Administrative Services Only

Based on real-time claims.

Instead of the monthly premiums of traditionally funded models, the costs of administrative services only (ASO) plans are based on actual real-time claims, coupled with an administrative fee to a third party who will administer said claims as set out by your custom-built plan design and in accordance with CRA guidelines.

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Why ASO?

Fees are based on claims paid

Your fees and taxes are calculated based on the actual claims paid, whereas with traditionally funded plans you pay taxes and fees based on your overall premiums paid.

Lower administration costs

With an ASO plan, the administration fee percentage is typically lower than traditionally funded programs which equate to bottom-line savings for your business.

Endless plan design options

ASO plans carry an immense amount of flexibility which allows for tailoring of deductibles, co-insurance, covered benefits and exclusions to perfectly fit the needs of your employees.

Any questions?

Can the cost of claims vary from month to month?

Yes – companies who are looking to go ASO need to be comfortable with ebbs and flows in monthly costs as it pertains to health and dental claims. Claim amounts can fluctuate from month to month so a business that wants to explore implementing an ASO plan should have a comfortable level of cash flow.
Does an ASO plan open you up to more risk?

No. This is a common misconception in the industry, however, an ASO plan doesn’t carry any more risk than traditionally funded programs. With an ASO program, you will still have a plan design in place that has limitations surrounding what can be claimed and how much – the only difference is that the company is paying the claims directly rather than the insurance carrier reimbursing the claims from premiums paid. Furthermore, companies who choose to go ASO are well established and have had benefits in place for some time. This provides a healthy history of claims experience to look back on which can help to guide an expectation for ongoing costs.
What is the benefit of going with an administrative services only plan?

One of the benefits of an ASO model is that your fees and taxes are paid based on the actual claims paid, whereas with traditionally funded plans you pay taxes and fees based on your premiums paid, and the fee percentage is typically lower with ASO than with traditionally funded programs.

An ASO plan also has incredible flexibility when it comes to creating a plan that truly meets the needs of your business and your employees.
Does an ASO plan provide costs savings over a traditionally funded program?

In an ASO plan, the employer can enjoy the advantages and savings in a few ways. The first of which is a favourable claims experience. From the perspective of a traditionally funded program, when the claims experience is better than anticipated, those savings are profit for the insurance company. In an ASO model, a favourable claims experience is realized in cost savings for the company.

Additionally, because the administrative fees of an ASO plan come at a lower cost than a traditionally funded model, the company will experience cost savings in this area as well.