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Archive for the ‘medical insurance Canada’ Category

A not so surprising study out of the US: Women taking financial responsibility/protection issues into their own hands

Tuesday, February 28th, 2012

MetLife Study Compares Women’s Views on Financial Responsibilities to Their Family
February 20, 2012

WESTPORT, Conn.–(BUSINESS WIRE)–While women across generations are willing and eager to provide financial support to their family members, they are also placing a strong emphasis on self-reliance, according to the MetLife Mature Market Institute study, Women’s Views on Family Financial Obligations: A MetLife Survey of Intergenerational Findings of Baby Boomers and Generations X and Y.

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Make the call!

Monday, January 25th, 2010

stop-sign 

Wondering if benefit plans are really worth it?

Make the call and speak with us and get the “straight goods” on individual benefit and insurance plans! 

As a broker, I have done the math, and we need to have a discussion about benefit priorities.

We are experienced benefit brokers that want to ensure that your money is not thrown away on unnecessary benefit plans that may not pay you anywhere near what you put into them. The truth is, individual benefit plans can be no where near as cost-effective as large company group plans, and this is often what people expect.

Are you really thinking of outlaying $100, 200, or $300 per month without consideration of the facts?  A two minute phone call may save you thousands of dollars. We urge you to get  the advice that may help you save a good portion of that hard-earned money? And, to set your priorities straight, it would be good to know where it really would hurt, wouldn’t it?

 

Hamilton: 905-667-4410

Toronto: 416-238-4410

Kitchener: 519-772-4810

Ottawa: 613-288-8194

Other regions: 1-866-856-6799

Thank you, and looking forward to speaking with you!

Craig Ferguson

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Benefit plans ABC, 123 – Sesame Street style (Ontario & Alberta, Canada 1.866.856.6799)

Tuesday, November 10th, 2009

SesamestreetgoestothedoctorWhy does insurance advice have to be technical and complicated?

Confused yet over your benefit plan choices? Well if you are not, then chances are you haven’t looked long enough. Keep going, and you will be really confused in a short time.

Why do I call this article Benefit Plans Sesame Street Style?

Because we need to get back to basics the more confusing an issue gets. Cut down a few trees to see what we have in front of us. The basic ABC’s and 123′s please!

Okay, here goes the logic behind my approach…..

You call for a benefit plan to ensure you are okay in the event of an illness. Because, after all, who will cover those expensive medical drugs right?

Question: How did you get to a point that you need expensive drugs?

Did you get cancer or have a heart attack or stroke that led to those drug costs?

Yes?

Okay, so were you working before? Are you working now? What if you cannot work?

If you cannot work, would you produce an income to pay the bills? The bills, including any premium for the drug plan you called for! Any bill for that matter?

So, priority number one is covering off the income problem, because without income, forget the drug problem, it pales in comparison.

And, this explains why if you are working for a large company they offer life and disability, medical, and dental, right?

The bottom line is that if you are looking for a benefit plan, you should first be looking to cover off the income need – that is, you need to ensure income or it’s game over. Then, the gravy is how you will look at the drugs and dental expenses.

And, if you are in Ontario, should drugs become a huge issue, there is also the Trillium Drug plan to help.

The United States is looking to move to a system (jury out) that is similar to Canada. Their problems are far greater than ours, as a simple pregnancy can be costly.

Which would be worse: the doc telling you you need a prescription or that you cannot work and earn your paycheque?

Which would be worse: the doc telling you you need a prescription or that you cannot work and earn your paycheque?

We have the luxury of having basic medical care in Ontario, Alberta, and Canada that is far superior to the issues facing Americans, and I hate to say it, we have income problems more than medical plan problems.

It really becomes a question of ensuring your lifestyle is not affected with illness or injury, or other medical issue. After that, it is a need to cover off inevitable expenses as cost-effectively as possible.

And that’s the ABC and 123 of that!

We are here to help – 1.866.856.6799

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What would you think of me if……?

Wednesday, October 21st, 2009

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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Dental health is not just a “mouth” issue

Tuesday, October 20th, 2009

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?

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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Dental Benefits and Insurance

Wednesday, October 7th, 2009

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!

