Frequently Asked Questions

The Argus office at 14 Wesley Street is now open to the public 9am to 4pm Monday to Friday. 

We want you to feel secure and comfortable when you visit Argus and we’ve followed the Government’s COVID-19 operations to create an environment that’s safe for all. New practices include, signage to remind and encourage social distancing protocols, the wearing of face masks, hand sanitiser stations and limited opening hours to allow for deep cleaning and sterilisation.

Argus will continue to support your needs online and by telephone. You can reach our Customer Service Centre on (441) 298-0888 between the hours of 8:30 am and 5:00 pm or email insurance@argus.bm for assistance.

We encourage our pensions and health members, corporate clients and personal motor policy holders to register for a Vantage online account to gain access to policy information and a number of self-service tools.

Pensions and health members and personal motor policy holders can register for a Vantage online account here.

Pensions and health corporate clients can register here for an online account.

Argus will cover treatment for COVID-19 based on your current health benefits plan. If you are travelling and your destination requires you to have a statement of insurance letter, please contact insurance@argus.bm.

Effective January 1, 2022, the administration of FDA-approved COVID-19 vaccines by local private healthcare providers will be covered for insured members with Preventive & Diagnostic (PD) benefits at 100% of the Bermuda Health Council (BHeC) fee schedule. For up-to-date information on COVID-19 vaccines for Bermuda residents visit: https://www.gov.bm/vaccines

For insured members with Major Medical (MM) benefits, Argus will cover FDA-approved COVID-19 vaccines received overseas at 100% of billed charges.

Check your insurance card for coverage details.

If you are an Argus Health client and experience any health issue overseas, you should immediately contact the Argus-owned One Team Health emergency hotline on 1-905-532-2954 or via the US toll-free number 1-800-720-7315 or email overseascare@argus.bm for assistance.

We will cover only PCR tests as the diagnostic test for COVID-19 for medical reasons, unless otherwise advised by the Government of Bermuda. Effective December 1, 2021, non-medical PCR sample collection and testing for travel (e.g. leisure or business) and group screening (e.g. SafeKey purposes, school or workplace) by private providers will not be covered services. Antigen and antibodies testing are not covered at this time.

Should you choose to have your PCR test sample collected at an authorised private facility by a private healthcare provider, there may be additional charges relating to sample collection, handling, patient assessment and personal protective equipment (PPE). Effective June 1, 2022 these charges will be covered at 50% of the Bermuda Health Council (BHeC) scheduled amount in accordance with your Home & Office (HO) benefits*

Argus Health will cover lab fees for local medically necessary diagnostic PCR tests processed at approved private labs at 100% in accordance with your usual diagnostic services (PD) benefit*.

*Check your insurance card for coverage details.

If you are travelling for non-elective medical reasons (i.e. treatment not available in Bermuda) PCR and observed antigen testing are covered locally and overseas if you are an insured member with Preventive & Diagnostic (PD) and Major Medical (MM) benefits*. Effective December 1, 2021 overseas non-medical COVID testing for leisure or business travel will not be a covered service.

*Check your insurance card for coverage details.

As part of your Travel Authorisation booking, you will be asked to pay a $40 fee* (*for individuals older than 2-years) by bank card to cover costs relating to COVID-19 public health monitoring.

Argus will reimburse insured members with Major Medical (MM) benefits for charges relating to the Travel Authorisation only if the member is returning to Bermuda after receiving medical treatment overseas not available in Bermuda and submits a receipt for the charges. Travel Authorisation fees for one approved travel companion will also be eligible for reimbursement. Members must contact One Team Health (OTH) for pre-authorisation and can submit a claim via their Argus Vantage secure member account.

Argus will continue to cover phone and online video calls with local healthcare providers for insured members with Home & Office (HO) benefits for the duration of the COVID-19 pandemic, or until further notice. Benefits are payable at the same amount as for in-person visits and are subject to annual benefit maximums and number of visits, if applicable. Coverage will be re-evaluated in light of government regulations and guidance. Coverage is for regulated healthcare professionals and approved non-regulated providers, including, but not limited to:

• Physicians
• Dentists
• Nurses
• Registered Dietitians
• Physiotherapists
• Psychologists
• Psychiatrists
• Approved counsellors/therapists with clinical oversight by a licensed psychologist or psychiatrist 

If you are an insured member with Major Medical (MM) benefits, Argus will cover initial consultation and follow-up telemedicine visits with overseas medical providers based on your current overseas care benefits. For pre-certification assistance with scheduling your appointment, contact One Team Health (OTH) and a Case Manager will be able to direct you to a provider based on your needs and to minimise out-of-pocket expenses.

Members who have recently received a challenging diagnosis (e.g. cancers, blood disorders, spinal surgery, etc.) may utilise the InfiniteMD virtual medical second opinion offered by Argus. Contact OTH at 1-800-720-7315 or email overseascare@argus.bm to get started.

Yes. Argus Health clients may obtain refills of prescribed medications from pharmacies up to a 90-day supply.

New and existing members can access their cards and policy information via Argus Vantage. For hard copy ID cards please contact our Customer Service Centre on (441) 298-0888 between the hours of 8:30 am and 5:00 pm or email insurance@argus.bm for assistance.

While every business has different needs, we recommend your company consider viewing the following https://www.gov.bm/coronavirus-workplace

Argus Health will cover the administering of FDA-approved COVID-19 vaccines at 100%, in accordance with Bermuda Health Council pricing guidelines, for insured members regardless if received locally or overseas*. For up-to-date information on the phased vaccine distribution in Bermuda visit: https://www.gov.bm/vaccines

*For insured members with Supplemental In-Hospital (SH) benefits. Not available to members with only legislated benefits (G & H classes). Check the Provider Portal for member coverage details.

To complete registration you will need your Health Certificate Number. You must also provide a jpg of a valid government-issued photo ID such as a passport or driver’s license. Click here to register and, after reading the requirements, click ‘Next’.

Fill the form with the requested details and press ‘Next’. Once you have uploaded your ID, agree to the Terms of Service and Privacy Policy and press ‘Submit’.

Once completed, a confirmation will appear onscreen. After your account is verified and approved, you will receive an activation link via email.

