Suggestions and reminders for Plan Administrators
Some helpful suggestions & reminders for your plan at your fingertips.
Insurance – Mortgage or Term Life
The Value of Group Benefits to Employers & Employees
Why Consider Employee Benefits?
As a small business owner, you understand how important your employees are to you. Simply put, the right employees can “make” the company. Besides wanting to treat your employees well and making sure they are in the best of health, employee benefits plans have numerous advantages:
- Attract and retain high-quality employees. Studies show better compensation and benefits is the number one reason candidates cite for accepting a job.
- Creates a healthy culture. Having healthy employees’ results in increased productivity and reduced absenteeism. This mitigates some of the cost of providing the benefits plan.
- Tax Deduction. They are a tax efficient way to increase a compensation package for both the employee and the employer.
- Cost Effective protection for employees and their families. There are no requirements to pay into CPP or EI and the employee gets tax free medical benefits.
- Increased morale. It helps establishes the company policy on health and sickness
And last but not least… Employees Value Employee Benefits!
Today, top employees demand a comprehensive health insurance plan. In fact, in a 2016 Canada health survey, 77% of respondents say they wouldn’t move to a job that didn’t include some health benefits.
Reasonable and Customary Charges for Paramedical Services
Extended Health Care plans generally include coverage for the services of several types of healthcare practitioners such as chiropractor and massage therapists. There is a range of usual fees most practitioners in each province typically charge for certain services. Insurance companies use these “reasonable and customary” fees as the basis for pricing their benefit plans and determining the maximum eligible amount that they will reimburse. Most provider associations publish a suggested fee schedule for their practitioners. However, there is no requirement for them to charge according to this and fees for similar services can sometimes substantially differ from one practitioner to another.
Most paramedical expenses claimed by plan members fall within the reasonable and customary fee range. If a health care practitioner chooses to charge more, the member is responsible for the extra cost. Below, you will find the reasonable and customary charges for each type of practitioner in BC. Please note: Some carriers do not publish their listing as they believe it helps protect the plan member (as some service providers will then charge the maximum allowable rate) as well as limit any fraudulent or excessive service fees.
Your plan may not cover all the practitioners listed; check your contract or contact your group benefits representative if you are unsure.
- Acupuncturist (For Initial assessment and Subsequent visit) – $100
- Audiologist (per hour) – $125
- Chiropodist or Podiatrist – (For Initial assessment and Subsequent visit) – $100
- Chiropractor – Initial assessment $135; Subsequent visit $60
- Dietician (per hour) – $150
- Massage Therapist (per hour) – $100
- Naturopath – Initial assessment $210; Subsequent visit $155
- Occupational Therapist (per hour) – $140
- Optometrist (For Initial assessment and Subsequent visit) – $120
- Ophthalmologist (For Initial assessment and Subsequent visit) – $200
- Osteopath – (For Initial assessment and Subsequent visit) – $120
- Physiotherapist – Initial assessment $80; Subsequent visit $135
- Psychologist (per hour) – $190
- Social Worker (per hour) – $175
- Speech Therapist (per hour) – $120
Please note:
This list only reflects the maximum Reasonable and Customary amount allowed per treatment. Claims will still be subject to the terms of the policy.
Usually, a plan limits paramedical services to one treatment per service per person per day.
Also, please remember that it is the plan member’s responsibility to ensure their paramedical providers possess the credentials accepted by their insurance carrier.