For Group Members: 2021 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, 2021 and this guide will help to answer your questions regarding this process.


Article Image

Group Members
Frequently Asked Questions
2021 Health Benefits

 

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

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.

This year, the right thing to do was to issue a rebate to qualifying policyholders. Restricted access during the pandemic to certain services, particularly overseas care, meant there was a decline in overseas claims last year. We recognise that 2020 had a temporary positive impact on an otherwise normal three-year claims experience.

2. How will my premium be calculated this year?

The Standard Premium Rate (SPR), which includes the Mutual Reinsurance Fund (MRF) levy that Argus pays to the Government on your behalf, currently 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.

Supplementary Premium
The premiums for supplemental medical, dental and vision care benefits, if applicable, 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 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.

  • 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

*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. Our telemedicine benefits further support the objective of a better healthcare model.

5. Who should I contact if I require medical treatment overseas?

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 298-0429 to speak to an OTH representative.

6. What tools are available to help me better manage their healthcare?

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.

7. What are the benefits of using the Argus Vantage portal?

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.

8. Can I receive my Argus reimbursement payments via electronic funds transfer (EFT)?

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

 

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

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.