Does an agent have an

    Original URL path: http://www.smallbizadvisor.ca/group-benefits/the-moral-argument-for-more-life-insurance-1744 (2016-04-26)
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