Benefits Ontario (Canada) 1.866.856.6799

One of the best arguments for personal, individual disability plans I have ever seen!

For those that think group insurance is adequate, and are relying heavily on the promises of industry to back it up – you’d better take a hard look at the pitfalls of any kind of group insurance – especially one that is designed to protect income in the event of disability…..

You are an employee of a company with a long-term disability plan.

Do you know the terms of how it may pay, and more importantly if it might not?

How much control do you as an employee have over the payments that might be made from the long-term disability insurance?

Well, bizarre as this may sound, Nortel was covering the payments in disguise of an insurer (Sunlife), and now with the company in hard times, those disabled employees stand to lose their benefit:

Imagine that you have a good job at Canada’s premiere telecommunications manufacturing company. You choose to make regular contributions to your company’s long-term disability (LTD) benefit plan because, while you are unlikely to ever need it, you don’t wish to risk finding yourself living in poverty or possibly institutionalized as a result of an accident or disease.

One day Fortune knocks, recruiting you into the world of the disabled. Though you’ve lost much, you are thankful that you’re not also left penniless. Then you receive a letter from your employer informing you that, regrettably,your LTD plan was not really covered by an insurance company and when the business evaporates so will your paycheque.

 

Even as an insurance broker of 21 years, I find this arrangement bizarre, and under the circumstances unacceptable.

Why on earth would the government allow a company to self insure an area of insurance that can be very expensive indeed?

And, as argued in the article, shouldn’t the money be locked up, as a form of pension plan, as has been argued  in the past as companies faltering try to tap into the company pension coffers?

A single disability claim can add up to millions of dollars in payments, and therefore Nortel, with over 400 employees on disability would need to set aside an enormous amount of money. Again, it begs a couple key questions that employees should demand, and seek the answers to:

1. Does my company have a similar arrangement?
2. How much net income will I get paid if I am disabled?

It also stresses the need to discuss these circumstances with a qualified broker who can help you with an overview of your options and alternatives. In light of the uncertainty of group long-term disability plans, you should discuss the individual options a personal policy could provide.

Insurers can give a discount for employees that want to take out individual policies.

So, while your group plan may be first payor, the individual plan will not leave you hanging as the group plan at Nortel has done.

Premiums for individual policies are guaranteed, the policy cannot be cancelled with the best plans, and you can take it with you from employer to employer.

When you rely on your income, and you stand to earn millions of dollars over the course of your career, can you tell me of a single more important issue you need to look at now?

Call us at 1.866.856.6799.

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Let me ask you a question or two.

What if you called our office looking for medical and dental benefits for you and your family because you didn’t have any?

And, our office found you a package for say, $150 per month covering medical drugs, semi private hospital, and dental care. Okay.

And you paid your premium for months, but then all of a sudden you got sick.

Still with me? Okay, good….

So now you are sick, and it looks like it is pretty serious, so you get your spouse to talk with the company you work for and they work out how much you will receive income wise when you are off on long term disability.

You have a mortgage and a family, and basically you needed every bit of your income to make it every month.

They give you the news…..your net pay will be about half of what you made net before. Is that okay?

You panic, and then you wonder why you were spending the $150 per month for a “benefit” plan if you could no longer afford to keep it.

You call me up and explain the situation, and I advise you that the plan you were so adamant to buy does not have an income replacement feature, and it therefore cannot make up the 50% loss of wages.

You become even more distraught and you realize that you can no  longer even afford to pay for the insurance you bought in case you got sick (which you now are) because you won’t be receiving enough money. What a nightmare.

What went wrong?

What went wrong is that if I didn’t ask you pertinent questions to first ensure your income would be enough if sick or disabled I would have failed you from the start.

When you called in originally for a benefit plan, “my job” would have been to screen out your current circumstances to see where you would be in the event you ended up where you did – disabled and sick, or injured. The bottom line is that you could no longer work to produce an income to live on.

I wouldn’t have done my job because I know that the likelihood of a disability is far greater than dying before age 65, and without income the bills (including health insurance) will not get paid.

I would not have done my job because the chances are you will earn millions of dollars in your lifetime, and it takes money to live. I would have failed you as your benefit advisor if we didn’t take the time to look at what would happen if you got into the situation you got into – not out of fault – but out of circumstance.

