For Employers: 2020 Health Benefits Frequently Asked Questions



Every year, Argus reviews its current health policies and makes revisions needed to keep up with Bermuda’s rapidly changing healthcare system to ensure that Argus members have top rate quality coverage. This year’s renewals are effective as of June 1, 2020 and this guide will help to answer your questions regarding this process.


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Employers
Frequently Asked Questions
2020 Health Benefits

 

 1. How is Argus supporting my company during the COVID-19 pandemic?

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.

2. Has the Bermuda Government made additional amendments to the Bermuda Health Plan?

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.

3. 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 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

4. What are the 2020 benefit enhancements to my health 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

5. What is Argus doing to reduce the escalating costs of healthcare?

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.

6. 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. Contact our Population Health Specialist at 294-5736 or thrive@argus.bm to learn how Thrive. can support your workplace wellness programme.

7. What are the benefits of using the employer and employee Argus Vantage portals?

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.

If you have any further questions, please contact the Argus Customer Service Centre at 298-0888 or insurance@argus.bm