2021 Health Renewal Frequently Asked Questions
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.
This year, we have chosen to issue a rebate to eligible clients, a decision based on the temporary positive impact on an otherwise normal three-year claims experience. Restricted access during the pandemic to certain services, particularly overseas care, meant we saw a decline in overseas claims last year.
Note that your policy is made up of two major components, Argus Supplemental Insurance and Government Mandated Standard Benefit/MRF. This rebate is derived 100% from the Argus component.
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, remains legislated at $355.31 per month per insured adult.
Please note that we anticipate Government will be legislating a significant adjustment to the SPR in the near future.
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:
- The physical demographics of your group
- 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
3. What are the 2021 benefit enhancements to my company's health plan?
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.
- Oral Appliances – We have added coverage for oral appliances (used in the treatment of sleep apnea) at 80%, to a max of $3,000, every five policy years. The services must be pre-certified.
- Neuropsychological Testing – A neuropsychological assessment is a formal comprehensive evaluation of cognitive abilities (e.g. memory, problem-solving, visual-spatial skills, attention, processing speed) that is done to understand brain-behaviour relationships (i.e. how the brain works) and is 100% covered for a maximum of one test, every 2 policy years.
- COVID-19 Testing – Unlimited; details found here
- COVID-19 Vaccination – Unlimited; details found here
1 Depending on your healthcare plan
4. What is Argus doing to reduce the escalating costs of healthcare?
As we journey through COVID-19, our mission remains the same – to support our members with greater access to affordable, high quality care, while employing approaches that focus on better outcomes, remove wasteful practices and create long-term, sustainable savings.
The acquisition of Island Health Services and the Family Practice Group reinforced our commitment to support change in the Bermuda healthcare model, giving the patient access to the care they need, while controlling the escalating cost of healthcare. This was demonstrated with the no co-pay partnership received enjoyed by the Safeguard Plus plan members. Our Thrive. programme and Telemedicine benefits further support the objective of a better healthcare model.
5. 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 firstname.lastname@example.org to learn how Thrive. can support your workplace wellness programme.
6. What are the benefits of using the employer and employee Argus Vantage portals?
With Vantage, our secure online portal, you need only one username and password to obtain a total view of your Argus Health and Pension (if applicable) accounts, and one place to visit for tools and tips that can help you learn about industry changes.
Dashboard enhancements include the ability to:
- Easily search for employee and dependent details through the new Manage Member option
- Remove employees and dependents from your plans in just a few simple steps
- Quickly download claims and census reports, and your schedule of 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.
Please contact your Relationship Manager or a member of the Relationship Management Team on 298-0888 or email email@example.com to discuss your health plan 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