Implementation Glossary & FAQs

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We've put together this comprehensive glossary to help you get a firm grasp on some of the essential terms and concepts you'll frequently encounter when dealing with benefits and the implementation process.

These terms and phrases are frequently used in many documents, so understanding these terms will not only make your life easier, but it will also empower you to manage the benefits at your company more effectively.

Whether you're a seasoned veteran in the benefits world or just starting, this glossary is an invaluable tool designed to help you navigate the sometimes confusing world of benefits and implementation. Let's get started!

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Glossary

Contribution %

This relates to the monthly bill or plan cost. The policyholder (Company) must contribute at least 50% of the monthly premium. However, they have the flexibility to cover anywhere between 50% and 100%. This arrangement allows you to decide what best suits your company. Please note that the contribution percentage differs from the co-insurance percentage.

Contribution % vs

Co-insurance %

Contribution % refers to the monthly cost of the plan and designates who, between the policyholder and the member, is covering which portion of that monthly premium. If an employee is responsible for any part of the premium, you will need to set up that amount on their payroll deductions.
Co-insurance % indicates how much of a specific benefit the plan covers. For example, if a prescription at the pharmacy has 80% co-insurance, it means the employee must pay the remaining 20% out of pocket to obtain that prescription.

EP3 certificate

This form validates the eligibility of your previous plan's pooling details. Requesting the EP3 Certificate from carriers is standard practice, and they are well-acquainted with this document. Carriers are required to provide it upon request, provided it's available.

Initial Deposit for HSA (Float) Typically, this will represent 2/12 of the total annual allotment for the whole group.

Minimum hours worked

You can set the most suitable number of hours for your company. However, the minimum allowable number of hours is 20 per week.
PAD Agreement

You must enter complete banking information on the form and provide a copy of the void cheque to support. Although this may seem redundant, both documents are required by insurers for compliance and to prevent banking errors.

Policyholder

The policyholder is the company. Please enter the company name here.
Waiting Periods This is the length of time an individual must wait before they can use the medical plan. Though a waiting period can often align with an initial employment probationary period, it can also be tailored to best fit your company, even allowing for no waiting period at all.

WEBS Admin Page

This page provides access for up to three Plan Administrators to GroupSource's online portal, WEBS. Full administrative access is granted through "Add/Change," while "View Only" offers slightly limited access. However, it's vital to remember that Plan Administrators with "View Only" access can still view all member information, including salary details.
WSIB/WCB/CSST WCB, WSIB, and CSST are acronyms for Workers' Compensation Boards or agencies across different provinces. These organizations provide support and compensation to workers who suffer injuries, disabilities, or illnesses due to work-related incidents. They manage claims, offer wage replacements, medical treatments, and aid the return-to-work process for eligible employees. To determine if you're contributing to WSIB, please consult your company's accountant.

 

FAQ

Is the waiting period to be waived for all members hired on or before the plan effective date?

Do you want all current employees to be enrolled in the plan from the effective date, regardless of where they are in the waiting period? If so, select "yes" to waive the waiting period. Note, this waiver only applies to the initial implementation. Future hires will have to complete the waiting period as detailed in the Master Application.

Who can sign the forms?
Anyone with signing authority for the company.
What to do if we have new hires coming on board soon, how do they get enrolled?
The carrier will require a “cutoff” point and anyone hired after that date can be added once the implementation is complete. The ideal cutoff point is the day you submit the documents.

 

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