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 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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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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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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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:

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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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BY: NANETTE GOZUTOK (PARTNER, INTEGRITY INSURANCE PLANNING)

There is so much to say that people really need to know.  I have just spoken to a person who has $800 in drugs costs each month.  Trillium does not work for her and she has nowhere to turn to help with the costs.  Her pharmacist is actually trying to get the drugs company to provide her with the drugs free of charge. 

 There are several issues here:
 
The majority of Canadians do not understand that Group Benefits are temporary.  They can be taken away at any time and if you have medical costs you are then left to cover them yourself.
 
Not all drugs are covered by the government, I am getting more and more calls from retirees whose drugs are not on the provincial formulary list and therefore not covered by the government.
 
Health and Dental insurance, and more importantly, disability insurance needs to be purchased when you are healthy.  This lady I have just been speaking to cannot work due to her illness, she did not have disability and therefore has no income to assist with her drugs costs.
 
The average cost for cancer drugs which usually need to be taken for up to 5 years is $500 per month.  Some Canadians are under the impression that they are covered by the government and they are not.
 
Disability is so important, we need to make people understand that.
 
Let’s see if we can help some of these people.  Put into perspective, the cost of your disability insurance could be the price of a couple of meal out each month and no one seems to think twice about that!

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If you are self-employed, and looking for benefits, what should be your priorities and why?

Insurance Priorities for the Self-Employed family

For the self-employed family without a traditional benefit plan, what should be the priority sequence of coverage choices, as the income of the business and the family increases?

If you were an employee of a corporation, you would likely be provided a benefit plan that includes some levels of

• Life Insurance
• Disability Insurance
• Medical coverage (Health Spending Accounts & catastrophic medical coverage)
• Dental Coverage

With our Integrity planning process, there are ways to help us address all these areas, while maintaining your budget.

Many self-employed families are extremely budget conscious, and we tend to look at solutions for “what is hurting now”, seeking pieces of the benefit puzzle only as the need arises. This is a very dangerous way to go about the process.

What if we were to take out a dental plan only, and in six months, we become disabled?

Without income, will the dental plan replace the money the family needs to live on?

We don't know what can happen, and the devastating effect on our savings

Will there in fact, even be money available to continue to pay the premium even for the dental coverage?

Without income, all the hard work we did to grow our business can be lost in a short time. Therefore, it is very important to look at the big picture at the outset! Discussing these areas with a qualified Insurance Planner is vital to protecting you and your family.

Insurance Planning must be done with integrity – that is completeness, honesty, and with your budget in mind! All issues must be addressed from the start, with several plans and insurers considered, and the most appropriate solutions examined.

Please contact us at 1-866-856-6799 (extension 201 for Craig, and 204 for Nanette) to discuss your needs further.

Craig Ferguson

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So, you have become self-employed, or you no longer have benefits at work, or you have never had benefits, and maybe that root canal is pending at the dentist?

Ok, so what to do?

That is the issue, isn’t it?

What to do and who to trust?

Well, I like to consider myself a kind of ‘tell it like it is’ kind of guy. You might already know me…..if you are a hockey fan in Hamilton or the GTA. I run the site, Make it Eight, eh?.

I saw where injustice and greed had beaten out common sense and compassion. Put those things together, and I’m there. Much to the chagrin of others around me that might think my time better spent making money.

Oh well, sometimes the causes are the justification.

But back to benefits.

You are not sure what your greatest risk is, and if it is truly a good idea to put a good chunk of change into medical and dental insurance.

To make a long story short, you are unique, but the principles of insurance – whether life, disability, or medical and dental – are the same.

Where is the greatest financial risk to you and your family? If we cover off this risk in an effective, common sense manner, our goal is to ensure you are not suffering from an illness or other unfortunate event that made you consider insurance benefits in the first place.

If you live in Ontario or Alberta, Canada, we are a call away : 1-866-856-6799. Or email us at integrityinsuranceplanning@gmail.com.

Give us a call, and see if we are what we say we are…..caring people that don’t mince words.

Oh, we represent several insurers so you know we will find the cost effective solutions, not biased or driven to promote one company only.

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