For Members: 2019 Health Renewal FAQs



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, 2019 and this guide will help to answer your questions regarding this process.


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Did you Know?
2019 Frequently Asked Questions on Health benefits for Employees

 

 1. What is changing in Bermuda’s healthcare system?

  • The Bermuda Government has proposed legislation to change the current ‘activities-based or fee-for-service’ payment model for the Standard Health Benefit (SHB), i.e. local hospital services provided by the Bermuda Hospitals Board (‘BHB’).
  • As a result of this change, the Mutual Reinsurance Fund levy (‘MRF’) , included in your health insurance premiums paid to Argus, will be increased to fund services provided by the BHB.
  • The premiums for supplemental medical, dental and vision care benefits will continue to be underwritten and administered by Argus.

2. How will the legislative change impact me?

Although the method of funding the BHB will change, your coverage will remain the same:

  • You will continue to pay insurance premiums in the usual manner
  • SHB for children, seniors and the indigent will be subsidised as before

3. What is the Argus response to the legislated changes?

  • In the wake of such transformative legislative change, Argus is committed to advocating for and providing innovative solutions for our members. We will continue to launch quality, cost-effective healthcare models and improvements in our business practices in response to the changes in our healthcare system.
  • While the full ramifications of this legislative change are unknown, we will continue our discussions and collaboration with the Government to ensure that we remain apprised of new developments.   

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

  • We are driving for increased efficiencies to keep our internal costs as low as possible
  • We are lobbying for change and sustainability, advocating for the best quality care at the lowest prices
  • We are working to prevent and manage chronic disease via our Thrive. Population Health and Nurse Case Management programmes

5. What tools are available to help me better manage my healthcare?

As Argus continues to advocate for sustainable solutions to Bermuda’s healthcare challenges, we encourage you to take full advantage of the broad range of Thrive. tools and resources, which are available at no additional cost.

The following is a list of the Thrive. resources available:

  • Thrive. Case Management
    Thrive. In collaboration with Johns Hopkins Medicine International and local healthcare providers, Thrive. Case Management supports members with chronic conditions with comprehensive plans, guidance and encouragement to improve their self-management skills and health status.

  • Get Up & Thrive.
    Get Up & Thrive. is our online activity-based platform available year-round, via any mobile device. Powered by Virgin Pulse, this social wellness programme drives engagement by connecting people to physical and wellness challenges and rewards to maximise well-being.  

  • Thrive. Resources
    In support of our Thrive. total health and wellness strategy, we have appointed dedicated resources to lead and promote initiatives for preventive care.
    • Shakira Warner, MSc, Population Health Specialist – Our Population Health Specialist evaluates, implements and promotes innovative programmes and initiatives associated with the Thrive. Population Health & Wellness strategy.
      Direct line: 441 294-5736, Email: swarner@argus.bm
    • Karima Stevens, MSN, RN, Nurse Case Manager – In collaboration with healthcare professionals, our Nurse Case Manager provides chronically ill members with a comprehensive plan, guidance and encouragement, with the overall aim of creating self-management skills and an optimised health status.
      Direct line: 441 298-0597, Email: kstevens@argus.bm
  • Health Risk Assessment (HRA)
    Our Health Risk Assessment (HRA) online tool is designed to evaluate the health history and lifestyle habits of our members. This online questionnaire helps to determine your overall health status and potential risks for certain chronic diseases or illnesses. Although the individual employee results are confidential, employers have access to an anonymised Summary Report that can provide the following:
    • Employee Demographics: number of participants (% of total employees), male vs female (%) and average age
    • HRA Data: Average wellness score, top three health risks, percentage of: current smokers, persons who are overweight and obese (BMI ≥ 25), and those with high blood pressure, impaired glucose tolerance and high cholesterol
  • HealthyLearn Library
    Our resource library (available at https://healthylearn.com/argus/) offers a robust supply of insightful and educational articles, newsletters and references that include healthy eating tips, chronic disease updates and investment planning advice.

6. What are the benefits of using the Member Argus Vantage portal?

With Vantage, using a single username and password, you can obtain a total view of your Argus Health and Pension (if applicable) accounts and have easy, organised access to educational support and manage your accounts:

  • Access your health information 24/7
  • View benefits
  • Submit claims online
  • Print ID cards from home
  • Compete in health and fitness challenges with Get Up & Thrive.
  • Complete the Health Risk Assessment (HRA) confidential screening tool


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


Glossary of Terms

[1] ‘activities-based or fee-for-service’ – A payment model in which the healthcare provider is paid for each particular service rendered to each patient, rather than bundled services

[1] ‘Standard Health Benefit’ – The SHB is funded by the Standard Premium Rate (‘SPR’). The SHB currently covers local hospital services including inpatient hospital care, services provided in the emergency and outpatient departments including diagnostic and laboratory tests, the ambulance service, and care at Agape House and the Mid-Atlantic Wellness Institute as well as approved community-based services in non-hospital facilities. As of June 1st, 2019, proposed legislation will transfer the majority of hospital services to the MRF. By law, all employers and self-employed persons are required to provide this cover for their employees and non-working spouses and to cover at least half of the cost of this insurance. Most employers provide benefits well in excess of the minimum for both employees and their insured dependents.

[1] ‘Mutual Reinsurance Fund (MRF) levy’ – A levy currently applied to all adults who are insured for the Standard Heath Benefit to fund the MRF. The majority of funds collected for the MRF have traditionally been allocated to subsidise the cost of the government-administered Health Insurance Plan (‘HIP’) and FutureCare programmes; the Bermuda Hospitals Board’s operational and administrative costs; the funding of the Bermuda Health Council and to cover the costs of dialysis treatment, kidney transplants and associated anti-rejection drugs. As of June 1st, 2019, in addition to the above, proposed legislation will mandate that the MRF will fund the majority of SHB hospital services provided by the BHB.