WSIB and Individual Insurance Apples Oranges Menu 1
WSIB and Individual Insurance Apples & Oranges Menu 1
WCB/WSIB This is general information from: AWCBC (Association of Workers Compensation Board in Canada) http: //www. awcbc. org/en/ Ontario WSIB http: //www. wsib. on. ca Menu 2
WCB/WSIB • • • Menu WSIB is a piece of legislation – not a contract Claims payments are often made on an administrative basis (e. g. , current procedure) WSIB claims can also vary based on situation and adjudicator – as well as by province 3
WCB/WSIB • Mandated coverage for most workers in designated occupations. • 5 Basic Cornerstones to the original workers' compensation laws. No Fault Compensation Collective Liability Exclusive Jurisdiction Menu Security of Payment Independent Board 4
5 Cornerstones No Fault Compensation • Compensated regardless of fault • No argument over responsibility or liability • Employers protected from law suits • Compensation becomes the focus. • Waive the right to sue. . . generally speaking Collective Liability • Cost is shared by all employers. • Common fund. • Financial liability = collective responsibility. Menu 5
5 Cornerstones Worker • Protection against loss of employment income • Medical & Rehabilitation Services • Mandatory coverage unless Employer or Independent Contractor Employer • Risk Management (lawsuits) • Protect their business from being sued if accident happens on the job • Needs to know that someone on their job site is either covered by WSIB or has proof that they are an Independent contractor (WSIB is not mandatory then) Menu 6
WSIB – Definition of Disability: a) Disability resulting in an inability to work due to: – an occupational accident (on the job – on the log) – an occupational disease b) Sudden and unforeseeable event c) On the job - injury coverage Menu 7
WSIB – Basic Coverages WSIB Coverage • Immediate coverage • Continuous coverage – automatically renewed • Accessibility – past health & safety records do no affect eligibility • Guaranteed benefits – if claiming on WSIB = first payor • Non-taxable benefit Menu 8
WSIB – Basic Coverages WSIB Coverage • • • Menu DI benefit based on 85% of earned income to a ceiling of $92, 600 up from $90, 300 in 2018. Lump sum payment for permanent disability or impairment Medical: Hospital and medical treatment costs, Approved health care expenses including chiropractic treatments, physiotherapy or counseling, Vocational rehabilitation services 9
WSIB – Basic Coverages WSIB Coverage • Survivor Death Benefit $40, 941. 65 – 122, 825 depends on age (add $2, 047 for each year the spouse is under age 40, subtract the same amount for each the spouse is above age 40. Child Benefit (No surviving spouse) - $80, 673. 30 • Burial Benefits – Minimum Burial expenses $3, 025. • Maximum – all expenses reasonably connected to burial or cremation. Menu 10
How WSIB Decides Premiums • • Industry and Job Classification Insurable earnings (T 1 or T 4 or other) Premium rates CAN change • “Premium rate increases and decreases are linked to injury frequencies and costs for each rate group. ” • Individual claims increase individual rates for Self. Employed • Company: if poor claims history, rates go up for whole group Menu 11
WSIB Insurable Earnings BASED ON: 1. T 4 or T 1 2. Other methods – “Inadequate records”* a) b) When business records not adequate/no evidence = 100% of contractor’s Gross Insurable Earnings considered. Evidence of material/equipment = 2 ways o o Menu Where a contractor provided labour and major materials, the principle is to use 60% of the contract value as the contractor’s gross insurable earnings. Where a contractor provided labour and heavy construction equipment, with or without major materials, the principle is to use 33 1/3% of the contract value as the contractor’s gross insurable earnings. * Source: WSIB Document 14 -02 -18 12
How WSIB Pays Out at Claim • • STD: First 12 weeks based on “take-home pay” LTD: Over 12 weeks = reviewed and adjusted Based on WSIB doctors (not yours!) Frequent reviews, reports to submit, and mandatory rehab. Split Income is NOT COVERED Menu 13
2019 Premium Rates Rate Group 30 33 159 190 308 311 432 570 707 711 719 723 728 737 741 748 Menu Description 2017 Premium 2016 Premium Percent Rate ($) Change Logging 13. 04 0. 00% Mill Products And Forestry Services 8. 60 8. 80 -2. 30% Livestock Farms 7. 09 0. 00% Landscaping And Related Services 4. 93 0. 00% Millwork And Other Wood Industries 5. 57 0. 00% Wooden Cabinets 4. 16 0. 00% Trucks, Buses And Trailers 4. 39 0. 00% General Trucking 6. 72 0. 0% Mechanical And Sheet Metal Work 4. 05 4. 16 -2. 6% Roadbuilding And Excavating 4. 87 5. 29 -7. 9% Inside Finishing 6. 65 7. 51 -11. 5% Industrial, Commercial & Institutional Construction 4. 4 4. 55 -3. 3% Roofing 13. 62 14. 8 -8. 0% Millwrighting And Welding 6. 36 6. 90 -7. 8% Masonry 12. 21 12. 7 -3. 9% Form Work And Demolition 15. 75 18. 31 -14. 0% Source: www. wsib. on. ca/WSIBPortal/faces/WSIBArticle. Page? f. GUID=939604048075003204 14
