Everything You Need to Know About Benaccount®’s Catastrophic Coverage

Published: Aug 20 | 2019
Modified: Aug 22 | 2019

When we say “insurance” or “employee benefits” what do you think of?

Most people come back with more traditional options like Life Insurance, Health and Dental, and maybe even Disability Insurance. Health and Dental aside, these are the kinds of insurance products that protect against high-cost, unexpected events that might otherwise drastically affect a person’s life, financial stability, or ability to work. It’s coverage you want to have, but hope never to use.

Benaccount combines this “just in case” coverage with a Health Care Spending Account (HCSA) to provide employees with a measure of flexibility and coverage for less serious health and dental claims. We’re seeing an increasing opportunity for Benaccount in the marketplace as the cost of drugs continues to soar, though we are taking important steps forward.

What Does Benaccount Provide?

Benaccount is a low-cost, high-deductible solution for businesses as small as three employees looking to cover catastrophic expenses that might otherwise leave employees financially at risk. It focuses on protecting them from costly, unexpected expenses and less on ancillary insurance such as dental, massage, or chiropractors. Benaccount provides:

 

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Catastrophic Coverage

This coverage is designed to cover unpredictable medical expenses. These could include, but are not limited to:

  • 100% prescription drugs
  • Prosthetic appliances
  • Eligible medical equipment
  • Private duty nursing
  • Accidental dental
  • Hospital and emergency travel

This is the main portion of the Benaccount plan, providing security and peace of mind that employees will be covered in tough situations.

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Deluxe Travel Coverage

Deluxe Travel Coverage provides coverage for certain emergency services when travelling in or outside of Canada*. Emergency services are defined as sudden, unexpected occurrences (disease or injury) that require immediate medical attention.

*Not including the Insured’s home province.

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Health Care Spending Account (HCSA)

The HCSA portion of the Benaccount plan provides coverage for eligible health and dental expenses (as determined by the Canada Revenue Agency). Here are some common uses:

  • Ambulance services
  • Specific cancer treatment
  • Dental services
  • Crutches
  • Visioncare
  • Paramedical expenses
  • Heart monitoring devices
  • Pacemakers

This list is not complete. A full list of eligible expenses under a HCSA is available on the Canada Revenue Agency (CRA) website.

 

When Should Employers Take Benaccount?

We have a variety of products at Benefits by Design (BBD) Inc. that each fills their own niche, and are specifically designed to fulfill a unique benefits need. Here’s where we see Benaccount fitting in best:

#1. When employers want to protect employees from expenses that might otherwise leave them financially at risk, such as high-cost drugs or hospital and emergency travel.

#2. When employers want to provide “just in case” insurance, including Deluxe Travel Coverage, for employees but have a limited budget.

When Should Employers NOT Take Benaccount?

Every employer and business is different. Depending on an employer’s values or the coverage they’re looking for, Benaccount may not be the right fit. Here are a few situations where we think Benaccount might not work, but another BBD product might be a better fit:

#1. When employers want to provide a benefit plan to keep employees healthy and well by covering their day-to-day expenses, like Health and Dental.

(Recommended product: Benepac®).

#1. When employers have an existing plan with stable claims history but feel they’re paying premiums for underutilized benefits and want to reduce costs.

(Recommended product: ASOnly®).

#1. When employers and their employees value flexibility and choice in coverage and want to be able to decide when to use their coverage and what for.

(Recommended product: Standalone®).

Combine Catastrophic Coverage with Pooled Benefits

Benaccount provides coverage for costly and unexpected expenses, which it does very well. However, because Benaccount fills a specific niche, there are gaps that can sometimes leave employees without coverage. In those cases, employers can choose to combine Benaccount with our Benepac pooled benefits for additional coverage.

Benepac provides additional options such as Life Insurance, Short- and Long-Term Disability Insurance, Critical Illness Insurance, and more. Between the coverage provided by Benaccount and Benepac, employers can build a comprehensive plan to cover almost anything. Employees will be covered for costly, unexpected expenses and still feel like they’re utilizing a benefits plan that covers their day-to-day expenses, such as Health and Dental.

Learn more about Benaccount and how it can work for you and your business!

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