Top 6 Tips To Manage Your Group Benefits Plan
Posted In: Employee Benefits Planning

Why Is It Important to Provide Group Benefits?

Glassdoor did a survey which significantly (79%!) determined that employees prefer group benefits over a salary increase. The most valued insurance coverage, in this study, were comprehensive health benefits; health benefits include prescription drugs, vision, paramedical practitioners such as registered massage therapy, physiotherapy, osteopath, naturopathy and much more!

1. Which Benefits Do Your Employees Value the Most?

At Elementus, we provide usage reports regularly to enable business leaders to see what benefits have the most usage and where potentially the company could reallocate funds to those more frequently used benefits.

2. Stay Compliant

Your group benefits insurance contract requires mandatory enrollment.  Once your employees meet the eligibility criteria (such as a minimum of hours worked per week), they will have to be enrolled in the plan. Employees and employers can not choose when they would like to be on the plan because then only the high-risk members would enroll, which would be detrimental to the insurance company and the employer, from a cost perspective.

3. Enrolling Employees at On-boarding

In order to avoid having a “late applicant”, Elementus recommends that the employee completes the enrollment during your on-boarding process. If there is a waiting period to join the plan, the employee will have access to their full benefits when eligible. It is cumbersome and detrimental to the employees if they are “late”, because most insurance providers will make them jump through medical underwriting hoops and potentially have restricted dental for an entire year. This is to protect the insurance company from members who are joining because they suddenly have medical expenses.

4. How Can HR Handle an Employee Who Refuses Benefits?

If an employee has coverage on their spouse’ benefits plan, they can enroll for family coverage and waive the health and dental benefits for their whole family. They would still be enrolled on the plan for Life Insurance, Critical Illness and other coverage such Long Term Disability if included.  This is best practice.  If that employee wants to add health & dental coverage later, they can do so without penalty. Refusing benefits is when an employee does not want any of the previously listed coverage. If the group is large enough, a certain percentage of members can refuse benefits.  However, please note that the plan providers will consider the employee a “late applicant” if he/she chooses to come on the plan later (see point above).

5. Life Events – Keep the Employee’s Information Up to Date  

Employees must inform the insurance provider or their company’s plan administrator to add children or spouses (including common law partners) to the plan in a timely manner. We recommend completing an annual review of all dependents and beneficiaries, with your team, to ensure this information is up to date. Always keep the original enrollment forms on file at the office.  These have the ink signatures of your employees and their beneficiaries.  Should there be a Life Insurance claim (or similar), insurance carriers will require original documents.

6. Spouses Can Coordinate Benefits  

If your employees have a family plan, and are also on their spouse’s plan, they must claim on their own benefits plan first. If there are costs the employee is out of pocket for, they can submit the remaining amount on their spouse’s plan. Note that “reasonable and customary” costs (an acceptable cost for that product or service) are considered for the overall claimed amount. If they have waived benefits on their spouses’ plan, then this would not be available.

Overall, benefits are becoming mandatory to attract and retain top talent as part of the overall compensation package.  We empower you to get the most value from yours!


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