You can also register for Argus Vantage to access your Pensions account or to renew your car and bike policies online. Simply follow the steps above and provide your Social Insurance Number to register with your Pensions account or your motor policy number to review and renew your bike or car policy.

Sign In to Argus Vantage, click ‘My Account’ and then click the ‘Change Email’ button. Enter the email you currently use to sign in to Vantage and the new email address you wish to use, and press ‘Submit’. You will receive an email to your new email address prompting you to press the ‘Reactivate Now’ button. You will not be able to sign into Vantage until you have reactivated your account via this email.

At the top right of the Argus website, click the green ‘Sign In’ button to access a drop-down menu. Under ‘Members’, click ‘Argus Vantage’. On the Vantage Sign In page click 'Don’t remember your password?'. Enter your email address and you will receive an email with a link to reset your password. Your chosen password must contain a capital letter, a symbol, a number, and be at least 8 characters long.

Sign In to Argus Vantage, click ‘My Account’ and then click the ‘Reset Password’ button. Enter the email address you use to sign into Vantage and press ‘Submit’. You will receive an email with a link to reset your password. Your chosen password must contain a capital letter, a symbol, a number, and be at least 8 characters long.

In order to deactivate your account, please call the Argus Customer Service Centre on (441) 298-0888.

To access the Get Up & Thrive website click here. If you have already signed up for the programme, simply enter your login credentials. If this is your first time using the website, you will need to register for the programme first by clicking the "Register" button. If you are a new Argus member, it may take up to three weeks for your account to be created.

Eligible participants are all insured members with Argus Health, including spouses and dependents provided they are age 18 or older and are included on your Argus health insurance plan.

Get Up & Thrive is a comprehensive, activity-based social wellness programme that helps individuals set and meet personal health goals alongside their eligible colleagues, friends and family members. Built upon the belief that social support is the key to lasting, healthy lifestyle changes, Get Up & Thrive helps individuals succeed by fostering strong connections.

You should always seek the advice of a physician or another competent medical professional before beginning any physical activity and/or weight loss programme, or if you have any questions or concerns regarding your medical care. The Argus Thrive programmes are intended to complement, rather than substitute, for proper medical advice or treatment.

You should always seek the advice of a physician or another competent medical professional before beginning any physical activity and/or weight loss programme, or if you have any questions or concerns regarding your medical care. The Argus Thrive programmes are intended to complement, rather than substitute, for proper medical advice or treatment.

The telenurse advice line is a free phone service (441-298-0430) providing Argus health insurance clients with greater access to medical advice and guidance. Registered nurses are available to assist callers with non-emergency health situations and direct them to the appropriate level of care.

Telenurse is available at any time- day and night, including holidays and weekends.

Telenurse is intended for those experiencing acute illness or injury, requiring basic medical advice or an opinion on whether further medical care is needed. Callers can get care advice after hours and prevent unnecessary ER visits, while adhering to shelter-in-place guidance. A telenurse call can help you:

• Decide when to visit your doctor, get urgent or emergency care*
• Manage common or everyday health concerns including, but not limited to, mild fever, rashes or minor burns, ear or sinus problems, etc.
• Learn about preventive care

*The telenurse advice line is not a substitute for emergency care.

Call 911 if you or someone else is experiencing any of the following:

• Chest pain/pressure or difficulty breathing
• Loss of consciousness, fainting or seizures
• Bluish lips or face
• Fever above 104 degrees
• Serious wounds/bleeding that won’t stop
• Severe abdominal pain
• Severe cuts or burns
• Poisoning
• Broken bones
• Vaginal bleeding with pregnancy
• Severe allergic reactions

During your call, a registered nurse will ask a few questions and give you information and recommendations to help you decide what to do next.

You should always follow the advice of your general practitioner (GP) and other healthcare professionals. Argus is covering phone and online video calls with local and overseas regulated healthcare providers for insured members**. You should not have a co-pay for these services. Contact your GP or other healthcare providers directly if:

• You are managing a chronic condition or need assistance with managing your medications
• You have follow up appointments and services, including routine wellbeing or maintenance, getting test results, reviewing medications and requesting refills.

**For insured members with Home & Office (HO) benefits. Check your insurance card for coverage details.

If you are experiencing symptoms related to or suspect you have been exposed to COVID-19, please call your doctor directly or the Bermuda Government help line at 441-444-2498 (WhatsApp 441-504-6045) for advice.

Those who do not have a regular local GP have the option of being directed to our medical partners, Island Health Services, if they are advised by a telenurse that the need further evaluation. Telenurse will assist with scheduling your phone or online video appointment with a doctor at Island Health Services to address your health needs. You will not have a co-pay for this service.

We understand at times that our clients may require assistance for a travel companion when accessing your Argus health benefits. Benefits for a travelling companion are approved in the following circumstances:

• When the Insured Person is a minor Dependent Child,or has surgery or mental incapacity.

Customer Service Centre:
For routine health claims questions, call 298-0888 to speak with one of our knowledgeable Customer Service Representatives. 

Worldwide Call Centre (if you require treatment overseas):
Before making any arrangements to travel overseas for medical treatment, please call us for pre-approval.From Bermuda, Canada and USA, call 1-800-720-7315 (toll free) or 1-905-532-2954 (collect) or email overseascare@argus.bm. Argus Representatives are available to provide assistance with emergency medical care, emergency medical evacuation, discharge planning, loss of travel documents and insurance verification.

Your spouse (including legally married or common law spouse or legal domestic partner) and children. 

