The roll of the die

Perception in benefits can sometimes be compared to casting the die on the corporate gameboard of culture—compensation—wellness—balance. Juggling the multitude of employment, human rights and liability issues.

Toss the die and land on the employee. Here you have the “user”, the ultimate benefactor of the plan provisions. At the end of the day, they want 100% coverage for all the items that they and their family members rely upon without issue. They would like these benefits available on whatever platform is the easiest to use in order to have the speed of response. Additionally, when crisis strikes, their income needs to be protected and they need to have the ability to reach out and get accurate answers fast.

Opposite to this side of the die is the business. Holistically, the company wants to provide benefits for the wellbeing of the employee. Benefits create an excellent attraction and retention tool for effective compensation. However, too many times the cost of the group plan falls within the expense leger, not as an “investment” into their top talent, but as a cost with no return. 

Here comes the challenge for consultant whose first priority must be education and communication to design a program which both allows coverage but on an acceptable budget. In this the consultant will draw on the effective relationships with the insurance carriers and benefit providers to ensure all the pieces of the puzzle are understood from the two main players on the board.

The insurance carrier is a for-profit company providing a service as a risk mitigator. They need to have the coverage available in the event of claim, but they also need to be able to price this according to their actuarial tables which predict incident of claim. Without the funds to effectively pay through long term planning, investment, and active policies, well, going back to the employee, there would be nothing for them. Group is one-year term insurance, for the most part, and so the rates based on a number of factors, usage and economic factors being just two, readjust their rates annually to continue to provide the insurance.

Benefit providers may be insurance carriers, but many times these are companies which provide avenues for self-insurance, whereby the corporation takes on the “risk” of claim and pays an administration fee in order to have these claim be compliant with a number of regulations, like privacy, Health Canada, the Income Tax Act, etc. These programs are referred to as Private Health Services Plans (PHSP) or better known as health spending accounts (HAS), or administrative services only (ASO). These offer a cost effective solution for the more predictable claims like vision, dental and paramedical services (massage, chiropractic, etc.) 

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