Health Plan Resources for Individual Members

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 remains at $400.31 per month, per insured adult. This includes the Mutual Reinsurance Fund and Standard Health Benefit Premiums, an amount set and charged by the Government that Argus pays on your behalf.

Supplementary Premium

The premiums for supplemental medical, dental, and vision care benefits are administered by Argus and are based on:

• Your specific demographics (two-year age band).
• General medical inflation.
• Trends in utilisation of services.
• Claims experience for our entire book of business.
• Your benefit plan.

Every year we review benefits[1] to ensure that they meet the unique healthcare needs of our members. This year’s new benefits are as follows:

Preventative and Diagnostic

• Allergy Testing – increased from $600 Lifetime to $900 every five years

Home and Office:

• Specialist Consultation at Island Health Services and Family Practice Group covers 100% of billed charges
• Physical Medicine/TENS:
• Individual Visit – increased the maximum from $75 to $85
• Group Session – increased the maximum from $35 to $40
• Chiropractic- increased the maximum from $75 to $85, per visit
• Chiropody/Podiatry – increased the maximum from $75 to $85 per visit
• Neuropsychological Testing – one test every five years to a maximum of $5,000

Major Medical:

• Specialty Network – Non-Solid Organ Transplants: to provide world class care while reducing costs for Bone Marrow, Stem Cell and CAR-T therapies.
• Increased our Accommodation Benefit on all plans for care in the Argus Preferred Provider & Specialty Networks.
• Student Mental Health Hotline available to students studying overseas.

[1] Depending on your healthcare plan

Argus, in partnership with One Team Health, Inc. (‘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 call 298-0429 to speak to an OTH representative.