Your child must be an unmarried, natural child, step-child, child of a dependent spouse or a legally adopted child who:

• is under the age of 19; or
• is over the age of 19 but under age 26, if the child is in full-time attendance in a recognised school, college or university; or
• is over the age of 19, and is impaired by reason of mental illness, physical illness or disability or intellectually disabled and unable to meet the requirement for physical health, safety or self-care

In general, your dependents will have the same health insurance benefits as you. Please note:

• your non-working/unemployed spouse must be insured for full coverage
• your working spouse may be insured for everything except Health Insurance Act benefits which must be provided by your spouse’s employer
• your self-employed spouse may be insured for full coverage
• dependent children may be insured for full benefits although they may be entitled to Bermuda government subsidies for the Health Insurance Act benefits

Providing you enrol in the plan within 31 days of first becoming eligible:

• coverage begins on the date that you commence active work or, if you are not actively at work on that date, on the date you return to work
• coverage for a non-working/unemployed spouse begins on the date your coverage begins
• coverage for any other dependent begins on the date your coverage begins or, the date you first enrol an eligible dependent, whichever is later
• coverage for any subsequent eligible dependent begins on the date of eligibility provided the dependent is not in hospital and is actively pursuing normal activities
• coverage for a new born child begins at birth provided enrolment is made within 31 days of the birth

If you or your dependent enrol in the plan more than 31 days of first becoming eligible:

• we may require proof of good health and coverage will become effective on the date we approve such evidence
• if dental coverage is provided, you and your dependent will be limited to $1,000 maximum in the first 12 months of coverage

Immediately. To ensure coverage is kept up to date, complete the Change of Information Form and submit it to your employer’s plan administrator for:

• Change in coverage
• Change of dependent status
• Change of name

Complete the Change of Information Form for Individual Coverage
Complete the Change of Information Form for Group Coverage

Yes. If your coverage terminates under this group policy you may apply, without providing evidence of insurability, for an individual health insurance policy within 31 days of your termination date. The individual policy we will issue may provide more limited coverage than the group policy. The premium due for the individual policy will be based on the rates in effect at that time for your gender and age.

Complete the Application for Conversion to Individual Health Plan Form.

We will continue coverage for eligible expenses incurred as a result of the total disability, without premium payment, for up to 3 months. This extension will only apply if the group policy remains in force.

You should submit claims as soon as possible after the date of service. In order for benefits to be paid claims must be received within 12 months of the date of service.  Original itemized invoices and receipts should accompany the Argus Health Claim form.

Sign up for our Electronic Funds Transfer service to receive your health claims via direct deposit to your local Bermuda bank account.

Reference to “policy year” in the attached schedule of benefits refers to May 1 through April 30.

All medical pre-existing conditions are covered. Dental pre-existing conditions limitations apply to the provision of a crown, post, inlay, onlay, denture, bridgework or implant.  Please contact our Customer Service Centre for more information before you receive treatment.

Your Health Insurance Act benefits end on the last day of the month in which your employment terminates. The Health Insurance Act benefits will be extended, without premium payment, for up to 4 weeks following the end of the month in which employment terminates, provided you do not become employed or eligible for insurance as a non-working spouse.  All other benefits end on the date your employment terminates.  

Your dependents’ coverage will end on the earliest of the following:

• The date your coverage ends
• The date the policy is amended to terminate dependent insurance
• The date the dependent is no longer an eligible dependent

Submit health and dental claims online through Argus Vantage. After Sign In, click on 'Health Dashboard' and then 'Submit a Health Claim' to complete the form in a few easy steps. You will be required to upload digital copies of your itemised invoice and proof of payment. For dental claims you will also be required to upload a completed and signed Dental Claim Form.

You should submit claims as soon as possible after the date of service. In order for benefits to be paid claims must be received within 12 months of the date of service. All claims over $2,000 require original invoices to be kept by the main insured for a year. Argus reserves the right to request these forms at any time for audit and/or administrative purposes.

If you have not yet registered for Argus vantage, click here.

The following is a list of care, treatment, supplies or charges that your health policy does not cover:

• Cosmetic surgery that is deemed to be not medically necessary and is performed primarily to improve or change an insured person’s physical appearance
• Charges which arise from work-related injury or sickness that are required to be covered under the Workers’ Compensation Act 1965
• Charges resulting from liability which is established under the provisions of the Motor Car Insurance (Third Party Risks) Act, 1943, or other similar act or legislation
• Charges incurred when no charge would have been made if no insurance coverage had been in force
• Services performed by a person who ordinarily resides in the insured person’s home or who is a close relative or by a physician or nurse who is an employee of a hospital and is paid by the hospital
• Charges for investigational/experimental procedures, or for procedures which are not medically necessary
• Charges as a result of complications of any excluded procedure
• Charges for testing or training for educational, vocational or learning disabilities
• Charges resulting from the voluntary taking or being under the influence of any controlled substance, drug, hallucinogen or narcotic not administered or taken on the advice of a physician
• Charges resulting from injuries sustained while committing, or attempting to commit, an indictable criminal offence or felony, or when operating a vehicle while the blood alcohol level exceeds 80 milligrams of alcohol per 100 milliliters of blood, or as otherwise defined by the relevant legislation
• Charges resulting from war, declared or undeclared, insurrection or active participation in a riot or rebellion
• Charges for replacement of supplies or appliances which are lost, mislaid, stolen or broken
• Charges for services performed by a provider of services not licensed, certified, authorised or practising within the scope of his licence or qualifications, or whose qualifications do not satisfy the requirements of the policy to provide such treatment, or who has not been approved by us
• Diagnostic tests performed for the use of a third party including, but not limited to:
  • visa requirements
  • employment requirements
  • school entrance,
  • sports activities, and
  • life insurance examinations
• Services provided mainly as a rest cure, maintenance or custodial care
• Infertility, artificial insemination, in vitro fertilisation, or the services of a surrogate mother
• Treatment of sexual dysfunction or for sexual transformations
• Treatment in connection with the reversal of surgical sterilisation
• The amount in excess of the usual & customary charges
• The part of any eligible expense that is in excess of the amount allowable under the Health Insurance Act or the Bermuda Hospitals Board Act (Medical and Dental Charges) legislation or the applicable Bermuda fee schedule
• Charges for which benefits are payable by any programme or agency funded by any government, including the Mutual Reinsurance Fund, or for which the insured person is entitled by law to obtain benefits without charge
• Charges for missed appointments, advice by telephone other than approved telemedicine services, completion of claim forms, supplying of records, referral letters or reports, or transportation costs incurred by a physician or other provider
• Professional services billed by a nurse while the insured person is confined in a hospital or other institution
• Amounts in excess of the amount shown in the schedule of benefits
• A temporomandibular joint (TMJ) disorder, except as specifically provided under the dental benefit
• Ionising radiation or radioactive contamination from any nuclear fuel or waste
• Charges from a hospital or other facility if the insured person has discharged himself against medical advice or failed to complete the prescribed treatment plan
• Treatment, care or services that would expose Argus to any international or United Nations’ trade or economic sanctions, laws, prohibitions, restrictions or regulations
• Charges that do not comply with the Argus claims editing process or standards of medical practice
• Charges incurred following the failure of an insured person to obtain a second opinion when requested by us
• Care, services and supplies provided to alter the body’s genes, genetic makeup or the expression of the body’s genes except for correction of a congenital birth defect specifically provided for in this policy
• Removal or replacement of dental implants
• Specialty prescription drugs that are not approved by us
• Charges for any injury or sickness arising from improper use of the Argus Wellness Programme
• Charges as a result of complications of services:
  • provided by a provider who is not licensed, registered or certified or is not practising within the scope of his licence or qualifications, or has not been approved by us, or
  • if the services have not been pre-certified by us, if applicable

