Employee Benefits Basics: Recent Episodes
Yafa Sakkejha at Beneplan
This audiobook is a detailed guide to the technical aspects of distributing and servicing group benefits plans in Canada. Designed for advisors, it gets into the nitty gritty of how renewals are priced, how to negotiate with a carrier, how to get exceptions for your clients, and any highly technical aspect of the day-to-day business. We will feature the best benefits advisors in Canada and if you have a question you'd like us to address, please reach out through our site at www.beneplan.ca.
For Canadian employee benefits advisors: My attention as a business owner was caught when someone commented on my podcast, left us a google review, engaged with me on social media, saw me in my personal life in community work, and invited me to an offline event at the expense of the Canadian group insurance company.
If you're an employee benefits advisor, it's important that you're aware of what captive insurance companies are, why they matter, and how it might intersect with your daily work. If you're a plan sponsor, it's good to know that you have an option to explore captives for your own insurance risk.
The GSC strike is now over, the call centre will be open again Monday April 22, 2024 for group benefits and group insurance phone calls from plan members. We're anticipating a higher than normal call centre volume on Monday.
Some Unifor divisions went on strike March 1 2024 especially those staff who answer the call centre phones for group benefits insurance questions. Let's see what happens over the next few days.
The Canadian budget presented in Parliament yesterday doesn't affect group benefits plans, but does affect independent insurance or financial advisors if and when they want to sell or transition their business, by way of a capital gain.
It's become more popular than ever for employee benefits clients to request that their payroll provider or human resources information system (HRIS) "connects" directly to their insurance carrier. This is doable and possible, but there is a lot of work to be done to ensure a clean file of data can pass through the systems. Here is how to project manage this if it comes across your desk.
It's critical to make sure you look out for opportunities to waive the premiums on pooled benefits where applicable. Here are 3 examines in the Canadian group benefits market.
Let me know what you want to hear about next: how to sell your brokerage? How to sell & prospect? How to manufacture your own products? How to get out of tough legal situations? How to come back to work after having a baby? Let me know at yafa@beneplan.ca or Yafa Sakkejha on LinkedIn
We have been told as Canadians to expect some form of universal national pharmacare since 2018. This new announcement by the NDP is vague, uninspiring, and unclear. Therefore, I'm not motivated to change what we're doing as employee benefits advisors and TPAs. Health insurance is complex in Canada and it's important not to take for granted the heavy lifting required to change infrastructure.
Let's get into the backlash that Manulife and Loblaws grocery experienced when they tried last week to roll out a preferred pharmacy network for 260 specialty drugs. This is a common employee benefits group health insurance tactic used to save money, but it needs to be heavily socialized in Canada and might ultimately fail.
Employee benefits plans sometimes come with optional add-ons, like employee assistance programs (EAPs). These can cost around $5 per person, per month (PEPM). Large group benefits purchasers usually find better success negotiating this on a pay-as-you-go (PAYG) basis.
Employee benefits in Canada can be taxable - or not - depending on which specific product, depending on who is paying the premium, and under what circumstances. It's best to read the CRA canada.ca revenue Canada taxable benefits employers guide. You can also call them to ask more questions. Group life and long term disability insurance premiums are taxable benefits. Medical expenses in cash are also taxable benefits.
The holidays are coming and it's a popular time for travel out of the province or country. Educate clients about the pre-existing condition clauses in emergency medical travel insurance, remind people not to give their credit card to a hospital, and what to say to a plan member when they're getting collections calls from a hospital outside of their home province.
The employee benefits industry probably has conflict every single day of the year. Here's a conversation pattern that I use to start a conversation with an opposing party. How to diffuse, de-escalate and move forward together to solve problems. Health insurance can create many negative emotions and it's important to not take things personally.
If you're looking to save money on dental premiums, make sure that if you decide to cover a previous year's fee guide, you tell the carrier to code it in a "this year minus 1" or minus 2, etc, not the specific year. That year will get stale and embarrassing as it ages. I've come across two plans like this and it was a recipe for disaster for the group and advisor.
At Beneplan, we hired a Drug Advocate to help small businesses leverage government and pharma cost sharing for high cost medication, in order to significantly reduce group health insurance premiums. Employee benefits brokers will learn the landscape of high cost drug programs in Canada in this episode. yafa@beneplan.ca
Canadian health insurance can be complicated， but nothing confuses or scares people quite like explaining what a price level agreement is: the ubiquitous PLA. Also known as a drug rebate, volume discount or even -gasp- kickback - this highly controversial area of group insurance is something everyone should know about. Narrated by Yafa Sakkejha, CEO of Beneplan and licensed broker.
