Guide to Insurance

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Government Funded Health Insurance

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Self-funded health care is an arrangement whereby an employer pays set fees called ‘fixed costs’ (which include administrative fees, stop-loss premiums and any other set fees charged per employee) to an insurance company, but the employer pays the claims costs incurred by the covered persons in the plan instead of the insurance company. The claims costs are the ‘variable costs’ to the employer, because they vary from month to month, depending on the claims activity of the group as a whole.



Typically, in this type of arrangement, an employer does not self-insure 100 or 3% state premium tax, which is another savings element to the employer.

Is a self-funded plan right for your business?

Most experts agree that the ideal size group for self-funding (otherwise known as ASO or Administrative Services Only) arrangements are for groups with 100 or more employees. The idea is that there are more employees in the group to help spread the risk and cost. The more members, the more predictable the forecast of claims experience.

Does your business have a high turnover of employees?

If so, self-funding may work for you as you are not paying a higher monthly premium for employees who may not stay with your company. However, larger employers have to be concerned with COBRA employees, who elect to retain their group coverage after leaving employment. The employer, in a self-funded arrangement, would still be liable to pay any claims for those COBRA employees and their covered dependents for the specified time period (usually either 18 or 36 months, depending on the circumstance of the separation of employment).

Most employers on a self-funded arrangement pay for a third party administrator to process any incurred claims, which is another expense to consider. And above all, an employer must have the reserves on hand to pay any claims that come due, or face lawsuits.

Ask your insurance agent if a self-funding arrangement makes sense for you.
Government Funded Health Insurance
One of the advantages of living in Canada is the ability to use the Universal Health Care program that has been in place in the country for decades. This initiative is paid for by the various levels of government through tax dollars, and alleviates many of the expenses involved with health care, such as the cost of a visit to the doctor or the hospital, various operations, prescriptions, and so on.

Although the program is called universal health care, it is important to note that in reality it is carried out from province to province. In large part this is due to the traditional Quebec medical system; as a result of the difference each province has its own way of administering and qualifying citizens for the program.

In British Columbia, you must register for the Medical Services Plan in order to access government-funded health care. Once registered, you will receive a personal health care card with your health care number on it; this card and number are vital when using any medical services in the province, from hospital visits to doctor's visits.

There are several ways to gain a personal health care number and card.

Individuals born in the province are automatically registered through their hospital, and receive a card in the mail.

Those who move to BC from another province must register to receive their card and number. This may be done through your union or through your job, in which case the office should be contacted. Otherwise, you need enrol yourself through a British Columbia government office or on the BC government's website.

Some individuals may qualify under the Health Canada act or the Ministry of Employment and Income Assistance, in which case those offices need to be contacted.

In order to qualify, you will have to prove that you are a resident of the province. This means including all documentation supporting citizenship or immigration.

In order to be deemed eligible, a person must be a citizen or permanent resident of Canada, must make her or his home in BC, and live in the province at least six months in each calendar year. Any dependants of a BC resident are automatically covered under the resident's plan.

It is worth noting that while MSP takes most of the cost out of health services, many individuals will have to pay premiums each month if not covered through their employers. The premiums will depend on income level and need and are calculated on a monthly basis.

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