The overall health and wellness of our members is our primary focus at this time. We understand the uncertainty caused by the COVID-19 pandemic and are here to help you through these challenges by offering flexible and meaningful solutions.

Please contact our Customer Service Centre on 298-0888 or email insurance@argus.bm to discuss your options.

To keep up to date on Argus policies, coverage information, and to find answers to frequently asked questions, visit our dedicated COVID-19 webpage at www.argus.bm/coronavirus.

As Government priorities have shifted to manage the COVID-19 pandemic, we anticipate minimal advances, if any, to the implementation of the Bermuda Health Plan and the resulting Standard Premium Rate (SPR). However, should Government mandate amendments that affect the SPR, those changes will be applied to your total premium at that time.

This year’s premium calculations remain the same as in previous years. Your total premium will be inclusive of the Standard Premium Rate (SPR) and your Supplementary Premium as follows:

Standard Premium Rate (SPR)
The SPR, which includes the Mutual Reinsurance Fund levy that Argus pays to the Government on your behalf, remains at $355.31 per month per insured adult.

Supplementary Premium
The premiums for supplemental medical, dental and vision care benefits are administered by Argus and adjustments will vary by company and/or account under policy and are based on:

• General medical inflation
• Trends in utilisation of services
• Claims experience for our entire book of business
• Your benefit plan
• The premium for your policy will also vary by age bands

Every year we review benefits* to ensure that they meet the unique healthcare needs of our members. This year we have introduced minimal, but meaningful, enhancements.

• Mental Health and Substance Abuse Treatments – We have removed the limits on overseas Mental Health and Substance Abuse Treatment. These treatments will now be considered like any other physical condition requiring treatment overseas at an Argus preferred network provider.
• Specialty and High Cost Prescription Drugs - We have seen an increase in the use of breakthrough specialty medicines, like biologics. These are significantly more expensive than traditional prescription drugs but can ultimately decrease the debilitating effects of certain diseases and improve the quality of life of members. To provide greater and affordable access to these drugs, they will now be covered at 100% if pre-certified and approved by Argus’ overseas healthcare management partner, One Team Health (OTH); otherwise at 50%.

*Depending on your healthcare plan

Our mission is to support our members by offering greater access to affordable, high quality care, with services that help eliminate wasteful practices and create long-term, sustainable savings. We have introduced cost containment services that include our free telenurse advice line (441-298-0430), which provides alternative access to medical advice and guidance that reduces out of pocket expenses.

Argus, in partnership with One Team Health (OTH), provides seamless overseas healthcare management while helping to reduce and control costs. The OTH staff of doctors, nurses and case managers work together to provide access to appropriate and high quality care, allowing you to focus on your health, not logistics. Please contact our Customer Service Centre on 298-0888 to speak to an OTH representative.

Supporting your physical, emotional and financial wellbeing is our top priority. We encourage you to take full advantage of the broad range of Thrive. tools and resources, which are available at no additional cost.

With Vantage, using a single username and password, you, your dependents and spouse can obtain a total view of your Argus Health and Pensions (if applicable) accounts. Using your desktop, tablet or smartphone, Vantage provides easy access to the tools and resources needed to help you better manage your plan.

• Access benefits information 24/7
• Submit claims online
• View and print ID cards from home
• Access digital wellness tools and challenges with Get Up & Thrive.

Yes. EFT allows you to receive your Argus payments directly into your bank account. To complete the authorization form online click here.

The diagnostic swab test for COVID-19 falls under your usual diagnostic services benefit. Therefore, if a diagnostic test is deemed medically necessary and ordered by a medical professional, it will be covered in accordance with your current health plan benefits. Free voluntary diagnostic and antibodies testing (in conjunction) is currently being offered to the public by the Government. More details can be found here. Health plan coverage of voluntary testing and antibodies blood testing will be in accordance with pending Ministry of Health and Bermuda Health Council COVID-19 testing and back-to-work guidelines.

The overall health and wellness of our members is our primary focus at this time. We understand the uncertainty caused by the COVID-19 pandemic and are here to help you through these challenges by offering flexible and meaningful solutions.

Please contact our Customer Service Centre on 298-0888 or email insurance@argus.bm to discuss your options.

To keep up to date on Argus policies, coverage information, and to find answers to frequently asked questions, visit our dedicated COVID-19 webpage at www.argus.bm/coronavirus.

As Government priorities have shifted to manage the COVID-19 pandemic, we anticipate minimal advances, if any, to the implementation of the Bermuda Health Plan and the resulting Standard Premium Rate (SPR). However, should Government mandate amendments that affect the SPR, those changes will be applied to your total premium at that time.

This year’s premium calculations remain the same as in previous years. Your total premium will be inclusive of the Standard Premium Rate (SPR) and your Supplementary Premium as follows:

Standard Premium Rate (SPR)
The SPR, which includes the Mutual Reinsurance Fund levy that Argus pays to the Government on your behalf, remains at $355.31 per month per insured adult.

Supplementary Premium
The premiums for supplemental medical, dental and vision care benefits are administered by Argus and adjustments will vary by company and/or account under policy and are based on:

• General medical inflation
• Trends in utilisation of services
• Claims experience for our entire book of business
• Your benefit plan
• The premium for your policy will also vary by age bands

Every year we review benefits* to ensure that they meet the unique healthcare needs of our members. This year we have introduced minimal, but meaningful, enhancements.