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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Medical (Health) & Dental Insurance in Ontario & Alberta, Canada

Tuesday, October 6th, 2009

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?first aid

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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Group Medical Services (GMS) Health Plans

Sunday, October 4th, 2009

Group Medical Services has proven itself to be a contender in the benefit field for Canadians. Please look closely at these plan features, and give us a call to see if they would fit your needs:

Individual Health Plans

 Information provided by GMS:

No matter what stage of life you’re in, you can ensure your family’s health care security, with supplemental health insurance coverage for everyday health needs, unexpected medical emergencies and protection from rising health, drug and dental costs.

OmniPlan®
Your premier health insurance choice. You get extensive health benefit coverage including health practitioner services like physiotherapy and message therapy, vision care, glasses and much more.

ExtendaPlan®
Comprehensive coverage with a wide range of benefits including coverage for medical emergencies, medical supplies & equipment and a variety of health specialists.

BasicPlan
Ideal coverage for unexpected emergencies including those essential health benefits not covered under your provincial health plan – like ambulance services, preferred hospital rooms and in-hospital drugs.

Additional Coverage Options
Complete your coverage with options for Prescription Drugs, Dental Care, Hospital Cash and Travel Medical.

Why Select an Individual Health Plan from GMS?

  • Comprehensive Coverage. Provincial health plans offer limited medical coverage for such things as ambulance services, casts, crutches, artificial limbs, in-hospital private-duty nursing and numerous others. Use GMS Individual Health to supplement your provincial health coverage or employer-sponsored plan.
  • Flexible Plan Design. You can customize your plan with several options such as dental care, prescription drugs, hospital cash and travel medical for one low annual premium.
  • Outstanding Customer Service. Our representatives are available to answer all or your questions and assist you whenever necessary (and, they answer your phone call in person).
  • Quick Claims Turnaround. In most cases, claims are paid within 5 working days from date of receipt.
  • Pay-Direct Service. GMS pays many health and dental providers directly. Present your GMS pay-direct ID Card at participating pharmacies and dental offices to save on out-of-pocket expenses.
  • Affordable Premiums. With several health plan choices, and a range of optional coverage, GMS provides health customers with affordable annual premiums and a choice of annual and monthly payment methods. 

Here is a basic comparison of plans that will vary by province:

Benefit         Omni                Extenda                Basic
Goods & Services Goods and services may be purchased anywhere in Canada. Goods can be purchased anywhere in Canada. Services must be received in your province of residence. Goods can be purchased anywhere in Canada. Services must be received in your province of residence.  
Eye Exam $75 / 2 most recent policy years N/A N/A  
Eye Glasses, Contacts, or Laser Eye Surgery $200 / 2 most recent policy years N/A N/A  
Health Practitioners Maximum $35 per visit to a maximum of $300 per specialty, per person, per policy year Maximum $35 per visit to a maximum of $250 combined per person, per policy year N/A Acupuncture, chiropractic, chiropody/podiatry, clinical psychology, speech therapy, massage therapy, naturopath and physiotherapy treatments.
Hearing Aids $800 / 5 years $500 / 5 years N/A One year waiting period.
Health Supplies & Equipment $500 / person / year $500 / person / year N/A See policy wording for a complete list of eligible items. Requires a Physician’s written prescription.
Diabetic Supplies & Equipment $300 / person / year $300 / person / year N/A Diabetic supplies and equipment, including testing devices when ordered in writing by a Physician. One year waiting period on testing devices.
Oxygen Supplies & Equipment $500 / person / year to a lifetime maximum of $2,500 $500 / person / year
to a lifetime maximum of $1,500
N/A Does not cover the cost of oxygen. One year waiting period on CPAP supplies.
Blood Pressure Monitors 1 in a 5 year period 1 in a 5 year period N/A Require Physician’s written order.
Custom Foot Orthotics 80% - 1 per 3 years per adult and 1 per year for children under 16 80% – 1 per 5 years per adult and 1 per year for children under 16 N/A  
Therapeutic Shoes $200 / person / year $200 / person / year N/A Require a Physician’s written prescription.
Mobility Aids $300 / policy / year $300 / policy / year N/A Canes, reaching aids, raised toilet seats, grab bars, bath safety rails and transfer benches when accompanied by a Physician’s letter of necessity.
Ostomy Supplies & Equipment $300 / person / year $300 / person / year N/A  
Accidental
Death
$4,000 for funeral expenses in the case of accidental death N/A N/A  
Out-of-Province Referral $50,000 / lifetime $50,000 / lifetime N/A Requires prior written approval from GMS.
Ground Ambulance Unlimited Unlimited $2,000 / person / year 100% emergency transport to hospital; 50% return of bedridden patients.
Air Ambulance $8,000 / person / year $5,000 / person / year $3,000 / person / year Transport within your province of residence.
Casts and Crutches Unlimited Unlimited Unlimited Fibreglass casts and the purchase or rental of crutches.
Preferred Hospital Rooms 45 days up to $3,500 / person / year $1,000 / person / year $500 / person / year Private or semi-private hospital room costs
Private Duty Nursing 80% to $2,500 per person per year for in-hospital or in-home as palliative care nursing. 80% to $2,500 per person per year for in-hospital or in-home as palliative care nursing. 80% to $1,500 per person per year for in-hospital nursing. In-home nursing is for palliative care only; must be prescribed by a Physician.
In-Hospital Prescription Drugs $2,000 / person / year $1,000 / person / year $1,000 / person / year  
Accidental Injury to Natural Teeth $5,000 / injury $2,000 / injury $500 / injury Services over $300 must be pre-approved. 
Wheelchairs, Motorized Scooters & Adjustable Beds 100% of purchase or rental to a maximum of $1000 / 5 years 100% of purchase or rental to a maximum of $750 / 5 years 100% of purchase or rental to a maximum of $500 / 5 years These benefits have a one year waiting period and require a Physician’s written order.
Artificial Limbs, Eyes & Larynx $5000 / person / year $5000 / person / year $5000 / person / year  
Patient Walker 80% of purchase or rental to a max. of $300 / 5 years / policy 80% of purchase or rental to a max. of $300 / 5 years / policy 80% of purchase or rental to a max. of $300 / 5 years / policy This benefit has a one year waiting period, and requires a Physician’s written order.
Breast Prosthesis $325 / 2 yrs lateral
$650 / 2 yrs bilateral
$325 / 2 yrs lateral
$650 / 2 yrs bilateral
$175 / 2 yrs lateral
$350 / 2 yrs bilateral
Excludes surgical brassieres.
Additional Coverage Options
Prescription Drugs 
Coverage for prescription drugs listed under your provincial drug formulary (as detailed under your province’s drug or pharmacare plan/program) up to $3,500 per person, per year. Pay only $4.00 for each eligible prescription. Use our convenient pay-direct card and reduce your out-of-pocket expenses. Prescriptions for pre-existing medical conditions are not eligible for coverage.
Prescription Drugs - Enhanced
Coverage for prescription drugs and oral contraceptives up to $5,000 per person, per year. Includes up to $500 coverage per person, per year for prescription medications for pre-existing medical conditions and legal prescriptions for medications not listed under your provincial drug formulary. Pay only $4.00 for each eligible prescription. Use our convenient pay-direct card.
Dental
1st yr - 75% to $500; basic services
2nd yr - 80% basic, 50% major to $750
3rd yr - 80% basic, 50% major to $1,000A three month waiting period applies to all dental services. Services over $300 must be
pre-approved by GMS.
Hospital Cash $100 / day, up to 30 consecutive days.Begins on the 4th day of hospitalization and on the 7th day if hospitalization is due to maternity. 30 day waiting period.
Travel
$2 Million coverage3 options:
15 days per trip
30 days per trip
48 days per tripSubject to exclusions for pre-existing conditions. GMS indiv policy wording for complete detail.


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Benecaid Plans and the self-employed

Friday, October 2nd, 2009

 

Shopping for Benefits? Have you done the math on Individual, Family, and other money hungry plans?

Benecaid plans fit nicely…

(click here to see the original article)

One of the biggest obstacles to self-employed people is the dilemma of buying expensive medical and dental insurance.

Until recently, I advised most of my self-employed clients to put their money in the bank, and only buy catastrophic medical coverage, as you never win with conventional insurance.

What do I mean by that?

Have you ever taken a good look at individual coverage policies, with their inherent co-payments (you pay a percentage of each bill) and their limits (the insurance company pays up to a set maximum amount per year per person, with lifetime maximums)?

