What Is Stop Loss Coverage and How Does It Keep Benefit Plans Sustainable?

When employees are prescribed a medication, cost can become a concern — especially if they want or need to stay on a brand-name drug. While many group benefits plans encourage generic substitution, there are still options that may help employees access eligible brand-name medications at a lower out-of-pocket cost. Two programs that can help are RxHelp ONE and innoviCares . Both are designed to support access to qualifying brand-name medications, and both can be valuable tools for employees who want more choice at the pharmacy. RxHelp says its program can be used alongside a current benefit plan and provides supplementary financial coverage for eligible brand medications, while innoviCares says it coordinates with existing insurance to help reduce costs for qualifying medications. What is RxHelp and innoviCares? RxHelp ONE is a brand-name prescription savings program that connects Canadian patients to participating pharmaceutical manufacturers’ patient assistance programs. RxHelp describes the card as a way to help patients remain on covered brand-name medications, in some cases at little or no additional cost versus the generic alternative. innoviCares is a free prescription savings card available to Canadians for qualifying original brand medications. The program is funded by participating pharmaceutical manufacturers and is intended to improve affordability and support patient choice. innoviCares says it currently covers 65+ medications . What are these programs for? These programs are meant to help people who have been prescribed an eligible brand-name medication and are looking for ways to reduce the cost difference between the brand and generic version. They can also be helpful for people who prefer to remain on a brand-name medication they know and trust, where an eligible assistance program is available. How do RxHelp and innoviCares work? In general, the employee checks whether their medication is on the program formulary, registers for a free card, and presents the card at a participating pharmacy when filling their prescription. The RxHelp ONE card is free, requires a valid prescription from a physician, and can be used at participating pharmacies in Canada. The card can work with an existing benefits plan. innoviCares is also free and if you already have private insurance, the card can coordinate with that coverage to help provide the lowest cost for a qualifying medication. Is there a large list of covered medications? Yes. Both programs promote broad formularies for eligible brand-name drugs. innoviCares says it covers over 65 original brand medications , with some differences by province. Its website directs users to check coverage by province to confirm whether financial assistance is available for a specific medication. RxHelp also maintains a long list of participating medications through its card registration. What about medically necessary brand-name drugs under a group plan? This is an important point for employees to understand: some group plans may still cover a brand-name drug when it is medically necessary , even if the plan is mandatory generic. In those cases, the insurer may require supporting clinical documentation from the prescribing physician, and the request may need to go through a prior authorization or brand-name drug review process. Why this matters for employees For employees, programs like RxHelp and innoviCares can provide more flexibility when a brand-name medication is preferred, prescribed, or medically necessary. They may help lower out-of-pocket costs on eligible medications, support continuity of treatment, and work alongside existing drug coverage in certain cases.

Life Happens: When to Update your Benefits (and Why Timing Matters)

When it comes to medication, a one-size-fits-all approach rarely works. What works for one person may not work for another, or could even cause side effects. Pharmacogenetic testing offers a solution by making personalized medicine a reality in your employee benefits plan.​ What Is Pharmacogenetic Testing? Pharmacogenetics is the study of how your unique genetic makeup influences your response to medications. By analyzing genetic markers, healthcare providers can predict how you’ll metabolize drugs, helping them choose the right medication and dosage from the start. This personalized care approach replaces the traditional trial-and-error method, leading to faster, more effective treatment plans.​ How Pharmacogenetic Testing Works The process is simple and non-invasive—usually just a cheek swab. A lab analyzes your genetic information and provides a report for your healthcare provider, detailing how your body is likely to respond to specific medications. Because your genetic code doesn’t change, you only need this test once, and the results can guide treatment decisions for years to come.​ Common Uses for Pharmacogenetic Testing Pharmacogenetic testing is especially helpful for managing conditions where finding the right medication quickly is crucial, including: Depression and anxiety ADHD Cardiovascular disease Chronic pain management These applications help reduce medication side effects, improve treatment adherence, and enhance overall health outcomes.​ Privacy and Security of Genetic Data Your genetic data is protected under strict privacy laws such as PIPEDA, HIPAA, and GDPR. Testing providers ensure your information is not linked to personal identifiers and that samples are securely destroyed after analysis.​ Why Pharmacogenetic Testing Matters for Employers and Employees Including pharmacogenetic testing in your employee benefits plan delivers tangible benefits for both individuals and organizations: Faster recovery times and shorter disability claims Reduced medication side effects and improved adherence Increased workplace productivity and long-term cost savings Enhanced employee satisfaction and retention Many insurance carriers now offer pharmacogenetic testing as part of their disability management programs, supporting faster return-to-work outcomes and overall plan stability.​ The Future of Personalized Care Pharmacogenetic testing is transforming healthcare by making treatment more targeted, efficient, and effective. By integrating personalized medicine into your group benefits strategy, you can help employees achieve better health outcomes while supporting your organization’s success.​ For more information on how pharmacogenetic testing can be included in your employee benefits, contact Curry Group Benefit Solutions. We help organizations leverage innovations like personalized medicine to support their workforce and strengthen their benefits offerings.​

