Houston, we have a problem!

And the problem for the self-employed and contracted workers in Ontario are the hefty fees that WSIB is charging.

The problem with WSIB is not only  the high rates, but the fact that it covers workplace related incidents – nothing off the job!

What happens when you become disabled at home, or in your car, or anywhere else for that matter?

 The short answer – WSIB will not cover you.

I recently discussed this coverage with a gentleman that was quoted the rate by WSIB at 8.7% of his gross wage. His premium was going to be well over $800 per month just to be able to work! But what if the company you work for has “contracted” you and you cannot seem to convince WSIB to insure you? Are you then effectively unable to produce an income?

No matter what your health, there are companies that we can insure you with that are far superior to WSIB, and the odds of being declined for the accident coverage portion is almost non-existent.

This means no expensive “consultation” with experts and lawyers to appeal your WSIB ruling is required!

We looked at an alternative, well-rounded personal disability plan that covers disability on or off the job, and includes sickness, and the premium was $111 per month – a savings of almost $700.

If WSIB is able to mandate all self-employed workers to have this high-priced cash grab by 2012 there are going to be many angry self-employed families.

It is bad enough the government taxes us in several ways already, but the WSIB premiums may make the other taxes pale in comparison.

I will be working with several others to lobby against this, and I urge you to do the same. Let me know you are unhappy about the WSIB’s plans, and let’s form an alliance to combat this cash-grab.

The bottom line is that the insurance industry has plenty to offer, that makes the offering from WSIB non-competitive indeed.

Please contact me for a review of your disability needs at 1 866 856 6799, extension 201. Located in the GTA, we can personally look after you with old fashioned, face to face service!

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Why 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?

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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Let’s talk about your issues as a self employed contractor, shall we?

If you are an “employee” your company must by law insure you for workplace related injury. This might explain why so many companies are forcing employees to go on contract, and hiring them back at higher wages in lieu of benefits.

And, this is not necessarily a bad thing for you as the contracted employee. There are tax advantages, and if done right, more protection options in areas of disability coverage that will put you in the driver’s seat. Nortel has proven that group LTD is not the be all and end all, and it should send shock waves through the corporate employees to realize they had better take measure to protect themselves. But we are here to focus now on WSIB.

Perhaps your client is looking to cut back on cost, and by hiring companies and contractors, they can avoid the high premiums of WSIB.

Specifically, what are your issues and shortfalls with the WSIB insurance program?

The best little graph I have seen so far is this one that compares the WSIB situation with that offered by private disability:

Workplace Safety & Insurance Board	Private Insurance
On the Job Coverage Only (Work Related Injury plus Illness)	24 Hour Coverage Injury optional illness coverage at Home, Work or Play. Covers any type of injury or illness
Extended Health (Work Related Only)	Extended Health (Blanket Coverage). Alternative to WSIB contracts may offer $10,000 to $100,000 of Accidental Medical Emergency coverage. Group or Individual Extended Health contracts offer blanklet coverage any type of medical coverage to the terms of the contract purchased.
Rehabilitation discretion of WSIBReturn to work with Modified Duties	*Unlimited Rehabilitation Benefit in good contracts, others limited to the limit within the terms of the contract. *Return to work once client is able to return to work in his own occupation thereafter any occupation
WSIB doctor assessment of injury	Clients own doctor assessment
16 sprain & strain coverage	60 day coverage, options for higher sprain & strain coverage or no limit on sprain or strain Non Cancellable contracts with a 30 day wait offer NO limitation on Sprains & Strains
Coverage capped to reflect average industry wage1st year capped at $22, 567.00. Normal Rate for Owner Operator $5.78 per $100 of replacement Income based on net $32,000 of replacement income. Annual Premium $1,849.60	Overall Maximum Combined of $6,000 monthly for both Loss of Income and Business Overhead Expense Reimbursement.Coverage based on Gross or Net Taxable Income. Average Rate for Injury Only Coverage $3.76 per day. Annual Premium of $1,349.88 or $112.49/mo. Add Extended Health Coverage Optional. Annual Premium $2,098.68.
LTD at discretion of WSIB	Long Term Disability to Age 65 or 70 based on any occupation, education, training and skill.
Integrated with CPP	Integrates with CPP
Accidental Death & Dismemberment $300,000	Accidental Death & Dismemberment up to $500,000
Specific to Employer’s Market	Specific to Small Business Owners needs
Mandatory for Employees, Optional for Business Owners
Inflexible to alternate coverage in place.	Flexible. Purchase coverage by assessing your overall needs.

