Health Plan Resources for Employers

Health Plan Resources for Employers - Argus Bermuda

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We’re here to help make this year’s health renewal process as simple as possible. Here are some of the important things you need to know:

Health Renewal FAQs

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.

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.

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.

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