Aurora Workplace Solutions are about creating brilliant futures by developing wealth security for businesses and individuals. As experts in the industry, they keep on top of recent news including changes to relevant group benefit plans, retirement savings options, and guidelines and policies. They also keep their eyes open for informative articles we think are of interest to our current and potential clients. Aurora Workplace Solutions are Trusted Saskatoon Group Benefits and Insurance Professionals!

What is Stop Loss Insurance?

Stop-loss Insurance takes claim off the Employer’s shoulders

When an employee has a health issue requiring expensive treatment, the associated high-cost claims can be significant for their benefits plan sponsor. But it’s impossible to predict when a large claim will arise, so stop-loss insurance, which takes the claim off the employer’s shoulders, is one option to help protect against these unexpected costs.

As a type of insurance policy that sits on top of a benefits plan, stop-loss is available to both fully- and self-insured plan sponsors. When choosing stop-loss insurance, an employer selects a threshold up to which it can reasonably cover claims — ranging from between $10,000 and $100,000 — and any claims beyond that will be covered by the policy.

Stop-loss not a substitute for plan management

The main benefit of stop-loss insurance is its ability to protect the Saskatoon employer from catastrophic claims. For self-insured groups, it primarily acts as a budgeting tool so there aren’t any unexpected hits that could affect accounting.

On the other hand, stop-loss can become costly. While a claim may be mitigated in the first year, premiums can rise in the following years, essentially providing only short-term stabilization. This is especially difficult if the claim is reoccurring, which is the case for most drug claims.

“Stop-loss doesn’t help you avoid cost; it simply helps you prevent an unexpected surge in costs in a given year. It’s not a substitute for plan management.”

Another drawback is that most plans only have a single market for stop-loss insurance, meaning employers can only purchase it from one group, typically their own health insurer, which limits them to that insurer’s quote.

To limit risk, employers can use a pre-existing condition clause for an employee’s first year of employment by setting benefits to a specific limit so they can’t bring in unexpected expenses. Another option is to put a limit on drug reimbursement levels or incorporate provincial drug programs into the benefits plan.

While stop-loss prevents large, unexpected claims from affecting a plan sponsor, it’s important to understand that issues can still arise after a claim is made and employers should be aware of all the available options, so they can make a decision before it’s too late.

Aurora Workplace Solutions design & create custom group benefits plans that meet custom organization goals. Read more about their Group Benefits Plans or contact them today to get started!

'Creating Brilliant Futures'

Aurora Workplace Solutions are Trusted Saskatoon Group Benefits and Insurance Professionals!

Wiegers Financial & Benefits is one of the largest private financial planning and employee benefits consulting firms in Saskatchewan. Its Saskatoon Financial Planning Division provides business owners, households, retirees, and students with expert investment and insurance planning services to help them reach their long-term financial goals. They also have a Benefits and Personal Insurance planning, division. In this latest Wiegers Group Benefits expert tip, they explain just how much employee benefits plans do for employees and their families. Wiegers Financial & Benefits are Trusted Saskatoon Insurance and Group Benefits experts.

Takes Care of Employees With A Group Benefits Plan

When employees think about their benefits plan, the benefits that most often come to mind are for prescription drugs, massages, and maybe a dental check-up every year. However, I’m confident that if you were to ask any Benefits Advisor or Consultant, he or she would swiftly tell you that benefit plans are so SO much more than that! These benefits are just the tip of the iceberg in terms of what a plan can provide for employees and their families.

Many people – employees and employers alike – are surprised by just how extensive an employee benefits plan can be. They’re often also surprised by how much a plan can do for an employee’s physical, mental, and financial well-being. If the COVID-19 pandemic has taught us anything, it is that our well-being is something we can no longer take for granted. And having an employee benefits plan is one of the best ways to stay protected.

There are two cornerstones of a benefit plan that deserve a lot more attention than they typically receive: Life Insurance and financial protection in the event of a disability or illness, namely, Short-Term and Long-Term Disability Insurance. These benefits are often included in benefit plans but are not touted enough for the critically important protection they provide.

Benefits Canada reported recently that many people between the ages of 30-50 have no Life Insurance outside of what is provided through their employee benefits plan. On the one hand, this makes for a hefty responsibility for employers. But on the other hand, employers who provide their employees with a strong Life Insurance benefit have a competitive advantage that helps them attract and retain top talent.

As for Disability Insurance, Wiegers Financial & Benefits is passionate about including it in every benefits plan. The reality is that many employees work paycheck to paycheck, and in the event of a severe or prolonged illness or injury, most don’t have enough money saved to be able to weather the storm financially. Disability Insurance is very often a financial lifeline that enables employees to focus their time and energy on getting better instead of stressing about how they’re going to pay their bills. And it’s apparent that the pandemic’s impact on mental health and disability is not going to lessen any time soon. This Benefits Canada article speaks to how the majority of Canadian employers are prioritizing mental well-being, and Disability Insurance benefits are a key part of what they’re doing about it.

If you’re like a lot of Canadians who believe that employee benefit plans are most important for getting their prescription drugs paid for or their massages covered, I encourage you to delve into the details of your plan. You’ll likely be surprised by what you learn, and you’ll be in a better position to know what you can be, or should consider, doing outside of your plan to protect your well-being. Your personal financial advisor will be a great asset to you in advising you on a good path to take and then actually putting these wheels into motion. But always remember that your benefits plan is likely doing more for you than you realize so be sure to provide your advisor with all of the details. Your benefits plan is there to help take care of you; let it do all that it can!

Jewelian Berry,
Benefits Account Manager, Wiegers Financial and Insurance Planning Services Ltd.

Wiegers’ Benefits Consulting Division includes many consultants and support staff who custom-design the most employee-valued and cost-effective group benefit, personal insurance, employee assistance programs, and retirement plans available. Contact them today for a no-obligation consultation to determine how they can help you.