For Employers: 2024 Health Renewal Frequently Asked Questions



We have compiled a list of frequently asked questions (FAQs) regarding this year’s health policy renewal, which will take effect on June 1st, 2024.


2024 Health Renewal Frequently Asked Questions

For Employers
2024 Health Renewal Frequently Asked Questions

 

1. How will Argus support my company during the 2024 health policy period?

Our unique value lies in our integrated approach to wellbeing. By aligning healthcare delivery with insurance coverage, we seamlessly merge custom solutions, elevate the quality of care, and streamline coordination, resulting in meaningful financial benefits for our clients and members. 

Highlights include:

  • New Benefit!
    Argus Members enjoy no co-pay at Island Health Services and Family Practice Group for GP and specialist services. This includes annual physicals. We are committed to removing financial barriers to promote preventive and chronic care and will ensure annual exams are scheduled in a timely manner.
  • Coordinated Care:
    Together, Thrive. Case Management and One Team Health, our overseas care provider, form a powerful combination, ensuring superior care coordination, data validated health outcomes, and significant cost savings.
  • Empowering Wellness Education:
    In response to your feedback on the importance of wellness education, our expanded Thrive. team is primed to offer health fairs and targeted events, such as onsite clinics, educational initiatives, and programmes designed to empower members with the knowledge to make informed health decisions.

2. How will my company’s premium be calculated this year?

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 (MRF) levy that Argus pays to the Government on your behalf, currently remains at $400.31 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 
    The overall increase in healthcare costs due to factors like medical technology advancements, higher service demand, and increasing labour and supply costs. Worldwide healthcare costs have seen a reported increase of approximately 10%, as noted in the AON Medical Trends Rate Report.
  • Utilisation trends
    The patterns or changes in how often healthcare services are being used by the insured population. This year, utilisation was at an all-time high. 
  • The overall claims experience
    The collective claims history across all Argus policies, including frequency, amounts, and the demographics of your employees and their dependents. These demographics encompass age, gender, lifestyle, and employee turnover rates. 
  • Plan-specific claims history
    The detailed claims history of your plan over the past three years, including the number, type, and cost of claims. 
  • Benefit plan details
    Specific coverage details, including the types of benefits, coverage limits, and the scope of coverage, which can influence premium adjustments according to the assessed risk level, claim potential, and coverage breadth.

3. What are the 2024 health benefit enhancements?

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:

  • No Co-Pay at Argus Medical Practices:
    Argus Members enjoy no co-pay at Island Health Services and Family Practice Group for GP and specialist services. This includes annual physicals. We are committed to removing financial barriers to promote preventive and chronic care and will ensure annual exams are scheduled in a timely manner.
  • Increased Benefits:
    • Immunisations and Injections: increased to $50 from $30, $1000 maximum for children under the age of 19
    • GP Office Visits: increased to $130 from $125 (or 100% at Argus Medical Practices)
    • Specialist Office Visits: increased to $150 from $125 (or 100% at Argus Medical Practices)
    • Well Baby Exam: increased to $150 from $107
  • Other Benefit Changes:
    • Major Medical lifetime maximum is $5,000,000 (from unlimited)
    • Overseas Psychiatric & Substance Abuse Treatment: maximum 90 days per policy year
    • Hearing aids: 1 every 5 policy years
    • Orthotics: 1 every 2 policy years
    • CPAP: 1 every 5 policy years, up to a maximum of $5,000

[1] Depending on your healthcare plan.

4. What tools are available to help my employees better manage their healthcare?

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. Our Thrive. Wellness Rewards Programme, powered by the Tictrac app, can be customised to help employees build healthy habits. Tictrac measures your activity against a weekly target of 150 active minutes. Meet this goal and we'll reward you $5 each week – that's up to $260 a year! All rewards will be paid on a quarterly basis through our electronic funds transfer service.

Contact Shakira Warner, VP of Population Health Management, at 294-5736 or thrive@argus.bm to learn how Thrive. can support your workplace wellness programme.

5. What are the benefits of using our online employer and employee portal Argus Vantage?

Employer Benefits:

With Vantage, our secure online portal, you only need one username and password to view your Argus Health and Pension (if applicable) accounts.

With Vantage, you can:

  • Access your Group plans, reports, administration documents as well as health and wellness resources, 24/7.
  • Add and remove members and dependents, across all plan types, without the need for paper forms.
  • Keep track of the status of your requests throughout the enrolment process.
  • Enjoy increased privacy and data security with member records stored electronically.
  • Easily search for employee and dependent details through the Manage Member option.
  • Quickly download claims and census reports, and your schedule of benefits.

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. Vantage users can:

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

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


DISCLAIMER: The content in this article is for informational purposes only and is not intended to be a substitute for professional financial or investment advice.