So when you come to me looking to spend $150 per month on a benefit program, please excuse me for caring, and ensuring that we know what will happen if you get to a point where you need some serious drug coverage.

It is not my job for you to appreciate my concern, but it is my duty to try to go over these important areas with you.

And I share that responsibility with my business partner, Nanette Gozutok. She is at extension 204, and I am at extension 201.

Pull up a chair, pour yourself a coffee, and give us a call. We want to hear about your situation, and discuss your needs.

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Well, did you know that periodontal disease is linked to heart disease?

It is. And yes, I am here to scare the daylights out of you!

Put mildly, poor oral health links your teeth to your heart. And you thought you could avoid going to the dentist.

Bacteria is in tremendous number in one’s mouth, so imagine if it should get from an infected gum, into your bloodstream, and bingo, to your heart. Not good, right?

Please see  this article for more information on periodontal disease, which affects at least 10 to 15% of the world’s population. Will you allow this to become a health issue for you and your family?

Is it really something to be "cut" from the budget?

If fact, if you do not have a dental plan, and say are self employed looking to cut expenses, then Houston, we have a problem if you think that not going to the dentist is the route for you and your family.

Here’s an interesting article for further reading.

Here’s the deal….

If you are self employed it really is an issue of priorities, tax savings, and many other issues to streamline your business, to make it the most “bottom line” conscious it can be. We have all “wasted money”, and what’s the sense of working for everybody but yourself?

Call us, and we can set you up with good advice and other professionals that specialize in their respective fields, to ensure you are taking advantage of all you can, so you can get to that dentist appointment.

There is help, and it’s a phone call away – 1.866.856.6799.

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Why would I need private health insurance? (see original link)

Important Information for Newcomers to Ontario

Most people who are residents of Ontario are eligible for OHIP. But, even if you are eligible, you must live in Ontario for 3 months before your OHIP coverage starts. This is called the “3-month waiting period.” However, you should apply as soon as you arrive in Ontario, have a permanent address, and all the documents you need to apply.

The Canadian Life and Health Insurance Association (CLHIA) recommends that newcomers purchase private health insurance for the 3 months that you are not covered by OHIP. Keep in mind that some insurance companies have rules and deadlines for buying insurance. For example, for some companies, you might have to buy insurance within a certain number of days after arriving in Ontario.

Also, according to the CLHIA, not all health related expenses will be covered with this private insurance. For example, pregnancy-related expenses may not be covered.

Call us to discuss the insurers that can help you! 1.866.856.6799.

Generally, the coverage you need is for “visitors to Canada.” The cost of coverage depends on the company you choose, the coverage package you choose, you and your dependent’s ages, health history and any number of other issues.

NOTE: If you are buying from your country of origin, read the policy to make sure that you are still eligible for coverage if you emigrate to another country. Make sure that it covers one-way travel, because many do not. As well, after you land and are no longer a resident of the country where you got the insurance, you may no longer be eligible for coverage you bought in that country. Read the policy “fine print” and tell the insurance company what your situation is and ask if you will still be covered before you buy.

Service Coverage

It is important to know that there are some services that OHIP does not cover at all. You should check with your doctor or hospital to find out whether a particular procedure or treatment is covered by OHIP.

OHIP may provide partial coverage for:

• Your first 3 months in Ontario.
• Some services your doctor provides.
• Some services from podiatrists, chiropractors and osteopaths.
• Physiotherapy treatments, depending on where you access them.
• Dental services.
• Eye examinations.
• If you live in northern Ontario and must travel long distances for specialty medical care.
• If you travel outside of Ontario or Canada there are some restrictions. The Ministry of Health and Long-Term Care recommends that you get private health insurance when you travel. Health care services outside Canada can cost much more than the Ministry pays.

Private Insurance

Featured Links

Contact the Canadian Life and Health Insurance OmbudService (CLHIO) Consumer Assistance Centre for information about health insurance companies and their products.

Guide to Supplementary Health Insurance – This booklet is designed to help you understand health insurance that supplements your public coverage, including information to help you decide what supplementary health insurance you need

Your employer may offer a group insurance plan that will cover some costs not covered by OHIP, or you can buy an individual plan from a private company. If you belong to a union or professional association, you may also be eligible for group insurance.

You pay a monthly fee for private health insurance plans. Employers cover all or part of the fee for their employees.