In a world where healthcare often focuses on treatment instead of prevention, Medcan stands out as a global leader in proactive health and wellness . With locations in Toronto, Oakville, Collingwood, and Muskoka, Medcan helps individuals, families, and employers take control of their health — not just react to illness. Focused on Health span, Not Just Lifespan Medcan’s mission is to help people live well, for life. Their philosophy centers on health span — the number of years lived in optimal health, free from disease and disability. By combining the latest medical research, technology, and evidence-based care, Medcan aims to prevent chronic conditions like heart disease, diabetes, and cancer before they occur. Comprehensive and Personalized Health Assessments At the heart of Medcan’s approach is its Annual Health Assessment , a detailed, physician-led experience that goes far beyond a standard physical. Clients receive same-day results from advanced screenings, including blood work, imaging, and wellness evaluations, all in one visit. This proactive process helps identify potential risks early and provides a clear road map to better long-term health. Specialized Programs for Every Stage of Life Medcan offers an extensive range of specialized services, including: Genetic screenings for cancer, heart health, and medication effectiveness Women’s and men’s health programs addressing hormone balance, fertility, and vitality Mental health and wellness services , including counselling and therapy Nutrition, fitness, and weight management programs designed for sustainable results Sports therapy and rehabilitation for recovery and performance Each program is supported by multidisciplinary medical professionals who work together to create a personalized care plan. Corporate Wellness and Employee Health Programs Medcan also partners with employers to elevate workplace health through customized corporate wellness programs . These initiatives help companies attract and retain talent, enhance productivity, and support the overall well-being of their teams. By focusing on prevention and education, Medcan helps businesses build healthier, more engaged workplaces. A Leader in Preventive and Proactive Care With over 30 years of expertise, Medcan continues to evolve with advancements in medicine and technology. Their proactive model empowers clients to make informed health decisions — turning checkups into lifelong health strategies. Contact us at Curry Group Benefit Solutions for more information

Group benefits are a valuable part of employee compensation, offering financial protection and peace of mind. Understanding the components of your benefits plan helps you make informed decisions and get the most out of your coverage. Here's a breakdown of some key pooled benefits: Life Insurance Group life insurance is typically more affordable than individual plans and provides a tax-free lump sum to your named beneficiary. Coverage generally ends upon termination, retirement, or reaching the plan’s age limit. Some plans allow conversion to individual policies without medical evidence, though premiums may be higher. Long-Term Disability (LTD) LTD coverage supports employees unable to work due to injury or illness. Benefits usually start after a waiting period (e.g., 119 days) and provide a percentage of pre-disability income. Case managers often assist with recovery and return-to-work plans. Dependent Life Insurance This covers spouses and dependent children with a flat benefit amount. Children are generally covered until age 21 or while in post-secondary education, with exceptions for those with disabilities. Accidental Death and Dismemberment (AD&D) AD&D provides an additional benefit if death or dismemberment occurs due to an accident. Coverage amounts vary depending on the injury, and specifics are detailed in your benefits booklet.  Critical Illness A tax-free lump sum is provided upon diagnosis of a covered critical illness. This benefit can be used for recovery expenses or to ease financial strain during treatment. Understanding your group benefits ensures you’re prepared to make the most of your coverage. If you have questions, consult your plan sponsor or employee benefit booklet. Pro Tip: Review and update your beneficiary details regularly to ensure they align with your current wishes. For more information, contact us at info@CurryGBS.Ca

Mental health support is becoming a priority for many employers, and benefit plans are evolving to meet these needs. Historically, coverage was limited to Clinical Psychologists and those with a Master of Social Work (MSW). Now, many insurers have expanded their lists of eligible mental health providers. Newly Covered Practitioners Include: Registered Clinical Counsellors Canadian Certified Counsellors Psychotherapists Registered Clinical Therapists Registered Therapeutic Counsellors Registered Professional Counsellors Health Spending Accounts (HSAs) can also be used to cover these services, providing additional flexibility. Next Steps: Review your benefits booklet for specific details. Reach out if you need help finding forms, accessing services, or learning more about your plan.  We’re here to ensure your team gets the support they need for their mental health.