Employees • Mandatory! No exceptions • Employer pays premium • Benefit received tax-free Menu 15
Construction MANDATORY NEW – Bill 119: independent operators, sole proprietors, some partners in a partnership, and some executive officers who work in the construction industry http: //www. beregisteredbeready. ca/ EXEMPT 1. One executive officer or partner. This must be an individual who does not perform any construction work on any building site 2. Home Renovator Menu 16
Business Owners/Sole Proprietors • • • Menu Must register yourself or company as of January 1 st 2013 Must have a clearance certificate in order to work for other companies Must renew your clearance certificate every quarter 17
Employers • Must have copy of clearance certificates for all subcontractors in your file • Must continue to follow up every quarter to make sure file is current • Must not have any subcontractor on payroll without a clearance certificate • Fines can be up to $100, 000 to you • Fines can be up to $25, 000 for the non-registered sub-contractor Menu 18
WSIB False Sense of Security 1. Only 5% of disabilities happen on the job* = 95% of their disability risk is not covered 2. WSIB does not include split income 3. On the job coverage only – injury only 4. Rates go up based on usage – lacks cost containment http: //www. disabilitycanhappen. org/research/CDA_LTD_Claims_Survey_2011. asp Menu 19
Is Covering 5% of Your Risk Enough? WSIB Coverage Accident Sickness Menu 10 hrs work WSIB 7 hrs play 7 hrs sleep 95% exp osu re 20
The EDGE Solution #1 Get The EDGE 24 hr coverage on their Full Income (including split) #2 Wrap around WSIB: “off the job” coverage (non-occ). = Covers 100% of your clients’ time Menu 21
The EDGE covers: • more time • more income • more risks WSIB Coverage Accident 10 hrs work 7 hrs play 100% o f the tim 7 hrs sleep e WSIB + Sickness Menu 22
Using The EDGE as a Complement or Alternative to WSIB Menu 23
Target Markets Owners and Independent Contractors Computer Consultants Menu Engineers Clinical Researchers Graphic Designers Taxi & Limo Drivers Mechanics (Owner) Nursing (RN) 24
The EDGE Alternative Coverage needs to match/better WSIB Benefits Loss of Income Benefit – to age 70* Medical ($10, 000 -$110, 000) & Rehabilitation Your doctor vs. WSIB doctor Immediate Coverage & Guaranteed to Issue (2 qualifying questions) $50, 000 -300, 000 AD&D Menu 25
The EDGE Extras 24 hour coverage Every day – all day Gross or net income = Higher benefit Business Expenses (Standalone) Loans, lease payments, keep the doors open while recovering Flexibility: Add-on benefits (illness) Menu 26
Employment Insurance Government Benefits Menu
Employment Insurance Do not confuse with EI ‘loss of job’ benefit!!!! Eligibility • Must be ‘actively working’ • Have accumulated at least 600 hr of insurable employment (in the 52 weeks before the benefit period begins) • Employee-workers who must pay into EI: • Workers with a job for 15 h/week with an employer • Self-employed: eligible for benefits on a voluntary basis since 2010 (see warning about this at the end!) Menu
Employment Insurance Note: Shareholders who own 40% or more controlling shares cannot have EI benefits! EI Wording Must be: • an illness, injury, pregnancy or quarantine • that has rendered the claimant incapable of performing the functions not only of his or her regular or usual employment - but also any other suitable employment. Menu
Employment Insurance 24 hour coverage – Injury & Illness Waiting period • 1 week *2019 EI Statistics Menu Benefit period • Maximum: 112 days Maximum benefit • $562 per week and the benefit is fully taxable (55% of T 4 income up to yearly max. income of $53, 100)*
Employment Insurance EI is ‘first payor’ except: • Sick leave days from work • Group insurance ‘Weekly Indemnity’ (short term DI) • WSIB benefit payments Premiums charged: • Per $100 of insurable earnings • Employee: $ 1. 62 / $100 • Employer: $ 2. 27 / $100 Menu
Top-Up Plan for EI with The EDGE Paycheque Insurance! 1 st day To age 70 The EDGE Plan A (Top up based on Net income in excess of EI insurable earnings) $1, 000 TAX FREE Employment Insurance $2, 000 Fully Taxable 7 th day The EDGE Plan B $2, 000 TAX FREE 120 th day To age 70 112 days **EI offsets for other coverage based on T 4’d income ** Menu 32
Integration Example Client earns $80, 000/year Qualifies for $4, 600/month coverage (EDGE) Qualifies for $2, 400/month EI (Max) Qualifies for $4, 600 EDGE #1 $2, 000 0/70 $2, 400 EI Client gets BOTH. (Is under the limit of what he qualifies for) Menu EDGE #1 $2, 000 0/70 EDGE #2 $2, 500 120/70
Employment Insurance Watch out for… EI for Self-Employed: ‘Life Sentence’ • Once you receive benefits you will have to pay EI premiums for the entirety of your self-employment career (life sentence). • Regardless of the date you file the notice of termination, you must pay EI premiums on your self-employment for the entire calendar year. Menu