• Mental Health and Substance Abuse Treatments – We have removed the limits on overseas Mental Health and Substance Abuse Treatment. These treatments will now be considered like any other physical condition requiring treatment overseas at an Argus preferred network provider.
  
  
• Specialty and High Cost Prescription Drugs - We have seen an increase in the use of breakthrough specialty medicines, like biologics. These are significantly more expensive than traditional prescription drugs but can ultimately decrease the debilitating effects of certain diseases and improve the quality of life of members. To provide greater and affordable access to these drugs, they will now be covered at 100% if pre-certified and approved by Argus’ overseas healthcare management partner, One Team Health (OTH); otherwise at 50%.

*Depending on your healthcare plan

Our mission is to support our members by offering greater access to affordable, high quality care, with services that help eliminate wasteful practices and create long-term, sustainable savings.

We have introduced cost containment services that include our free telenurse advice line (298-0430), which provides alternative access to medical advice and guidance that reduces out of pocket expenses.

Argus, in partnership with One Team Health (OTH), provides seamless overseas healthcare management while helping to reduce and control costs. The OTH staff of doctors, nurses and case managers work together to provide access to appropriate and high quality care, allowing you to focus on your health, not logistics. Please contact our Customer Service Centre on 298-0888 to speak to an OTH representative.

Supporting your physical, emotional and financial wellbeing is our top priority. We encourage you to take full advantage of the broad range of Thrive. tools and resources, which are available at no additional cost.

With Vantage, using a single username and password, you, your dependents and spouse can obtain a total view of your Argus Health and Pensions (if applicable) accounts. Using your desktop, tablet or smartphone, Vantage provides easy access to the tools and resources needed to help you better manage your plan.

• Access benefits information 24/7
• Submit claims online
• View and print ID cards from home
• Access digital wellness tools and challenges with Get Up & Thrive.

Yes. EFT allows you to receive your Argus payments directly into your bank account. To complete the authorization form online click here.

The diagnostic swab test for COVID-19 falls under your usual diagnostic services benefit. Therefore, if a diagnostic test is deemed medically necessary and ordered by a medical professional, it will be covered in accordance with your current health plan benefits. Free voluntary diagnostic and antibodies testing (in conjunction) is currently being offered to the public by the Government. More details can be found here. Health plan coverage of voluntary testing and antibodies blood testing will be in accordance with pending Ministry of Health and Bermuda Health Council COVID-19 testing and back-to-work guidelines.

With many businesses facing uncertainty caused by the COVID-19 pandemic, we are actively partnering with our clients to address their specific circumstances. Argus is here to help you adapt to these new challenges by offering flexible and meaningful solutions.

Please contact your Relationship Manager or a member of the Relationship Management Team on 298-0888 or email insurance@argus.bm to discuss your options.

To keep up to date on Argus policies, coverage information, and answers to frequently asked questions, visit our dedicated COVID-19 webpage at www.argus.bm/coronavirus.

As Government priorities have shifted to manage the COVID-19 pandemic, we anticipate minimal advances, if any, to the implementation of the Bermuda Health Plan and the resulting Standard Premium Rate (SPR). However, should Government mandate amendments that affect the SPR, those changes will be applied to your total premium at that time.

This year’s premium calculations remain the same as in previous years. Your total premium will be inclusive of the Standard Premium Rate (SPR) and your Supplementary Premium, as follows:

Standard Premium Rate (SPR)
The SPR, which includes the Mutual Reinsurance Fund levy that Argus pays to the Government on your behalf, remains at $355.31 per month per insured adult.

Supplementary Premium
The premiums for supplemental medical, dental and vision care benefits are administered by Argus and adjustments will vary by company and/or account under policy and are based on:

• General medical inflation
• Trends in utilisation of services
• Claims experience for our entire book of business
• Your plan’s claims experience over a three-year period
• Your benefit plan

Every year we review benefits^[1] to ensure that they meet the unique healthcare needs of our members. This year we have introduced minimal, but meaningful, enhancements.

• Mental Health and Substance Abuse Treatments – We have removed the limits on overseas Mental Health and Substance Abuse Treatment. These treatments will now be considered like any other physical condition requiring treatment overseas at an Argus preferred network provider.
• pecialty and High Cost Prescription Drugs - We have seen an increase in the use of breakthrough specialty medicines, like biologics. These are significantly more expensive than traditional prescription drugs but can ultimately decrease the debilitating effects of certain diseases and improve the quality of life of members. To provide greater and affordable access to these drugs, they will now be covered at 100% if pre-certified and approved by Argus OTH; otherwise at 50%.

¹ Depending on your healthcare plan

Our mission is to support our members by offering greater access to affordable, high quality care, with services that help eliminate wasteful practices and create long-term, sustainable savings. We have introduced cost containment services that include our free telenurse advice line (441-298-0430), which provides alternative access to medical advice and guidance that reduces out of pocket expenses.

Supporting your employees’ physical, emotional and financial wellbeing is our priority. We encourage your company and employees to take full advantage of the broad range of Thrive. tools and resources, which are available at no additional cost. Contact our Population Health Specialist at 294-5736 or thrive@argus.bm to learn how Thrive. can support your workplace wellness programme.

Employer Benefits
Vantage is an integrated employee benefits administration portal, designed to reduce administration and support HR professionals with tools and tips to help them manage their HR and business risks. Vantage provides quick access to simple and effective resources so management can respond to the need for information by their employees, senior management and Board committees. With Vantage, you’ll only need one username and password to obtain a total view of your Argus Health and Pensions (if applicable) accounts and one place to go for tools and tips that can help you learn about industry changes. Dashboard enhancements will continue throughout the year and will include the ability for you to enrol, terminate and make and/or approve employee information changes online.

Employee Benefits
With Vantage, using a single username and password, your employees, their dependent(s) and spouse can obtain a total view of their Argus Health accounts. Using a desktop, tablet or smartphone, Vantage provides easy access to the tools and resources needed to help them to better manage their accounts.

• Access benefits information 24/7
• Submit claims online
• View claims online
• View and print ID cards from home
• Access digital wellness tools and challenges with Get Up & Thrive.

