Recent Articles

Canadian Provincial Drug Reform Overview

Drug reform has swept across Canada with 5 provinces making changes in 2010 and 2011 to the way generic drugs are regulated in Ontario, Alberta, British Columbia, Quebec and Nova Scotia. The proposed changes drastically change the drug landscape and the delivery of drug benefits, both from the public’s perspective through government-funded programs, and from the private perspective and employer-provided group health insurance programs.

What is Mandatory Generic Substitution?

Mandatory Generic Substitution is a drug plan feature that limits the ingredient cost of a drug charge to that of the lowest cost alternative.  Where there is a generic interchangeable drug (a generic equivalent) then the generic drug will be dispensed or the plan member will be reimbursed up to the cost of the generic […]

How A Claim is Defined

A discussion of how a claim is defined by benefit category – Life Insurance, Accidental Death and Dismemberment Insurance, Critical Illness, Short Term Disability, Long Term Disability, Health and Dental – who it applies to, and general commentary surrounding market prevalence

Underwriting: Refund-Accounting

A group that uses the refund accounting underwriting arrangement to fund it’s plan is essentially prospectively rated however choosing to share in the financial results of the program through an annual accounting of surplus/deficit completed by the insurer.

Group Health Insurance – Deductibles, Coinsurance and Out-of-Pocket Maximums

A tutorial highlighting the coinsurance, deductibles and out-of-pocket maximums that are used within Group Health Insurance plans as strategic levers in limiting utilization and sharing program costs with employees.

How To Calculate Monthly Life Insurance Premium

Life insurance is expressed as a rate per $1,000 of insurance.  To calculate Life Insurance premium you take the benefit volume per $1,000 of coverage multiplied by the monthly rate.  For example, to calculate the monthly premium based on a 2x annual earnings (assume $40,000) schedule and a rate of $0.12 per $1,000 of coverage […]