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Products > Group Benefits > Health & Dental > Cost Plus

What is Cost Plus?

Cost Plus is a non-insured, ASO benefit arrangement where the plan sponsor requests the processing of certain ineligible claims under the core policy. The plan sponsor reimburses Manulife Financial for the cost of the claim as well as the corresponding administrative expenses.

Cost Plus is applicable to Extended Health Care (EHC) and dental benefits and is available to all segments. It provides flexibility to reimburse non insured expenses for plan members, usually those in classes eligible for the most extensive coverage.

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Cost Plus is used most often to cover legally reimbursable EHC and dental care expenses not provided for under an existing policy.  For example:

  • expenses exceeding coinsurance and maximums;
  • disputed claims outside the terms of the policy;
  • expenses usually excluded in the policy, for example:
    • cosmetic dental care;
    • cosmetic surgical or medical treatment;
  • claims incurred by individuals usually excluded by underwriting guidelines; and
  • high end benefits available to management-level plan members only.

There are two types of Cost Plus plans available:
1. Cost Plus Account, and
2. Unique Cost Plus 

 

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