 I would add that the best policies will not force you to find a job outside of your occupation. And, this is important as your earnings increase with talent and experience. Why should you flip burgers at $7 per hour, when you have been trained at a specialty for $50 per hour? Why should you be penalized? Short answer – you shouldn’t!

It would seem there is a whole industry surrounding WSIB, it’s pitfalls, the complications of getting it, etc.

I just spoke to a client in his 30′s that was told by WSIB, that should he qualify, the premium would be 8.7% of his wage.

So, if he earned $3000 per month, the premium would be $261 per month.

Wow!

What would he be getting for that $261?

Well, what he is getting may better be described by what he is not getting.

• If he was in a car accident outside of work and became disabled – nothing.
• If he got an illness such as cancer or a heart attack that rendered him disabled – nothing.
• any other accident outside of work time and duties – nothing again.

The point is, if you are going to insure yourself adequately, why not be in control and be insured for any reason that might cause a disability?

Are you any less in need of money for disability issues not covered by WSIB? No.

As brokers, we are able to access the best disability plans, at the best cost, and these plans are yours.

In other words, good disability policies will be portable, will not be cancellable, and the rates are locked in at the time you take out the coverage.

Some plans can and do pay back a portion of premiums if you cash in, at 25% or 50%, and some allow you to convert them to other forms of income streams at retirement – specifically long term care coverage.

This literally leaves WSIB and it’s offering in the “dust”.

Like all protection, for the money, what is the best value?

Well, it certainly is not the schedule of benefits offered by WSIB.

The company you are contracted with, and that requires you by law to insure yourself, needs to know you are covered. By getting good coverage, they can be given a copy and their liability is over.

WSIB reminds me of an option in life insurance known as AD & D (accidental death and dismemberment).

AD&D will double the amount of insurance if death is caused by accident. So, I suppose if you get diagnosed with cancer, it would be a good idea to drive off the nearest tall bridge to ensure your family gets enough money.

Crazy or what?

Give us a call, and we can take care of your needs properly. 1.866.856.6799

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Well, all we tend to hear these days is the jeopardy of the pension system.

So, do not be surprised if Ontario Finance Minister Dwight Duncan ignores last year’s proposal from former law dean Harry Arthurs to increase the maximum pension guarantee from $1,000 a month – where it has stood since the early 1980s – to $2,500 a month.

Guarantees are harder to find.....life insurance may be the answer

The government of Canada  and it’s provinces has thrown their hands in the air and pleaded an inability to guarantee Canadians their supposed right to receive their company pensions.

History has shown that when companies fail, or reach a point of restructuring or going out of business, they look to tap into what should be the “untappable”.

Laws tend to not protect the hard workers that have contributed to, and are relying on their company plans.

Now, let’s take this a step further.

The husband and wife living off one pension, and realizing the uncertainty are looking for ways to ensure the survivor and their children are left with a half decent standard of living need to look at what can be guaranteed.

In the old days, countless sales ideas were bantered around to suggest that life insurance can be an estate creation tool, and an estate preservation tool.

It is also a tremendous way of creating a pension, and it is this aspect that should be explored.

When young, and furthest from retirement, the amount of life insurance a couple needs is the greatest.

Often however, the agent looking to sell a policy looks to sell the one with the highest commission, and therefore leans toward the permanent versions at the outset.

This can cause a variety of issues, the greatest being a high premium outlay, and a low insurance amount.

If you are lucky enough to survive to retirement age, and are looking to use your insurance as a pension plan backup for your family, have you got enough coverage to be turned into an income stream?

If you are no longer insurable, you have now created a situation that you cannot change the amount of insurance (money) you will be able to leave your spouse and family. Wouldn’t it have been better to guarantee the higher amount with term insurance?

And, there is another problem you have when working – disability.

If you bought expensive life insurance and did not look at disability issues, then you will be taking additional chances.

You work to provide income, but also only by working do you contribute to your pension.

If the disability plan at work does not include a contribution to the pension when disabled, your pension will be smaller than it should be.

And, what if your income level is literally cut in half? Would your mortgage payment be covered?

Would you become a bank mortgage statistic? Another foreclosure because of poor planning or an insurance agent that did not include disability as part of your insurance planning?

It happens, and it happens more than you might think.

To prove it, ask yourself when your insurance agent last looked at your situation should you become disabled, and did he/she review your long-term disability coverage in your employee booklet?

You can ask us to help you – 1.866.856.6799.

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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.

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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