The sharp rise in the dental fee guide in Canada means that we're seeing higher increases across group benefits dental premiums in 2023 and 2024. Here is a list of ways you can help your clients trim costs without cutting the benefit entirely.
I know it's tempting, but extending extended health and dental benefits or group insurance to Canadian independent contractors may cause the business to fail the employee test with the CRA and therefore owe back taxes, penalties and interest. Here are some other options.
Everyone is the group benefits industry has been terminated. This episode shares some tough termination stories, discusses how you protect your own mental health, stop the fight or flight response, and how they can be prevented. Hosted by Beneplan CEO Yafa Sakkejha.
If you're a Canadian employee benefits broker trying to grow your block of business, here's your sign that you don't need to wait for the perfect MGA or super intermediary to get started. You just need to be willing to read the fine print.
Should employees be cut off of benefits while they're on workers compensation? Should they be fired? What can a benefits consultant or broker recommend to an employer during this time?
Explaining how the new Canada Dental Benefit works and what it means for employee benefit plans.
The Canada Revenue Agency just released a notice #325 on when and how insurance intermediaries need to charge GST or HST on their commissions and fees, and when it is exempt. We also talk about what you can do when a large insurer or government tries to change the parameters of your work.
Here's why I adore Canada's Employment Insurance premium reduction program and why every group benefits plan should take advantage of it. yafa@beneplan.ca
As an employee benefits advisor, you'll need to get comfortable speaking in front of groups of strangers... Often people who are coming into the meeting or presentation already with a negative view of you. If you have ever done an employee meeting or a tough renewal, and want to learn how to stop being nervous, this one is for you. 💙
What is supposed to happen to employee benefits during a temporary layoff? This episode is focused on employers in Ontario, Canada and the employment standards act.
A highlight of the changes and coverages of gender transition surgeries in private health insurance, employee benefits in Canada.
The Canadian Life and Health Insurance Association is an industry peer group for insurance companies. They work together to agree on basic rules of the game to make sure that consumers are treated fairly and consistently within the industry. My name is Yafa Sakkejha, and I'm the CEO of Beneplan.
A guide on the 4 steps to obtaining your LLQP license in Canada. This license allows you to sell life insurance, accident and sickness insurance, disability Insurance and other group benefits products.
Here's a quick history as to how my father, Mark Faiz Sakkejha, came to Canada as a refugee, became an insurance broker, pension consultant, group benefits broker, and finally a benefits third party administrator (TPA) and employee benefits cooperative
I get pitched different preferred provider networks all the time. It's a distraction from the financial incentives of plan sponsors. Benefits brokers should instead look at formulary management or PLAs (price level agreements)
Knowing when to bend the rules is a critical skill that you need to learn. Here's how I think about asking underwriting for permission to add late applicants, add ineligible dependants, ask for an open enrollment...and what to do when you can't break the rules.
Employee benefits advisors ask me all the time how much commission to charge their plan sponsors. Here are my two cents.
In B2B sales and relationship management, it's important to think about these ten pieces when it comes to video call etiquette.
So many business leaders I've spoken to over the last two years have quietly admitted that they've been sucked back into the day-to-day grind of their business... After years trying to "delegate and elevate". What does that mean for your advisory practice, and how inflation will affect your growth plans in 2023.
The one person you're guaranteed to find in the office? The owner/operator. Work around the edges of what's considered normal to catch these key influencers in person. They want to see people in person.
Encourage your clients to spend "ugly money" on core benefits like disability, life insurance and drugs -- and try to avoid having them spend "pretty money" on massage, vision and other benefits that aren't as fundamental to financial security and life sustaining healthcare.
I'm shocked how often I see advisors double ending the deal - meaning, acting as both the benefits broker and the CFO or HR manager. Be careful not to do this, and here's what to do when you come across it.
Using Loom to record tutorial videos will take your career to the next level. Save your clients time, don't ask for more zoom meetings, and get right to the point. Private Video tutorials can be rewatched, shared, sped up or slowed down. It allows the client to multitask. It allows them to take an important phone call and pause the video. Give yourself and your clients the gift of Loom! This is not a sponsored recommendation...we just think it's a great value add.