During this unprecedented time, Argus is here to help providers adapt to these new challenges by offering flexible and meaningful solutions. To learn more click here.

To keep up to date on Argus policies, coverage information, and to find answers to frequently asked questions, visit our dedicated COVID-19 webpage at www.argus.bm/coronavirus.

Every year we review benefits to ensure that they meet the unique healthcare needs of our members. This year we have introduced minimal, but meaningful, enhancements.* 

• Mental Health and Substance Abuse Treatments – We have removed the limits on overseas Mental Health and Substance Abuse Treatment. These treatments will now be considered like any other physical condition requiring treatment overseas at an Argus preferred network provider.
  
  
• Specialty and High Cost Prescription Drugs - We have seen an increase in the use of biologics and other breakthrough specialty medicines. Specialty drugs are significantly more expensive than traditional prescription drugs but can ultimately decrease the debilitating effects of certain diseases and improve the quality of life for our members. To provide greater and affordable access to these drugs, they will now be covered at 100% but only if pre-certified and approved by Argus OTH; otherwise at 50%. Prior to prescribing, please submit requests for medical review and pre-authorisation to insurance@argus.bm. 
  
  * Depending on each member’s healthcare plan

Argus, in partnership with our overseas care management company, One Team Health (OTH), provides seamless overseas healthcare management while helping to reduce and control costs. To ensure that our members receive the maximum reimbursement under their insurance plans, please contact OTH for pre-approval. For the most up to date facility listings please click here. OTH administrators are also available to assist you in locating specialists within our network for overseas care. To contact an OTH representative email overseascare@argus.bm or call 1-905-532-2954

The Bermuda Health Council has announced that effective June 1st, 2020, ICD 10 codes are required for claims submission. ICD 9 codes will no longer be accepted.

Hardcopy paper claims will not be accepted until further notice. Claims can be submitted electronically via the Provider Portal, either via our Online Claims submission feature or scanned into PDF format and uploaded. To assist us in paying claims quickly and accurately, please ensure that claim forms are (i) completed in full, (ii) contain current policy and certificate numbers, and (iii) include the total billed amount.

Supporting the physical, emotional and financial wellbeing of our members is a top priority. We encourage our members to take full advantage of the broad range of Thrive. tools and resources, which are available at no additional cost.

The Provider Portal offers easy access to tools and functionality that help you support our members and administer your Argus account:

• Access benefits information 24/7
• Submit claims online and receive payment within five to seven working days. Hardcopy claims submissions may experience longer processing times
• View member accumulators/balances per benefit
• View and print Explanation of Payments (EOP)

Yes. EFT allows you to receive your Argus payments directly into your bank account. To set up, please contact our Customer Service Centre at 298-0888 or email insurance@argus.bm.

Once set up, funds will be transferred into your account typically on Tuesday or Wednesday and a PDF version of the associated Explanation of Payment (EOP) will be emailed to the specified email address.

The Argus office at 14 Wesley Street is now open to the public 9am to 4pm Monday to Friday. 

We want you to feel secure and comfortable when you visit Argus and we’ve followed the Government’s COVID-19 operations to create an environment that’s safe for all. New practices include, signage to remind and encourage social distancing protocols, the wearing of face masks, hand sanitiser stations and limited opening hours to allow for deep cleaning and sterilisation.

Argus will continue to support your needs online and by telephone. You can reach our Customer Service Centre on (441) 298-0888 between the hours of 8:30 am and 5:00 pm or email insurance@argus.bm for assistance.

We encourage our pensions and health members, corporate clients and personal motor policy holders to register for a Vantage online account to gain access to policy information and a number of self-service tools.

Argus will pay life insurance benefits according to the terms of your policy regardless of type of illness. There are no specific exclusions related to COVID-19.

The Non-Medical Limit (NML) is the guaranteed amount of life insurance that an employee will receive  without requiring medical underwriting. All amounts in excess of this amount are subject to satisfactory medical evidence of insurability. In other words, medical underwriting will be required for all excess amounts of insurance above the NML. NML’s vary by employer and are reviewed every year during renewal.

Medical underwriting is the use of medical or health information to assist in the evaluation of an applicant for coverage and determining the appropriate benefit and premium. Read more detail here.

The medical underwriting department should be advised of a death claim by the employer or the named beneficiary. If you need assistance please contact our Customer Service Team on 298-0888 or at insurance@argus.bm 

Renewals occur for Group Life plans throughout the year. It depends on the anniversary date of the policy (i.e. the original policy effective date). For example, ABC Company insured for Group Life on November 1, 2012. ABC’s policy will renew on November 1st every year thereafter, unless otherwise stated.

An average rate per $1,000 of insurance benefit is calculated for the plan based on the age and gender of insured employees. The average rate is multiplied by the employee’s volume of Insurance divided by $1,000 units of cover. The volume of insurance is determined by the employee’s insured benefit amount and the benefit plan which is either a multiple of salary (e.g. 2 x annual salary) or a flat benefit amount (e.g. $5,000)

The average rate is reviewed annually.

An example of a Group Life Premium calculation would be:
$100,000 (volume) x $0.15 (rate) /$1,000 (units of cover) =$15.00 per month

An example of Group Accidental Death and Dismemberment (AD&D):

$100,000 (volume) x $0.04 (rate)/$1,000 (units of cover) = $4.00 per month.

Monetary benefits, which are payable to an insured’s beneficiary, depend on the covered employee’s benefit plan. The plan sponsor is the policyholder. The policyholder can take out a Group Life plan with a benefit as a multiple of salary or a flat life benefit. A flat life benefit is a lump sum amount determined by the demographics of the company.

At Argus we have a reduction clause, whereby typically an insured’s benefit reduces by 50% once they obtain age 65 up to a maximum benefit of $100,000. Most Group Life plans terminate coverage once an employee has attained the age of 70 years. Please note, group life plans do vary from one policyholder to the next.

Group Life Insurance provides protection against financial consequences due to death. By insuring employees, the company is providing their dependents with financial security. Group Life provides a monetary benefit in the event of an employee’s death while employed by the employer. It is provided to all active full-time employees who work a minimum of 20 hours per week.

Under the Employment Act 2000, employers must pay up to 26 weeks of wages on an employee’s death resulting from an occupational disease or accident. Our Group Life Insurance policy may be used to provide this benefit.