Most private health insurance plans include

• Extended health care (prescription drugs, medical supplies, hearing aids, vision care, semi-private or private room in hospital, complementary health services such as chiropractic and registered massage therapy)
• Dental plans
• Disability income, if you develop a serious health condition and can no longer work
• Critical illness coverage, if you are diagnosed with a serious condition such as cancer
• Travel insurance
• Accidental death and dismemberment benefits that will pay for your body to be returned home or for a prosthetic device if you lose a limb

Useful Resources

Guide to Supplementary Health Insurance – This booklet on supplementary health insurance brings together to answer to many of the questions Canadians ask when they call the Canadian life and health insurance industry’s Consumer Assistance Centre (CAC).

For more information:

• Canadian Life and Health Insurance Association (CLHIA) – Represents more than 80 private insurance companies in Canada. The CLHIA website describes the different types of insurance products, services, and CLHIA publications.
• Canadian Life and Health Insurance OmbudService (CLHIO) – An independent service that assists consumers with concerns and complaints about life and health insurance products and services. The Consumer Assistance Centre provides information on life and health insurance products and services.
• Health Insurance for Travelers: What you should know before leaving Canada – A brochure that can help you determine what supplementary health insurance you need to travel outside of Canada. Prepared by the Canadian Life and Health Insurance Association.

Ontario Health Insurance Plan (OHIP) – describes how OHIP works and provides fact sheets, forms, answers to frequently asked questions and a list of OHIP offices across Ontario. Provided by the Ontario Ministry of Health and Long-Term Care.

CALL US and tell us your situation. We are here to help! 1.866.856.6799

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The Edge^TM Disability

Loss of Income Injury Coverage Is Guaranteed To Issue*

(issue ages 18 – 64, coverage to age 70)

$1,000 to $4,000 per month
Injury only or Injury & Illness coverage, 24 hour or Non-Occupational available
Benefits payable to age 70 for most occupations
5 year benefit period available for all eligible occupations
Payable from the FIRST DAY
30 day or 120 day waiting period also available
Benefits based on Gross Business Revenue or Net Earned Income

Other Key Features

Partial Disability Benefit – 50% benefits for up to 180 days
Waiver of Premium – after 30 days of Total Disability and when benefits are payable
Return to Work Assistance Benefit – rehabilitation and financial assistance in returning you to work
Accident Medical Reimbursement Benefit, providing reimbursement up to $10,000 for a number of medical expenses not covered by provincial plans

Optional Benefits

Business Overhead Expense Coverage $1,000 to $4,000 per month
up to 12 times the monthly benefit (Starts after 30 days)
How long would your business survive if you were temporarily disabled? Don’t let your disability due to injury or sickness, disable your business also. Business Overhead Expense Coverage is designed to reimburse a business for overhead expenses in the event a key person of the business becomes disabled.

Accidental Death and Dismemberment Coverage $100,000 or $200,000 or $300,000
A lump sum payment for specific losses, in addition to any other insurance you may have.
Principal sum amount in the event of Death, Paraplegia, Hemiplegia or Quadriplegia.
Includes an enhanced loss schedule, as well as benefits like day care, education, home alteration/vehicle modification.

Out-of-Province/Canada Travel Emergency Medical Coverage
Provides up to $5,000,000 of coverage for reasonable and customary medical expenses as part of the emergency treatment arising from a medical condition.
Covered Expenses include hospital accommodations, physician charges, diagnostic services, paramedical services, ambulance services, emergency air transportation, transportation to bedside, and more.

• ·  Emergency Assistance Service available 24 hours 7 days a week no matter where you travel.
• ·  Unlimited number of trips and within the first 30 consecutive days of each trip. Certain exclusions, limitations, and definitions apply. All provisions of the plan are contained in the policy booklet. Please review the policy booklet when received for complete details.

  There are exclusions and limitations in all policy contracts and it is important that you understand under what circumstances a claim may not be paid. It is important to review your policy contract in its entirety for complete details of these exclusions and Limitations.

  * provided you satisfy

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What’s my what? Your PDQ!

What’s a PDQ?

Probability Disability Quotient, that’s what!

It takes factors into consideration, and determines a percentage likelihood that you may become disabled.

This calculator is US based, but we are all North Americans, with a similar lifestyle.