Don't be offended if a business owner asks you to talk to one of their key people before making a decision. It's a critical part of building trust across the organization.
Cafeteria style flexible benefit plans seem to go through phases where they're popular, and then go out of vogue. We wanted to share the challenges with running a flex plan (hint: anti-selection), and how to explain the pitfalls to a plan sponsor. We also encourage advisors to take a leadership role in designing a simplified class and division structure in group health insurance.
Beneplan is raising the floor of minimum coverage on health & dental to include fertility, erectile dysfunction, more mental health support, IUDs, breast pumps and smoking cessation treatments to any new group or group who updates their plan through an amendment.
I loved the book Atomic Habits by James Clear and was inspired to share with you all how I structure my day for maximum success and to create an upward spiral towards achieving my goals as an employee benefits leader within Beneplan
LTD cases plummeted in 2020... Why? Warehousing illnesses, later diagnoses, but could it be that people are less triggered when they're working from home and away from stressors? Do we think insurers will decrease LTD rates as a result? Spoiler: nope!
It's only a matter of time until people realize that their benefit plan is starting to look like their Netflix account - lots of choice on creators (carriers/services), hyper personalized, on-demand, and digital. We're not going back to the 'old normal' and people will be able to Uber Eldercare to their homes in 2 hours...through their benefit plan. How will you be part of it?
Why do some insurance companies give different rates to different brokers...on the same client, same plan design, same claims experience and demographics? Four reasons: (1) block arrangements (2) different commissions as directed by the advisor (3) different plan design, and (4) they just felt like it.
The very first thing on my new year checklist is to start to prepare for spring renewals. Your May renewals should start now with analysis, discussion and gathering questions from your clients. Be prepared and proactively anticipate questions.
Plan sponsors moving carriers in the middle of covid are most likely doing it for either ease of use of a new platform, because they've been hit with very high increases at renewal, a tax angle such as the EI Premium Reduction Program, or simply changing their agent of record that was in the works prior to the pandemic. Here are some tips on what to do to ensure a smooth transition.
The tectonic plates of benefits products are shifting, and this is the time to make changes. Strike when the iron is hot and get better benefits coverage out there now. Think: double the mental health benefit, telemedicine, and stability in rates.
Be outcome oriented. Protect your client on how the sausage is made. Don't make them make 100 little decisions. Understand their bottom line outcome and curate a plan and experience that achieves that outcome. Finally, today and every day, Black Lives Matter.
No-one can take away the magical gift you have - the ability to build a relationship with a business owner. THAT is the magic. The rest are tools to help you do what you do best.
Beneplan just released the 2019 annual report, publishing the $2.5 million in dividends that are paid to plan sponsors, aka, our customers.
Everyone gets nervous. Everyone had felt the sting of rejection. And most business leaders suffer from some sort of imposter syndrome. If you've ever felt intimidated to talk to an important client, or scared to pick up the phone and talk to someone with authority, try a 30 day rejection challenge. See if you can get rejected every day... even if it's something small.
Insurance companies are making broad statements about renewals or premiums being deferred, but it's a double edged sword. Be careful, read the fine print, and talk to your clients.
During normal circumstances, there is a generally accepted method of extending benefits during layoff. We'll talk about that, and also about the implications of a pandemic and how that impacts benefits during this time.
We've had many brokers ask us if they should still be prospecting during the COVID-19 pandemic. The short answer is yes, but be extremely sensitive about how you go about it. Don't use generic messaging - be generous with your information, be practical and tactical in the information you share, and do your homework if they are an essential service.
The new legislated Act respecting certain measures in response to COVID-19 has just received Royal assent - here is our interpretation of the law with respect to employee benefits.
Our partners, Maple telemedicine (getmaple.ca) have added a free COVID-19 screening assessment within their app that all Ontarians with an OHIP card can use at no cost. Further, Shopper's Drug Mart has sponsored free virtual care visits with a GP, NP or ER doctor until March 23, 2020. This is a great tool for anyone who is sick or has symptoms but is staying home and unable to enter a clinic or hospital. You can also request this coverage be added to the benefit plan by requesting a quote from Beneplan.ca
Green Shield Canada released a statement regarding how the novel CoronaVirus (COVID-19) impacts their Canadian group benefit plan members.
