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How to control cost ? Health and Dental

How to control cost ? Health and Dental. Alain Parent Director of Sales, Group Insurance Assumption Life. Agenda. Who is responsible for our health? Why are the cost of Health Care increasing? How to control cost?. Questions.

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How to control cost ? Health and Dental

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  1. How to control cost ?Health and Dental Alain Parent Director of Sales, Group Insurance Assumption Life

  2. Agenda • Who is responsible for our health? • Why are the cost of Health Care increasing? • How to control cost?

  3. Questions Personal evaluation of your group insurance plan provided by your employer… A – Very generous B – Generous C – We would like to increase the coverages D – Decrease coverages or increase co-payment E – Status-quo The additional amounts required will be provided from ? There is only one budget…

  4. Questions Who is responsible for your health? A – Medicare? B – Your physician? C – Your pharmacist? D – Your employer? E – You?

  5. Questions Who pays for your health care? A – The governement, with your taxes? B – Your employer, group insurance? C – The insurer? D – You? E – A combination of A, B, C & D

  6. Rate Calculation Risk: Life, AD&D, Dependent Life • Rates are calculated based on the demographic factors of the group (salary, age, insurance amounts, sex) Experience: Health, Dental • Rates are calculated based on the group’s overall utilisation experience and the projected inflation rates. • With ASO plans: the claims plus the ASO fees. LTD: • Combination of risk and experience

  7. Claims Experience • Health premiums will be adjusted to remove all pooling and travel charges. • Health claims will be adjusted to remove all large amount drug pooled and travel claims. • The incurred but not reported claims are not included in this loss-ratio, but they will be added.

  8. Claims Experience - Health

  9. Claims Experience - Dental

  10. Why is the cost of health care increasing?

  11. Possible causes of increasing healthcare cost • Age of workforce • Lifestyle • Increasing rates of utilization • Increasing rates of chronic disease • Expensive new drugs • Cost-shifting by government

  12. Increasing Healthcare Cost Statistics Canada reports in 2004 • ADULTS • 23.1% were obese • 36.1% were overweight • CHILDREN ages 2 to 17 (National average) • 8% were obese • 18% were overweight

  13. Conditions resulting from being overweight and obese • Diabetes • High cholesterol • Ulcer • Depression • High Blood Pressure • …

  14. How to control cost? Health and Dental

  15. Cost Control Who contributes to the choice or dispensing of drugs? • Patient (Television, magazines, peers, beliefs, internet, etc.) • Doctor (Pharmaceutical rep., conferences) • Pharmacist (Cost, mark-up, dispensing fee)

  16. Dispensing Fees When the number of prescriptions paid for in a year for a group reaches the thousands, the difference in a dispensing fee can have a significant impact on the insurance cost.

  17. Cost Control (Health Care) How can you make a difference when choosing DRUGS? • Dispensing fees differences • Generics available • Drug supply to reduce number of dispensing fees • Quantity dispensed versus requirement • Exclude over-the-counter drugs • Alternatives to drugs

  18. Cost Control (Dental Care) Options are available • Is recall exam every 6 months necessary? • Do I really need another X-ray? • Ask the dentist what your options are. • Dentists cost differ. • Current fee guide

  19. What Can You Do? Education • Learn as much as you can about your condition through other sources (request resource information from your doctor, internet, news, work place resources). • Look for opportunities to improve your own personal wellness. • Joining a gym is not the only path to better wellness. Wellness consists of making smart choices every day because you and your family’s health are worth it. • Choices, not chance, determines the improvement of your own health.

  20. Ideas for Healthy Living EAT LESS TRIM FAT FROM MEAT LIMIT ALCOHOL QUIT SMOKING TAKE A WALK LEARN TO SING JOIN A GYM TAKE A YOGA CLASS PLAY WITH YOUR KIDS WALK THE DOG GO FOR A RUN CLIMB A TREE LEARN TO DANCE PLAY IN THE SNOW RIDE YOUR BIKE TAKE COOKING CLASS SWIM DRINK MORE WATER GET PLENTY OF REST GO CAMPING JOIN A PADDLE CLUB BUILD A SANDCASTLE EAT MORE FRUIT GO SNOWSHOEING PRACTISE BEING GRATEFUL MEET NEW PEOPLE TRY ROCKCLIMBING LISTEN TO THE OCEAN LEARN TO PLAY AN INSTRUMENT TAKE AN ART CLASS GO SKATING ON THE POND WATCH THE BIRDS GO CROSS COUNTRY SKIING LEAVE YOUR CAR AT HOME RAKE SOME LEAVES PLANT A GRADEN VISIT YOUR FRIENDS ENJOY THE BEAUTY OF NATURE SMILE LISTEN TO YOUR FAVORITE MUSIC GAZE THE STARS ATTEND A PLAY LEARN A SECOND LANGUAGE EAT MORE VEGETABLES CUT DOWN ON SALT READ A GOOD BOOK VOLUNTEER YOUR TIME MEDITATE RIDE A HORSE LEARN ABOUT ANOTHER CULTURE

  21. Benefits @ your Fingertips

  22. Market Segments 3 to 24 lives 25 to 49 lives

  23. Small Groups Quote System: 3 to 24 lives - Highlights Full range of benefits or Health and Dental only * Evidence of insurability for 3-4-5 lives (EHC only) * Grandfathering clause (Copy of last billing statement) Less than 41% family content – OK for LTD (2 out of 5) Less than 50% government funding – OK for LTD

  24. Small Groups Quote System: 3 to 24 lives - Guidelines • One year in business • Extended Healthcare renewal rates below $120 Single / $300 Family • No active employee on disability * • Not a home-based business

  25. Small Groups Quote System: 25 to 49 lives - Guidelines • One year in business • Extended Healthcare renewal rates below $120 Single / $300 Family • Claims experience: 9 months • Claims experience must be within the last 6 months

  26. Commi$$ion$ How muchdoesitpay?

  27. Standard Commission Structures * As much as flat 15% commission on small group!

  28. Bonus:On First-Year Commissions Credited The group insurance bonus is credited to the agent’s account at the beginning of each year , on the preceding year’s group insurance commissions.

  29. Bonus:Total Net Commissions Credited The group insurance bonus is credited to the agent’s account at the beginning of each year , on the preceding year’s group insurance commissions.

  30. Contest Period: • January 3rd – October 30th, 2011 • Two Spots are reserved for Group Insurance producers… • 1 - Top Spot • 2 – Wild Card • (Minimum $250,000 of annualized premiums)

  31. Contest Period • Janurary 1st, 2010 – December 31st, 2011 • Qualification Requirements • $1,2M of annualized premiums (net of terminations)

  32. 1-800-455-7337group@assumption.ca

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