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SmallBiz Employee Benefits – Employee Due Diligence Checklist

By July 11, 2019 No Comments

With the rising costs of Medical and Dental expenses, it is becoming more difficult to maintain an affordable Benefits Program. Now, more than ever, it is imperative that your employees do their due diligence to keep your Benefits Program costs down.

To keep costs down, here’s a great list to pass along to your Employees…

  • When choosing a pharmacy, take the Dispensing Fee into consideration.
  • If you are on a Maintenance Drug, make sure that your Pharmacist is dispensing the maximum amount allowed under the Drug benefit plan, i.e. 30 days? 60 days? 90 days?
  • Do not accept a receipt for services or supplies that were never received.
  • When deciding on a dentist, ask them if they provide lower costs to someone who does not have benefits. If they do, ask them why.
  • Ask your dentist to design your dental care plan with your limits in mind.
  • Request your Dentist to complete a pre-Determination form, if they suggest that you require a procedure(s) outside of your normal checkups.
  • Always ask for a copy of the claim that the dentist is electronically submitting to your insurance carrier.
  • Be aware of Dental Scaling Units – Make sure that the number of Scaling Units on your Dental Bill matches up with the time your Dental Hygienist actually spent cleaning your teeth… 1 Dental Scaling Unit is equal to 15 minutes of cleaning.
  • Should you require a procedure to be repeated on the same tooth or surface area, you should make it clear that the dentist is not to resubmit to the insurance company. They should not be permitted to “see if they can get anything back”. If your mechanic messed up with fixing something on your car, are you going to let them charge you again?

To be safe…

  • If you are going on a trip outside of the province or out of the country, check your booklet regarding “status of coverage” guidelines. If there is any question that you or your family members may not be eligible, contact the Emergency Travel provider and make sure that there are no pre-existing conditions that may preclude you from being covered.

Located in Cambridge, ON Sharkey Group Insurance  has been providing independent Employee Benefits advice & counsel to Small Business Owners across Ontario since 2013.