The Co-operators Life Ins. Co has issued a statement regarding COVID-19 considerations around Canadian group benefits coverage.
Many companies who buy benefits think they don't need to buy "pooled benefits" at first: group life insurance, critical illness, short term disability or long term disability. That said, it is very important to have in a benefit plan and there is a way you can successfully add these products to your customer's shelf.
Commission disclosure is important. It's very important to disclose the total amount of fees, commissions and bonuses that you earn on a group account. One, it's the right thing to do. Two, your client will find out eventually and they better find out from you. Three, if you don't, the financial regulator will force you to do so.
I see many brokers, carriers and clients operate from a position of fear rather than abundance. Fear drives behaviour, such as fighting in channel conflict wars, dealing with LOA requests, or a client refusing to hand over data. I urge you to refuse to work on this basis and instead, operate from a position of abundance and strength: there's plenty of business to go around, most if it will come your way, and you've not absolutely nothing to worry about -- you only need to worry about how to track all the business coming your way.
There is a huge increase in merger and acquisition activity (M&A) in Canada, and when your group benefits client is a business that has just been sold to a new company, you are at risk of losing that group. When you are defending the group from terminating your services, you need to keep 5 things in mind: have confidence, it's all about the money, impress the new owners, polish up your presentation skills, and recognize who the other broker is. These sales dynamics are different than the normal politics of losing a group, such as when your client hires a new HR manager, or the owner's family member just got their life license and is looking for a favour.
Although I'm a licensed agent, I am not on the hunt for new business... I rely on our strong broker network to do so. That said, there are 8 things that I do in my life that inadvertently bring me an average of 3 new leads per week. They are: writing for industry magazines, direct mail, my personal network and social media, providing outstanding service to existing customers, learning the google search engine tools and maximizing SEO, hosting lunch and learns, leveraging co-working spaces, having a strong partner referral network, and insurance carriers themselves. In this podcast, I go into detail on how these specifically played out and translated into new business.
The seasons of the year do matter in employee benefits. Claiming patterns and practices can change depending upon the time of the year or the industry. For example, construction may lay off people in the winter months and recall them in the spring. A school may hire new teachers in September and provide a fixed term contract until June, but still have a Jan 1 start date for their benefits year. Keep this in mind for renewal.
It's so important that all group benefits advisors read a group benefits booklet and contract from cover to cover. It's critical because most of the answers are in there, and 90% of people will never read it from start to finish. Highlight anything you don't understand and ask someone for help - an insurer, peer or mentor. In this episode, we cover a few examples of how contract wording can cause the broker to win an account or worse, lose an account.
Anti-selection is the practice of choosing to not buy insurance when you are healthy (or don't need to make a claim) and only buying insurance when you know you are about to make a claim. This is why there are rules in group benefit plans around enrolment windows, late applicants, waiting periods, and mandatory group participation. It's important as a broker to follow these rules. It's important as an employer to follow these rules also, and this podcast will dive into why.
What does it mean when a benefit is experience-rated? How can you negotiate down your premiums with more knowledge and more clarity into how premiums are priced? In this episode, we discuss how the majority of the benefits categorized under "health" or "dental" are not insurance. They are an expense account that is outsourced to a third-party who happens to be an insurance company.
Getting licensed to sell benefits is simple. Here, we outline the steps on how to get set up:
- Find your provincial regulator (FSRA in Ontario) and read their instructions clearly on how to get licensed to sell life insurance and accident & sickness insurance.
- Find an LLQP course provider and sign up.
- Take the course and practice exams until you are confident in your ability to pass. The practice exams are meant to mimic or be harder than the provincial licensing exam.
- Register for the LLQP provincial licensing exam through FSRA or your regulator. Durham College has been running it in Ontario. Sign up and pay the fee.
- Sit the exam and pass. It's open book and you get a tablet with all course material on it, so you should be in a good position to pass.
- When you get your exam results, buy E&O insurance.
- Submit your E&O and exam results to an insurer or MGA to request license sponsorship.
- Submit your package to FSRA.
- Find an MGA to partner with. You can go at it alone but when you are starting out as a single broker with a single client, you will get better treatment if you go through a larger intermediary. Benefits TPAs like Beneplan can help as well, if you plan on only selling benefits.