Employment Insurance Does it solve the problem? ? ? • For ‘employees’ only!! • 15 week benefit – injury & illness / 24 hour • Taxable benefit Answer: Good when combined with other personal or group coverage that continues and/or ‘tops-off’ this short term benefit Menu
Canada Pension Plan Government Benefits Menu
CPP Disability Benefit Canada Pension Plan: YMPE (Yearly Maximum Pensionable Earnings) Earned Income: 2018 $55, 900 2019 $ 57, 400 Qualifying requirements • You must have contributed to the CPP: 1. in four of the last six years at or above the minimum ($5, 100) level of earnings, or 2. three of the last six years if you have contributed at or above the minimum level of earnings for at least 25 years Menu
CPP Disability Benefit Canada Pension Plan: Max Monthly benefit: Disability Benefit 2018 $1, 335. 83 • Must have contributed in at least four of the last six years and earned at least 10% of the YMPE. • Elimination Period: 120 days after the person is determined to have a disability. • Benefit Period: to age 65 • Taxable benefit • Children under 18 or going to school full time 25: + $244. 64 Menu
CPP Disability Benefit CPP Wording • CPP defines a disability as: “a medical condition that is severe and prolonged” • Severe means that you have a mental or physical disability that regularly stops you from doing any type of substantially gainful work. • Prolonged means your disability is likely to be long-term and last indefinitely or is likely to result in death. Menu
CPP Disability Benefit Does it solve the problem? ? ? • Toughest definition of disability to qualify • Limited payment • Based on T 4 or net taxable income • Answer: Not good enough especially for Self Employed Menu
Polling Question Do you know any individuals who currently do not have any Disability coverage? q Yes, I have a prospect in mind, please contact me q No, I don’t have any prospects that need disability coverage Menu 41
What’s coming up at the EDGE Menu 42
March 2019 Seminar Menu 43
Advisor Incentives What’s In It for You? Menu 44
Quick Start Program WHO IS ELIGIBLE? ALL new advisors 1 st APPLICATION ANY NEW ADVISOR who submits their 1 st application within the calendar year will receive a welcome letter with a stylus pen to help with their next application. 2 nd APPLICATION ANY NEW ADVISOR who submits their 2 nd application in the same calendar year will receive a $10. 00 gift certificate, AND one or more ballots* entered into a draw for a Flat Screen TV to be drawn at year-end. Menu You will also receive ballots* for each and every application submitted thereafter within the calendar year. 45
SUPER Quick Start BONUS Program IN ADDITION TO THE QUICK START PROGRAM ALL NEW ADVISORS are eligible for a BONUS if they submit their 2 nd and 3 rd applications within a specific time frame. 2 nd APPLICATION Write your SECOND APPLICATION within 6 weeks of your first application, and you will earn $50 3 rd APPLICATION Write your THIRD APPLICATION within 6 weeks of your second application, and you will earn $100 Menu 46
VIP Club 1 st Division Top 50 share in $300, 000 AVERAGE 10% additional paid out Contest Criteria Top 50 Advisors qualify for the VIP Pool, where Incentive Premium equals 66 2/3% for H&D and 100% for all other products. Max Bonus payable per Advisor is $25, 000. Written premium is shown for illustration purposes only, where Actual Bonus Pool is paid out proportionately based on SETTLED calendar year Incentive Premium. Persistency Factor applied against Incentive premium, where Advisor Persistency is measured against The Edge's Total Company Persistency, where the delta (whether positive or negative) is applied against Incentive Premium. Menu 47
VIP Club 2 nd & 3 rd Division First Division Bonus Spots 51 to 100 share in $30, 000 NEW! - $50, 000! Up to $1, 000 available! NEW! Second Division Bonus Spots 101 to 150 share in $25, 000 Contest Criteria Advisors in spot 51 to 150 will qualify for the Pool, where Incentive Premium equals 66 2/3% for H&D and 100% for all other products. Max Bonus payable per Advisor is $1, 000. Written premium is shown for illustration purposes only, where Actual Bonus Pool is paid out proportionately based on SETTLED calendar year Incentive Premium. Persistency Factor applied against Incentive premium, where Advisor Persistency is measured against The Edge's Total Company Persistency, where the delta (whether positive or negative) is applied against Incentive Premium. Menu 48
Presidents Club Conference Top 10 EDGE Advisors Will Qualify (Or $100, 000 total premium credit achievement to guarantee a spot) Top 10 qualify based on written premium. No minimum premium required, but you must be in the Top 10. You can guarantee a spot by writing a minimum of $100, 000 in Premium credits. All EDGE premium counts towards the Conference, however, there is 66⅔% credit for Health and Dental Premium and 100% for all other products. Persistency must be within 15% of the company average. Menu 49
Thank You Menu 50
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