The Fundamentals of Group Insurance

Hardiman Mount & Associates has evolved over the years to become truly full service benefits specialists. We offer a wide range of products and services from the one-of-a-kind Health Care Providers Group Insurance Plan, Chambers of Commerce Plan, and of course our latest innovation, 3G Benefits™, as well as the standard offerings to meet individual and specialty needs.

Over the past 25 years, we have learned that, to paraphrase Mark Twain, the difference between the right benefit plan and almost the right benefit plan is the difference between lightening and the lightening bug! With that adage in mind, we know that everything begins with analysis: A problem well defined is a problem half-solved:

With the answers to these and a host of additional questions we can craft the solution that is right for you and your employees and offer a product that will meet your needs today and into the future. The underlying issue in any benefit plan is the funding method. Organizations need different employee benefit funding methods depending on their employee count and comfort with fluctuating premiums.

While we have the expertise to accommodate any type of benefit program, in our experience the vast majority of firms will be well served with one of three fundamental funding methods.

All three funding options provide the protection of fully pooled and insured Life Insurance, Long Term Disability and Accidental Death & Dismemberment Insurance protection, if you choose these options in your plan design.

Although each of these options is best understood in terms of the financial aspects of funding the plan, a simple illustration related to the number of lives insured may be helpful:

1. Option One – Stability and Guaranteed Premium

   • Optimal for companies with 1 to 9 employees
   • Available to companies with up to 50 employees
   
   Firms with less than 10 employees require guarantees and rate stability. One employee could have a dramatic effect on claims experience and if the plans design is not created for the specific purpose of protecting the firm against fluctuating claims and more specifically against high claimants the firm will not be able to burden the cost of a high claimant and could have coverage cancelled or unable to afford the premium when they need it the most.
   
   Our recommendation: for these clients, HMA is proud to represent the Chambers of Commerce Group Insurance Plan™, The Chambers of Commerce Group Insurance Plan is the #1 plan for this target market in Canada for employee benefits, covering over 25,000 small businesses across the country. This plan is second to none in meeting the needs of firms looking for the protection provided under Option One.

2. Option Two – Structured stability with no risk of loss and guaranteed profit sharing

   • Optimal for companies with 10 - 50 employees
   • Available to companies with 4 - 75 employees
   
   As a firm develops and grows in employee count their financial comfort often allows them to leave the structure of a pooled rate plan. This enables them to take advantage of more aggressively priced alternatives that offer bottom line savings with benefit options more tailored to the individual firm’s needs.
   
   Our recommendation: for these clients, HMA is proud to present our latest innovation: 3G Benefits™. The 3G Benefit Plan provides the guarantees of traditional fully insured pricing methods with competitive target loss ratios. Moreover, this program offers the additional guarantee that that should your premiums provide a higher profit than expected you will share in those profits up to 50%. The profit sharing begins in the year following the profitable year’s renewal.

3. Option Three – self-funding, individually tailored solutions

   • Optimal for companies with 50 – 1000 plus employees
   • Available for employees with 25 – 1000 plus employees, who have experienced stable claims history as well as stable employee demographics and have strong corporate financial management practices.
   
   A financially stable firm whose history provides reliability for future forecasting can take advantage of significantly lower claims management costs by self-funding Extended Health and Dental claims up to a chosen level. Our plan design actually permits a client to lower their liability exposure of catastrophic health claims from the traditional standard insurer plan design by providing stop loss coverage at reduced levels.
   
   Our recommendation: individually tailored solutions offering self-funding plan designs provide the best of both worlds -- fully insured pooled rates with reduced handling costs while providing more insurance protection against unexpected high health claims.

Whichever Option you choose, there will be three additional key elements in the successful group benefits program: implementation, ongoing claims management and closing the loop with review, analysis and response.

Implementation

- Communication is the key to any successful implementation and we have dedicated, experienced staff who can organize the full roll-out from contract wording to enrolment to employee meetings to final implementation.

Claims Management

- With the convenience of toll-free telephone lines and trained service representatives as well as access to a national claim adjudication organization your claims are handled with speed, precision and efficiency.

Review, Analysis and Response

- With ongoing, in-depth claims and marketing analysis we continually review the changing realities of your group benefit plan. We realize that in the complex world of employee benefits nothing remains static. Our commitment to you and to the level of service that we offer to over 550 businesses, including almost 50 public institutions, demands a constant understanding and evaluation of your experience— financial and emotional. Until you are satisfied, we won’t be.