1 in 6 couples of child-bearing age are struggling with fertility. They are having to pay out -of-pocket for treatments such as in-vitro fertilization (IVF), IUI or AI (artificial insemination) because they have a medical condition that requires some additional help to conceive. It's not just women - sperm counts have plummeted over the last 20 years according to the WHO (thanks to cell phones in pockets or plastics in the water - estrogen reduces sperm), and it's not just because people are waiting longer. Many people are in their 20s and 30s and need help because the incidence of infertility has increased.
While governments may cover some IVF, it is not enough. People are going into debt or asking their family for help conceiving. Private insurance may cover it if its a large employer, large insurer, or grandfathered contract -- but many employers have the choice to remove fertility coverage because it's impacting premiums.
I believe it's our role -- as health insurance professionals -- to find ways to help employers keep this coverage without adding costs. The most seamless way to do so is to couple fertility coverage with a managed drug formulary. We use either the Reformulary through Co-operators Life or the Conditional Drug Formulary through Green Shield Canada. It typically negates any increase for fertility (+3% to health rates) by a decrease (-3% to health rates) as a result.
Do you agree or disagree? Let us know - follow us on social, @Beneplan.
When you are selling a group benefit plan, you have to interact with Users and Choosers. Users are Plan Administrators and Plan Members - that is, employees who make claims and the office admin staff who have to administer the plan on a daily basis. Examples include HR Managers, Office Managers, CFOs, Controllers, and so on. There are also Choosers - the group who ultimately make the decision and sign on the dotted line. These are CEOs, Owners, Board Members or they could be a CFO or HR Manager if they've been given the unilateral authority to hand off control. In this episode, we explain the difference and what motivates each party. You'll need to work hard to win over all parties even though they have opposite financial motivations.
ASO stands for Administrative Services Only. It means that a group benefits plan sponsor (an employer) has chosen to self-insure a part of their benefit plan, usually the health and dental portion. Here's a summary on what that is and the difference between ASO and fully-insured benefit plans.
Insurers often make exceptions when claims have been declined. There is a way to overturn claims, but it involves looking at the amount of risk involved, whether the plan is in a surplus or deficit, reading the fine print, and if the insurer wants the customer business badly enough.
Many companies are faced with an increase in group benefits premiums at the annual renewal time. Many of them will negotiate. Some of them will choose to shop the market of other insurers, get a lower rate, and switch away. Insurers know this, which is why they are willing to give customers almost any rate they need to get the deal. After the first or second renewal, they will slam the customer with a huge increase in premiums, knowing that they'll have a hard time shopping the market again after only one cycle, and how the customer hates the work involved in switching carriers so often.
Find out the basic of what Best Doctors or Second Opinion Consult covers, the basic pricing, and whether it makes sense to include this in a Canadian employee benefit plan.
What do carriers mean when they say 'IBNR?' The 'incurred but not reported claims reserve' is an important part of what a group benefits client is paying in their premiums. This episode will explain what it means in real-world terms, what is a fair IBNR to build into rates, and talk about how it exists with group health & dental benefits, as well as group LTD or Life insurance. Questions? Email us at admin@beneplan.ca.
You've just landed your first client, and it's time to transition carriers. Great! Now what? This episode will simply cover how to craft the termination letter so that you are leaving all of your options open. It's always a good idea to leave an insurer or carrier with respect and grace, so that if you need to ask for their help after transition, you haven't burned a bridge. Questions? Email us at admin@beneplan.ca.
I hear advisors talk about how they feel obliged to spend money on their clients. Entertaining, sports tickets, HR software, charity events...there are an endless number of ways to over-spend your commission on group benefits clients. Some advisors express unhappiness that they end up in a negative position in order to keep the group. I'm here to say that you can win an account without spending money entertaining them, and it all comes down to understanding the contract. Here are five real examples of sentences that advisors used to get AOR.
What is Target Loss Ratio? How does that compare with Actual Loss Ratio? What does it include? How would you explain this to your client? Is it better to have a low TLR or a high TLR?
Aloha! This audiobook is a chapter-by-chapter guide to the technical aspects of the Canadian group benefits business. Designed for advisors, we get into the nitty gritty of how renewals are calculated, the marketing game, how to negotiate and build relationships with carriers, how to get favours and exceptions for your clients, and all of the minutia of group health insurance. If you'd like to be a guest on the show, please give us a shout at beneplan.ca. Thanks!