Our Group Life Policy provides a Living Assurance benefit, wherein Argus pays up to 50% of the life insurance benefit (up to a maximum benefit) to an employee, while living, should that employee become terminally ill as defined by the policy.

Other highlights include an Accidental Death and Dismemberment (AD&D) rider, which provides an additional level of protection by offering more financial security in the event the employee’s death or dismemberment was due to accidental means. AD&D also provides such benefits as continued education for dependent children and rehabilitation in formal rehabilitation programmes.

In addition to life insurance for employees, Argus offers options for employees to purchase additional amounts of insurance for themselves, as well as coverage for their spouse and dependents. These benefits come under our Additional Voluntary Life, Spousal Life and Dependent Life Insurance policies.

The Argus office at 14 Wesley Street is now open to the public 9am to 4pm Monday to Friday. 

We want you to feel secure and comfortable when you visit Argus and we’ve followed the Government’s COVID-19 operations to create an environment that’s safe for all. New practices include, signage to remind and encourage social distancing protocols, the wearing of face masks, hand sanitiser stations and limited opening hours to allow for deep cleaning and sterilisation.

Argus will continue to support your needs online and by telephone. You can reach our Customer Service Centre on (441) 298-0888 between the hours of 8:30 am and 5:00 pm or email insurance@argus.bm for assistance.

We encourage our pensions and health members, corporate clients and personal motor policy holders to register for a Vantage online account to gain access to policy information and a number of self-service tools.

No. To qualify for Short Term or Long Term Disability benefits, you must be totally disabled due to an accident or illness and unable to work. Check with your employer to determine the company’s policies with respect to time off from work.

If an employee is unable to work due to symptoms of or tests positive for COVID-19, your employee might be eligible to receive STD benefits in accordance with the policy benefit. Note that self-quarantine or self-isolation minus illness are not qualifying factors. Illness is the determining factor to receiving the STD benefit. 

Group Underwriters set Short Term Disability Premiums during renewals. A group underwriter will review a group as a whole, factor in claims experience and set the rate based on a pre-determined cost analysis spreadsheet. The Short Term Disability premiums are billed monthly to the policyholder and will appear on the same invoice as their group health.

Short Term Disability plan renewals occur throughout the year and usually renew on the anniversary date of the policy or its original effective date.

Short Term Disability claims should be directed to our Customer Service Team on 298-0888 or at insurance@argus.bm Our Claims Team will advise if the claim is deemed a disability and communicate with the policyholder and employee on the particulars of the case.

Our standard income replacements are 50%, 66.67% and 75% of weekly earnings. Each benefit is subject to an overall weekly maximum, and plan design varies from plan sponsor.

Weekly Benefits will be paid to or on behalf of an Insured Employee if he/she becomes disabled while insured, is totally disabled throughout the Elimination Period, remains disabled beyond the end of the elimination period and submits proof of loss to us.

The Weekly Benefit will not exceed the Insured employee's net weekly benefit, or be paid for longer than the maximum benefit period. Please check with a group underwriter for additional information.

If you are a permanent full-time employee, under 65 years of age less the elimination period, and work a minimum of 20 hours per week at the employer’s usual place of business, you are eligible to join the plan.

Yes, benefits under the policy will not be paid in connection with a disability, resulting directly or indirectly, from a pre-existing condition until an employee has been insured under the policy for at least 12 calendar months.

The Argus office at 14 Wesley Street is now open to the public 9am to 4pm Monday to Friday. 

We want you to feel secure and comfortable when you visit Argus and we’ve followed the Government’s COVID-19 operations to create an environment that’s safe for all. New practices include, signage to remind and encourage social distancing protocols, the wearing of face masks, hand sanitiser stations and limited opening hours to allow for deep cleaning and sterilisation.

Argus will continue to support your needs online and by telephone. You can reach our Customer Service Centre on (441) 298-0888 between the hours of 8:30 am and 5:00 pm or email insurance@argus.bm for assistance.

We encourage our pensions and health members, corporate clients and personal motor policy holders to register for a Vantage online account to gain access to policy information and a number of self-service tools.

No. To qualify for Workers’ Compensation benefits an employee must be disabled due to a work-related accident or occupational disease as defined in the Workers' Compensation legislation and unable to work.

Workers' Compensation is a wage loss replacement benefit for expenses arising out of an accident or illness that occurs while working for an employer. In other words, job-related injuries and illnesses.

Bermuda has legislated benefits under the Workers’ Compensation Act (1965) together with subsequent amendments that hold employers liable to compensate their employees for loss of income and medical expenses. However, for most industries, insurance is not mandatory and the employer can choose either to self-insure against such expenses or purchase a workers’ compensation policy from an insurer.

All employees, aged 16 or above, of the Employer as defined by the Employment Act of 2000 and subsequent amendments, who are Bermuda residents and work for the Employer in connection with the Employer’s Business.

Eligible classes of employees can include:

• Part-time employees working less than 15 hours per week for the Employer,
• Temporary employees working less than three months per year for the Employer,
• Students working for the Employer on weekends, public holidays and /or vacation periods.

Please note eligible classes of employees can vary from plan to plan. 

There are six components included in our Workers' Compensation Plan in accordance with the Workers’ Compensation Act 1965. Benefits are payable in the event of death, disability or injury resulting from a workplace accident as follows:

 (1) death benefit equal to the deceased employee’s earnings in the past 3 years*

(2) permanent total incapacity benefit equal to the disabled employee’s earnings in the past 4 years*,

(3) permanent partial incapacity benefit equal to a percentage of the amount payable for permanent total incapacity

(4) wage loss replacement for an injured employee who is unable to work in the amount of 2/3 of weekly earnings (or a higher percentage of salary if selected by the employer)

(5) medical expenses in accordance with legislated fees and benefits and

(6) employers’ liability at law is covered .

*or 3 or 4 years, as applicable, of the average annual per capita income as recorded by the Bermuda Government

The Argus office at 14 Wesley Street is now open to the public 9am to 4pm Monday to Friday. 

