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EMPLOYEE BENEFITS

Service Overview

CIC's Employee Benefits Department is arguably the most competent and experienced Group Health, Group Life and Pension professionals in the Insurance Brokerage community today. The Employee Benefits team has over 100 years combined experience. Its staff of eight (8) employee benefits specialists is available to provide personal brokerage advice, consultancy and intervention with insurers to its portfolio of gilt edged clients. A network of recognized health care providers and consultants are available 24/7 to assist you during your time of crisis.

Our objective is to make Employee Benefits simple and minimize your burden when faced with the unexpected. At CIC we provide the solutions to assist you with planning for the unexpected from your health care and life insurance plans, individual or corporate, to planning for your future in the form of pensions. Through our access to local and
international markets, we can secure that which
best suits our clients’ needs.

INTRODUCTION

One of the key elements under an insurance portfolio is the employee benefits area. Some employers handle this aspect separately from the Property & Casualty lines; however, others see this as a part of their overall insurance programme and include it as one of the integral parts. The employee benefits area typically would include the employee plans for Group Life and Accidental Death benefits, Group Health and Group Pensions. Our services include the provision of advice and consultation for all aspects of Employee Benefits.

Group Health Benefits

In designing a Benefit Plan, it is critical to meet the needs of the members and also to maintain a viable plan and manage costs. Whether a plan is fully insured or self insured this is the single most important factor that affects the plan’s current and future costs. Group Health benefits are a bit more flexible than Group Life benefits as some insurers may provide network managed plans apart from the typical reimbursement plans. Our experience indicates that the majority of plans are not actively managed, and the policyholder is only made aware of heavy claims losses and the likelihood of severe rate increases just prior to renewal.

Our approach will involve monitoring the plans performance on an ongoing basis with quarterly reviews which will allow for determination of claims trends and corrective action where necessary. This will also require ongoing monitoring of the insurer’s performance and administration of the plan, as well as the ability to provide claims statistics and analysis when required.Our reviews would also consider the use of technology for the communication with the policyholder and the ability to use technology for the administration of the plan e.g. ability to track claims online, and the ability to add or terminate members online.

Another important factor will be the monitoring of new products developments and trends in the Health insurance industry as it will affect our client plans. This will also include reviews of new services offered by the insurance carriers as well as changes in the legislative environment that will impact on our clients’ plans. These services are in addition to the provision of assistance with plan benefit design and obtaining the relevant quotations from the market and analysis of the quotations received where new plans are being implemented or the client desires a change from current arrangements.

 

 

Group Life Benefits

In addition to Group Health Plans we can also arrange Group Life Plans for your employees.
Group Life Plans add value to your employees by ensuring their beneficiaries are well taken care of in the unfortunate event of an untimely demise.

 

 

Pension Plans

We can also arrange various Pension schemes to benefit your employees. Just leave the heavy lifting to us.

 

FREQUENTLY ASKED QUESTIONS

EMPLOYEE BENEFITS

 

 

What's the difference between a deductible and coinsurance? 
Your deductible is the initial amount you must pay each year for covered health services before your insurer will start to reimburse. Your plans have an individual deductible ($300.00) and a maximum of 3 family deductibles. Covered charges incurred in the last three months of a calendar year, which were used to satisfy the Deductible, either in full or in part, may be carried over into the following year to assist in satisfying the Deductible.

Co-insurance is a fixed percentage that you pay toward each service. Your plan carries an 80% - 20% co-insurance factor.
 
What is a waiting period?
A stated period after the beginning of coverage during which no benefits are paid. Your plan carries waiting periods for Dental (3 months), Vision (3 months), Preventative Care and Maternity (10 months). This is applicable to both Members and Dependents. With transferred groups, no waiting period is applied.
 
What are pre-existing conditions and how do they impact coverage? 
A pre-existing condition is a health condition (known or unknown) (other than a pregnancy) or medical problem that was diagnosed or treated during a specified timeframe prior to the commencement of coverage.
 
What is Co-ordination of Benefits and how does it work? 
Even if you are insured under another Group Health Plan you are still eligible to enrol in this plan. Your claims would be handled under the Co-ordination of Benefits provision of the policy. The Primary Insurer would make the initial claim payment and the balance considered by the other insurer up to their plan limits. The order of payment is agreed among insurers.

  1. Claims for the member should be submitted to their existing Group Health Insurer first. It will then be forwarded to the secondary Insurer.
  2. Claims for the spouse should be submitted to his/her Insurer first.
  3. Claims for dependent children should be submitted to the father’s Insurer first.
     
Who can be considered my dependents vs. a beneficiary? 
A dependent is considered the spouse (married or common-law) and / or unmarried, unemployed children (inclusive of step-children or legally adopted children and / or foster children) up to 19 years of age or 23/25 (varies with insurers) years of age if they are attending school on a full time basis. Parents, siblings and/or extended family members are not considered dependents.

A beneficiary is the person or entity entitled to receive any claim amounts and other benefits upon the death of the member. It is advised that this person be 18 years and older and can include siblings, aunts, uncles and parents.
 
How is Overseas Medical Treatment handled? 
Medical expenses incurred for treatment abroad will be payable at the reasonable and customary levels prevailing in Trinidad and Tobago, unless it is proved to the satisfaction of the Company that such medical treatment is not available locally. This must be certified by two physicians, one of whom must be a specialist in the field of medicine to which the illness applies. The Insurance company must give approval of treatment prior to departure abroad.