You, disabled? What are your chances?

Higher than you probably think. You can ignore the problem, but it’s hard to ignore the facts:

• Every :01 second another disabling injury occurs. That’s 60 per minute, 85,000+ each day. Surprisingly, more than 90% are NOT work-related.
• Freak accidents are NOT usually the culprit. Back injuries, cancer, heart disease and other illnesses cause the majority of long-term absences.

So, click here and see what your PDQ is….then give us a call….1 866 856 6799.

Or, use the disability contact form to fill out your information.

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If you have just left a large company benefit plan, and are looking for replacement dental coverage, what should you consider?

Well, it depends of course on a number of factors:

One thing is for sure, keep going to the dentist to ensure health!

• Are you still working?If you have changed jobs, and are an employee again at another company, will you be eligible for another group plan once you meet the minimum employment time (waiting period)? If this is the case, you might want to see in advance what the terms of coverage are, and what your contribution will be. Under this scenario, you are  not likely allowed  to opt out unless you have a spouse that has coverage elsewhere. If that is the case, a “spousal opt out” is usually allowed to avoid double payments, and double coverage. Having said that, you can claim at one company where the other leaves off, so all these considerations need to be weighed carefully.
• Have you become contracted or self-employed? If this is the case, there are traditional options, and also another option – a health spending (savings) account. The argument for this method is for those that have mainly routine appointments, and paying extra per month to an insurer if you are not likely to reclaim the money does not make sense. The full deposit into these accounts is 100% tax deductible, which has more favourable tax treatment than the medical tax credit.

So, what else can you expect from a personal, or family dental plan, otherwise known as individual dental coverage?

The premium range per person in the current market is approximately $50 to $70 per month. Family discounts can apply, and depending on the company and your situation, you may find better rates.

The biggest question related to your quest to find dental insurance is the question of “why”?

Why are you looking for coverage? Is it because you had a plan and lost it? Or is it because you need dental work right now?

If you have been an employee in the past, and are now on your own as a self-employed worker, the bigger question you must ask yourself is what are the big risk issues?

• Did you have a full benefit plan,that included life, disability, medical and dental?
• Based on that, are you now losing your disability coverage?
• How would an illness truly affect your income and family security?
• Relatively speaking, would an illness affecting income have a bigger financial impact than the odd bit of dental work?
• The question then is, what should be the “benefit dollar priority”?

We fail to see what is not an issue.

We can see dental bills. We cannot, unless ill, see the impact of a disability.

You may know of others that have  been disabled and lost everything. And this would drive the point home.

Now, going to the dentist should be a priority. Did you know that your teeth and gums can affect your heart? Well, periodontal disease leads to heart disease if you get an infection in your gums, that travels in your bloodstream. It can cause major heart issues, even heart attacks.

So, if you are without dental coverage, that is not the end of the world. Not going to the dentist may be.

Some dental offices give special rates to patients that do not have dental coverage. If you are self employed, this may mean a health savings account, coupled with a good discount will ensure you pay the least amount for a given amount of dental work. And isn’t that the goal? Make the cost of going to the dentist as cheap as possible?

We offer dental coverage from many major carriers including Blue Cross, Manulife, and Group Medical Services. The health savings account option for the self-employed is provided by Benecaid.

We can help ensure you are provided with an overview and specific information enough to make an educated decision.

But as a strong proponent of ensuring there is money first, for the next dollar you spend on you new benefit plan, should it be used to ensure your income, or cover a bill?

Without income, we cannot pay the bills, including the insurance bills.

And that’s food for thought.

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Tangible is a tremendously flexible product line.

Personally used most for disability insurance purposes, there are life insurance, and critical illness components as well, in alternative forms. For the purposes of this discussion, we willl concentrate on the disability hybrid product.

The disability hybrid effectively turns the disablility insurance into a long term care plan at retirement. The coverage then can be with you for life, but only payable for 20 years, or age 65, whichever comes later.

One of the big issues today, are seniors looking into long term care coverage to avoid the potential devastation it can create for a couple’s pension plan. If say the husband needs to be put in a nursing home at some point, the government will tap into the pension to cover the costs, leaving the spouse in questionable financial shape.

The ‘anti -erosion’ factor is attractive. What often is not attractive, is trying to buy this coverage at an older age, and when health issues have become an issue. Then, it may be a question of either being unaffordable, or unattainable due to poor health.