When you use your group benefits, you expect it to cover the cost of health services like massages, physiotherapy, or medical equipment. But sometimes, you may find your reimbursement is lower than expected. A common reason. Reasonable and Customary (R&C) limits. At Curry Group Benefit Solutions, we believe that understanding R&C limits — and how to navigate them — can help you maximize your benefits and keep more money in your pocket. What Are Reasonable and Customary (R&C) Limits? R&C limits are the maximum amounts that your group benefits plan will reimburse for specific services. These limits are based on: Typical costs charged by service providers in your province Industry pricing trends that are reviewed and updated regularly If your provider charges more than the R&C limit , you are responsible for paying the difference. Example: If your plan's R&C limit for a massage therapy session is $100 but your therapist charges $120, your plan will reimburse only $100 — and you’ll pay the remaining $20 yourself. Why Do R&C Limits Exist? R&C limits are in place to: Help control claim costs for everyone Keep group benefit plans affordable and sustainable over time Protect the plan against inflated service prices Services such as paramedical care (massage therapy, chiropractic care, physiotherapy) and medical equipment are where R&C limits are most noticeable, since fee guidelines aren’t standardized like they are for physicians and dentists. How to Make the Most of Your Coverage To avoid unexpected out-of-pocket costs: Ask upfront: Always confirm a provider’s fees before your appointment. Shop around: Compare fees between clinics or service providers when possible. Be pharmacy smart: Did you know that the cost of a prescription includes three parts? Drug cost: The pharmacy’s purchase price Markup: Additional margin set by the pharmacy Dispensing fee: A professional fee for preparing and providing the medication Dispensing fees can vary significantly between pharmacies. Two pharmacies may sell the same drug but have different dispensing fees, impacting your total cost. Quick Tips to Lower Your Health Costs ✅ Compare pharmacy dispensing fees before choosing where to fill your prescription ✅ Ask providers if their fees fall within your plan’s R&C limits ✅ Be proactive when selecting medical equipment or services Small steps like these can lead to meaningful savings over time — and ensure you're using your benefits as effectively as possible.

When it comes to life insurance and accidental death & dismemberment (AD&D) benefits, one of the most important steps you can take is declaring your beneficiaries and keeping this information current. Here’s why it matters and how it impacts your loved ones: What is a Beneficiary? A beneficiary is the person or people you designate to receive the benefit amount, tax-free, in the event of your passing. What is a Contingent Beneficiary? A contingent beneficiary is the person or people you choose to receive the benefit amount if your primary beneficiaries are no longer living. What if I Designate a Minor Child as a Beneficiary? When naming a minor as a beneficiary, it is crucial to appoint a trustee to manage and protect the funds until the child reaches the age of majority. The Importance of Keeping Beneficiaries Updated Updating your beneficiary information regularly ensures that your life insurance and AD&D benefit amounts are directed to the correct individuals. Life circumstances—like marriage, divorce, or the birth of a child—can change over time, so it’s vital to review and adjust your beneficiary designations accordingly. The Impact of Not Declaring a Beneficiary If no beneficiary is declared, the proceeds from your life insurance claim will transfer to your estate. This can result in: Delays: Funds will only be distributed after the estate is settled, a process that could take months or even years. Reduced Payouts: Before your loved ones can receive any funds, the estate must settle debts, fees, and taxes. The Benefit of Declaring a Beneficiary If a beneficiary is declared, the proceeds will: Transfer directly to your listed beneficiary(ies) without delays. Be received as a tax-free payment, ensuring your loved ones have immediate financial support during a challenging time. Next Steps to Protect Your Loved Ones To ensure your benefits are distributed as intended, take the following steps: Download a new beneficiary form from your online portal or contact your plan administrator for instructions. Review and update your beneficiary information whenever there are significant life changes. Communicate your decisions to your beneficiaries so they are aware of your intentions.  Keeping your beneficiary designations current is a simple yet essential step in safeguarding your family’s financial future. Take a moment today to review your records and make any necessary updates.

Keeping your benefits information accurate and up to date with your provider is essential to ensure you and your family have access to the coverage you need. Missing or outdated information can lead to delays, penalties, or even declined claims. Here are a few key updates to remember: Family Changes : If you’ve had a life event—like a marriage, divorce, new child, or a child starting or finishing school—let your provider know within 31 days of the change. Spousal Coverage Adjustments : If your spouse’s benefits have changed (e.g., they’ve gained or lost coverage), this could affect how your claims are paid. Dependent Information : For children attending post-secondary school, ensure their enrollment status is updated with your provider to maintain their coverage. Failing to make timely updates may result in: Late Enrollment Penalties : You or your dependents might need to complete health questionnaires, risking coverage denial. Dental Coverage Limits : Late updates can limit dental benefits to as little as $125 during the first year, which may not cover even basic procedures.  Lastly, don’t forget to review your life insurance beneficiary details. If you’re naming minor children as beneficiaries, appointing a trustee ensures the funds are used as intended. Stay proactive—reach out to your benefits administrator or update your details online today to avoid any disruptions.