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Beneplan Inc offers the lowest stop-loss rates in Canada for SMEs.[/caption]Rates on stop-loss insurance are increasing as of 2013 renewals.Stop-loss is the portion of your premium which accounts for the pooling portion of your extended health care coverage. In English, that means the reinsurance you pay so that if one of your employees has a claim that goes above $10,000, the insurance company absorbs the risk above $10K.The first $10,000 is counted against you on your claims experience when your renewal rates are calculated. Anything above that is subtracted from your claims experience.Stop-loss mostly accounts for out-of-country emergency medical claims, Canadian hospital claims (upgrading to semi-private or private rooms), and drugs, if the plan has no drug maximum in place.Why are Rates Increasing?Beneplan Inc has been successful at keeping stop-loss rates unchanged from 2006-2012. These stop-loss rates are the lowest in Canada for companies with less than 500 employees.The prescription drug industry has changed dramatically in the past few years due to the following factors:
- Rapidly increasing uptake of expensive Biologic drugs, which cost 5-figures/year and up
- Increasing use of expensive recurring drugs, such as Remicade, Humira, or others which can run $30,000 a year, every year
- The creation of the new mandatory industry pooling plan among all Canadian group health insurers
Low-Risk RatesIf an employer has a drug cap of $10,000 or less, they pay the Low Risk category of stop-loss rates.
Single Monthly Rate
Old Rate: $1.74New Rate: $1.95Family Monthly RateOld Rate: $3.97New Rate: $4.37High Risk RatesIf an employer does not have a drug cap, and employees can claim an unlimited amount of drugs, they pay the High Risk category of stop-loss rates.
Single Monthly Rate
New: $3.64Family Monthly RateOld: $5.69New: $7.40Termination Age 75If your benefit plan has a termination age of 75, an extra $0.50 Single and $1.25 Family is added on to your stop-loss. This is because The Co-operators Life Ins Co amended plan design in 2012 to increase the age of coverage for emergency-out-of-province expenses to 75.If you have any questions, please call 1-800-387-1670 x252 or email yafa at beneplan dot net.