With the Blue Cross Tangible disability plan, certain occupations otherwise not looked at favorably by some other insurers, are in fact in great shape with this plan.

The scenario of the 40 something professional or business owner not requiring a guaranteed increase with age fits nicely. And, being able to see old age a little easier, the long term care feature is a nice bonus, seemlessly not adding to the monthly cost.

Here is the Tangible Brochure, and for the technically minded looking to dig deep, here is the Tangible contract.

Note that the option is there in the critical area – to extend coverage to age 65 for an “own occupation” definition.

Unlike many group insurance plans that restrict “own occupation” to 24 months, the Tangible plan will ensure your current income is protected should you not be able to perform your job!

Call us or use the contact form on the sidebar to fill out a request… 1.866.856.6799

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Depending on your personal situation, and that of your family, the right medical and dental insurance choices can be a daunting dilemma.

We do not serve one master. In other words, we are not tied to any one insurance company, and therefore are free to offer you the solutions (plans) that fit your particular needs.

How do we determine your needs?

Good question.

The size of your family, any pre existing medical conditions, and any current medication use is of obvious importance.

From there, what features are most important to you? Different companies and plans may have variances in this area.

If you are a diabetic with expensive testing strips, which company might actually cover a portion of this pre-existing condition?

All good issues. All good questions.

So, the next time you consider going online to try to invent this insurance wheel on your own, ask yourself an all important question. “Am I getting the best plan that fits my family best, at the best possible rate?”

Without a qualified broker that has already “invented that wheel”, you may be throwing away a lot of hard earned money, without proper consideration. Not a good place to be.

Our searching for you is on us! We do not charge to listen and suggest what would be best.

Of course, if you take out a plan through us, we do get paid by the insurance company.

Call us today, and let’s see what’s up! In Ontario and Alberta, 1.866.856.6799.

Oh, and if you want to send an email, look for the envelope on the left or right side, and it will link to a contact request form.

Thank you.

Craig

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There are a few great insurers for disability insurance.

Canada Life is definitely at the top of the pile.

But, depending on the occupation group, Canada Life may or may not be the choice.

So, let’s have a look at which occupation types that Canada Life looks favorably upon, shall we?

A rank of class 5, means that this is the best rate that can be had. Which occupations get the most favorable rating?

Let’s list them in alphabetical order:

• Accountants , CA, CGA, CPA
• Actuary
• Acupuncturist, MD
• Air Conditioning, Engineer, Office & Consulting
• Anaesthesiologist
• Architects, less that 20 hours per week at construction site
• Auditor, with professional accounting degree
• Bacteriologist
• Biochemist or biologist, consulting
• Botanist, with Ph.D
• Chemist, with Ph.D, consulting only, no lab duties
• Chiropodist – Podiatrist
• Chiropractor
• Computer Industry, systems analyst, consultants, programmers, website designers, earning $50,000 plus, or university degree in computer science
• Coroner
• Dentist
• Dermatologist
• Doctor of Medicine (Medical Doctor)
• Drug Store & Pharmacy, Druggist, or Pharmacist
• Engineer, professional
• Executive, Business Owners, under certain restrictions
• Geologist, office and consulting
• Gynecologist
• Homeopath
• Doctor in Hospital
• Judge or Justice of the Peace, office and court duties only
• Lawyer
• Naturopath or Homeopath, M.D.
• Ophthalmologist
• Optician, income of $75,000 or more per year
• Optometrist
• Orthodontist
• Osteopath
• Pharmacist
• Physician & Surgeon
• Physicist
• Podiatrist
• Psychiatrist
• Psychologist, with Ph.D
• Radiologist or Roentgenologist
• Teacher, University Professor, including cegep
• Topographer, office duties
• Vetrinarian, small animal

Now, it should be duly noted that there are certain occupations that are very close to the top rate, and in fact, Canada Life has a process called a quality risk upgrade,that may help occupations from 3 and 4 to get to a class 5 rate. This depends on income, job stability, and other factors.

Generally speaking, the riskier the occupation the lower the rating and the higher the rate for a given age group.

Speaking with a qualified broker is the only sure bet to ensure you pay for a disability plan that may actually be structured to ensure it fits your needs properly.

Call us today at 1.866.856.6799

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