We want you to feel secure and comfortable when you visit Argus and we’ve followed the Government’s COVID-19 operations to create an environment that’s safe for all. New practices include, signage to remind and encourage social distancing protocols, the wearing of face masks, hand sanitiser stations and limited opening hours to allow for deep cleaning and sterilisation.

Argus will continue to support your needs online and by telephone. You can reach our Customer Service Centre on (441) 298-0888 between the hours of 8:30 am and 5:00 pm or email pensions@argus.bm for assistance.

We encourage our pensions and health members, corporate clients and personal motor policy holders to register for a Vantage online account to gain access to policy information and a number of self-service tools.

Pensions and health members and personal motor policy holders can register for a Vantage online account here.

Pensions and health corporate clients can register here for an online account.

Your pension investments are well diversified. In structuring the Argus Select Funds, we created risk profiles with the understanding that the markets periodically experience stress. Creating a proper blend of high-risk, low-risk and uncorrelated assets helps us to preserve capital during times of stress. Click here to read more.

As always, when markets create significant moves there will be persons experiencing stress as they feel the impacts of being in higher risk positions. We encourage you to seek professional guidance before making any decisions to move your pension funds to ensure that you fully understand possible impacts.

The Pensions Department can be contacted at pensions@argus.bm or, alternatively, contact our Customer Service Centre at 441-298-0888.

If you require additional assistance, please contact the Argus Customer Service Centre at 298-0888.

Registration is easy. Click “Member Login” under the “Pensions” section. A login page will appear and select “Not Registered”. This will take you to the online registration form. You will need your social insurance number to register. This number can be obtained from your member pension statement, your employer or the Social Insurance Department.

Within one to two business days after completing registration, Argus will send you an email containing your login and password information.

The law allows you to receive your pension either in the form of regular annuity payments for your lifetime or by making withdrawals from your account using a prescribed formula to ensure that you receive payments for life. In either case, provision may be made for payment to a beneficiary upon your death after retirement.

The National Pension Scheme (Occupational Pensions) Act came into existence on January 1, 2000.

An employer must enroll all employees who are either Bermudian or the husband or wife of a Bermudian. Non-Bermudians may be included, excluded, or covered under a separate plan.

To complete registration you will need your Social Insurance Number. You must also provide a jpg of a valid government-issued photo ID such as a passport or driver’s license. click here to register and, after reading the requirements, click ‘Next’.

Fill the form with the requested details and press ‘Next’. Once you have uploaded your ID, agree to the Terms of Service and Privacy Policy and press ‘Submit’.

Once completed, a confirmation will appear onscreen. After your account is verified and approved, you will receive an activation link via email.

You can also register for Argus Vantage to access your Health account or to renew your car and bike policies online. Simply follow the steps above and provide your Health Certificate Number to register with your Health account or your motor policy number to review and renew your bike or car policy.

Log into your account and select “Beneficiaries” from the list under “My Profile”. Your beneficiary details will automatically populate. If you wish to change your beneficiary, download the form from the “Forms/Documents” tab. You will need to sign it and send it to Argus. You can either drop this off or email it to pensions@argus.bm.

To view your Fund Fact Sheet, click on the “Funds” tab under “My Profile”. From the list on the left, click on “Fund Fact Sheet” and then select the Fund Fact Sheet that you wish to view.

On the login page, click on “Forgot Your Password”. Enter the requested details (“SIN (social insurance) Number”, “First Name”, “Last Name” and “Date of Birth”) and then click “Continue”. Finally, you will need to answer three security questions and hit “Submit.”

Electronic Bill Payments

HSBC Bank of Bermuda Ltd

• Setup a new bill payment
• Select Argus Pension from the drop down box (either BMD or USD)
• You will be asked for your account number. Your account is your Pension Plan number (example A123456789)
• For reference please put your company name

Butterfield Bank

• Setup a new bill payment
• Select Argus Insurance Co. Ltd - Pension (either BMD or USD)
• Payee reference will be your Pension Plan number (example A123456789)
• Memo detail please put your company name

Direct Transfers

HSBC Bank of Bermuda Ltd

• Account Name:       Argus Insurance
• Account Number:   USD 010174571501; BMD 010174571002
• Reference: Your company name and policy number

NEW BUTTERFIELD ACCOUNT DETAILS

• Account Name:      Argus Insurance Company Limited
• Account Number:   USD 8400105070127; BMD 0600105070115
• Reference: Your company name and policy number

Advise Argus Pensions via email at pensions@argus.bm the value date of the payment and the amount you have authorised.

The contributions received by Argus Pensions will be allocated on the next applicable valuation date.

Electronic Bill Payments

HSBC Bank of Bermuda Ltd

• Setup a new bill payment
• Select Argus Pension from the drop down box (either BMD or USD)
• You will be asked for your account number. Your account number will be as follows:
  • For Individual Retirement Plan (IRP) - 916 followed   by your Social Insurance Number (example 916012345)
  • For Argus Wealth Builder Plan (AWB) - 2501 followed by your Social Insurance Number (example 2501012345)
• For reference please put your name

Butterfield Bank

• Setup a new bill payment
• Select Argus Insurance Co. Ltd - Pension (either BMD or USD)
• Payee reference will be as follows:
  • For Individual Retirement Plan (IRP) - 916 followed   by your Social Insurance Number (example 916012345)
  • For Argus Wealth Builder Plan (AWB) - 2501 followed by your Social Insurance Number (example 2501012345)
• Memo detail please put your name

Direct Transfer

HSBC Bank of Bermuda Ltd

• Account Name:       Argus Insurance
• Account Number:   USD 010174571501; BMD 010174571002
• Reference: Your name, Plan Number & SIN (example Joe Smith 916012345) Or (example Joe Smith 2501012345)

New Butterfield Bank Account Details

• Account Name: Argus Insurance Company Limited
• Account Number: USD 8400105070127; BMD 0600105070115
• Reference: Your name, plan number & SIN (example Joe Smith C0916000012345) Or (example Joe Smith C02500000012345)

Advise Argus Pensions via email at pensions@argus.bm the value date of the payment and the amount you have authorized.

The contributions received by Argus Pensions will be allocated on the next applicable valuation date.

Yes. The government (social insurance pension) plan, also called the Contributory Pension Fund, is separate from the Occupational Pensions Act.