If you have had experience with this, you no doubt tried doing the math….“if I pay this a month, and claim this a year, with these maximums am I ahead or losing money?”

The likely answer is you are losing money just to be able to say you have coverage. Not a good situation, and it makes little sense.

Until Now….

There is a rule in the Income Tax Act that allows self-employed individuals and their employees to either have the company pay the medical and dental expenses as a non-taxable benefit, or the owner of a non-incorporated business can reduce his/her income by the amount he/she puts into the health account (similar to an RRSP deduction). These are called Health Spending Accounts (or H.S.A.’s). You can also elect the Cadillac version of the plan which includes Catastrophic Coverage, eye glasses, prescription drugs, and professional services, called the Premiere Plan.

So, without losing a cent, the company and/or self-employed can cost-effectively pay for the costs of medical and dental with “pre-tax dollars”, effectively lowering their cost by up to 40%.

Now that makes good economic sense!

I now have clients telling me they have enough in their accounts to cover their kids’ orthodontics! You too can save $1000′s and have $1000′s to show for it. Why give up all that money to the profit thirsty insurance companies?

Send me a note and I can arrange to show you how this plan can benefit you and your employees. No employees? No problem, you are eligible to get your own plan even if it is just you!

And, you cannot be refused or declined for coverage as long as you are self-employed, or an employee of a company that has this plan in place!

Benefit Survey & Request form: If you complete our survey, it can also be used as a ‘quote request’, that will give us a good idea what your needs are…we check them regularly.

 

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Blue Cross plans in Ontario & Alberta , Canada

Wednesday, September 30th, 2009

How to decide which Benefit Plan may be right for you    

 

Note regarding Blue Cross Ontario:

We are an experienced and authorized BLUE CROSS Brokers, located in Ontario and Alberta, able to offer the full line of benefit plans and other unique products and quality solutions through our specialists in Ontario and Alberta. Blue Cross in Ontario utilizes the broker force to bring you good benefit advice, and the quoted cost is the same through a qualified Blue Cross Broker.

Blue Cross Service Issues on existing plans outside our office:

If you have been trying to reach Blue Cross directly for service issues on existing plans you have purchased elsewhere, please call our local or long distance numbers, or email us and we will be happy to direct you to the appropriate department. If however, you have lost your agent or would like us to service your plan, you have come to the right place!. We are driven to present to you all the appropriate solutions to your benefit needs.

 

Why should I speak with a Broker and not directly with each insurer?’

 

Let’s try to avoid the bungled ‘bundle’!

How are benefit plans like TV services? Have you ever frowned at your cable TV or satellite TV provider because the only way you can get the channels you want is in a bundle with other channels you don’t want? This adds to your cost, and the likelihood you will not cost-effectively cover your needs. Your money is best kept in your pocket, and you should buy the best combination of coverage that makes the most sense, with the least amount of wasted money.

We know the market, the company plans, and we know how to help you sort it out!

Why should you pay more for the coverage you need than you have to? 

Insurers market only the plans they offer, and they bundle their products. They also don’t take a very important aspect into consideration – YOUR HEALTH!

You should be shown plans that give you higher drug limits when you are in exceptional health. Don’t accept low limit plans that the insurer is at low risk for.

We are not tied or biased by one company, and can suggest solutions based on what you need. This saves you time, and does not waste money!

And, why shouldn’t you be exposed to all the options in the benefit market that make sense. Benefits you need may not be exactly the same as your neighbor, and trying to find the right plan is difficult to say the least.  We continually monitor the benefit market and can make your experience a positive one.

Here are some things we consider when discussing your benefit needs:

       To save money, if you are in exceptional health, you deserve to be shown plans that fit you best – some plans have unlimited annual and lifetime maximums on drugs. Your good health will qualify you for these programs, and you need to look at this as the most important aspect of the program.

        If you develop a medical condition that could financially devastate, will your benefit plan come through and pay all the expensive bills?

       If you are already in a position that drug costs are a huge financial burden and are living in Ontario, please see the Ontario Trillium Drug Program page. We want to help you with this process, and discuss if you would likely qualify. Please speak with us.

       If you are self-employed, there are cost effective, tax saving options

 

Call us today! We are here to answer your questions, and we do not charge for advice!

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