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Argus launches two new health insurance plans

Delighted: Argus CEO Gerald SimonsGerald Simons

The Argus Group has launched two health insurance plans designed for individuals who have had difficulty obtaining comprehensive health insurance.

President and CEO of the company Gerald Simons said that the plans were designed for retirees, long-term visitors and the self-employed, and could also be activated as a stop gap measure for individuals between jobs or children over 19 years of age who are not in school and unemployed.

The Argus Group is not the first local insurer to offer such plans, but with five percent of the population completely uninsured and a further ten percent of the population only on a basic healthcare plan, Mr. Simons said that his company had been concerned about "developing a product that was affordable and in which we could control the claims costs."

"The essential feature of this, which gives us a greater confidence, is the strength of our international network which we feel is superior and because we have a handle on the overseas claims aspect of the plan we feel comfortable in offering it on an individual basis and that wasn't the case years ago," he said.

The basic package, Essential Health, covers Hospital Insurance Act benefits such as public ward room and board and emergency care provided in Bermuda and overseas. Semi-private room and board coverage is available at an additional cost. The plan also covers surgery, anaesthesia, medical treatment and diagnostic services provided in a hospital.

Overseas major medical benefits are also included for emergency and referred treatment that is unavailable in Bermuda.

The second plan, Classic Health, includes all of the benefits of Essential Health plus doctors' home and office visits, prescription drug benefits and preventive and diagnostic benefits such as annual medical exams.

Cindy Campbell, executive vice president group insurance, said the idea behind offering two individual health plans was to give customers flexibility and choice based on their health requirements and budget.

"One of the cornerstones of our new plan is to provide our customers with 100 percent coverage in Bermuda and at some of the world's best facilities while still controlling premium costs," said Ms Campbell who added that customers who travel can have their emergency healthcare needs looked after through the Argus network of physicians and hospitals in over 130 countries.

"In 1999, we formed a partnership with CMN, an international managed care expert, to provide our clients with access to some of the best health care facilities and hospitals in the world at negotiated rates.

"Our proactive claims management allows us to offer out clients treatment in excellent facilities at reasonable prices. This is a big step in containing premiums and reducing our clients' out of pocket expenses."

Mr. Simons said that the individual plans will cost slightly more than group plans where the employer normally pays half the cost.

"Generally speaking, group plans are written more liberally than individual plans so you can usually get better benefits under a group plan, but if you're starting up in a business all by yourself, this might be the plan for you and you might buy an extra plan if you had one extra employee before moving into a group plan at some later stage."

Applicants must pay a one time $75 set up fee in addition to any medical evidence costs incurred. Essential Health starts from $135 per month while the price for Classic Health varies with age and sex as well as with the options each customer chooses.

Customers currently on another Argus plan may convert to the individual plan with no medical writing.

New clients must answer a medical questionnaire and submit to a dry blood spot test.

Clients over age 70 may remain with this plan as long as they join it before their seventieth birthday.