Administrative Services Only (ASO): Administrative Services Only is an arrangement whereby a company agrees to provide full administration and claim adjudication services to an employer but bears no liability arising from claims against those services. The employer self-insures the cost of providing the health and dental benefits.
Administrative Services Only arrangement is most often chosen where annual aggregate claims can be reliably estimated and the employer has the financial resources to assume the risk that claims will be higher than expected. Therefore, it is most suitable for large employers. By choosing an Administrative Services Only arrangement, the employer hopes to achieve economies of scale by outsourcing the administrative function while retaining the financial benefits of good claims experience. The employer also benefits from an insurers claims management, thereby controlling claim costs which comprise the most significant portion of overall benefits costs. (courtesy Wawanesa Life)
Non-Evidence Maximum (NEM) or Non-Evidence Limit (NEL): The maximum amount of life or long-term disability you can obtain without providing proof of good health.
Mandatory Enrollment: All eligible staff (usually full-time permanent) must participate in the benefit plan (usually a condition of employment).
How are life, WI (STD) & LTD rates shown? Life rates are per $1,000 of coverage, LTD rates are per $100 of coverage, WI(STD) rates are per $10 of coverage.
Life Insurance: Provides a one time benefit to the employee’s beneficiary in the event of loss of life.
Accidental Death and Dismemberment: Provides a one time benefit to the employee or employee’s beneficiary in the event of dismemberment or accidental death.
Critical Illness: Provides a one time benefit in the event that one of a list of “critical illnesses” is diagnosed.
Dependent Life: Provides employee with a one time benefit in the event of loss of life of a spouse or child.
Weekly Income (WI) or Short Term Disability (STD): Provides a weekly benefit in the event of total disability (usually beginning at hospitalization or accident and after 7 days of illness and continues to 119 days.)
Long Term Disability (LTD): Provides a monthly benefit in the event of total disability (usually beginning at 119 days and continues to age 65)
Extended Health Care: Supplements provincial health care plans to help cover costs such as; out of country travel, hospitalization, drugs, medical equipment, professional services, etc.
Dental Care: Provides coverage for initial dental care:
- *BASIC – preventative and restorative work
- *MAJOR – caps, crowns, onlays, dentures, bridges, etc.
- *ORTHO – braces for dependant children under 18