In 2016, the Toronto Transit Commission sued its insurer for allegedly not having appropriate benefits fraud controls in place to detect unusual trends or patterns. The lawsuit was settled three years later. In the meantime, 10 people, including nine TTC employees, were convicted in relation to the scheme and more than 250 TTC staff resigned […]
The federal government has begun imposing financial sanctions on the Canada Life Assurance Co. after months of outcry from public servants, retirees and their families who were left fighting for medical claims to be covered, according to a report by the Canadian Broadcasting Corp. Public Services and Procurement Canada said it’s “taking steps to address startup delays faced by […]
More than two-thirds (69 per cent) of U.S. employers say they’re focused on managing health-care plan costs, following a projected cost increase of 6.4 per cent in 2024, according to a new survey by WTW. The survey, which polled more than 450 U.S. employers, found 63 per cent said they’re focused on enhancing mental-health and […]
In 2022, Beneva Inc.’s fraud management department noticed unusual activity under a plan member’s account. The insurer’s artificial intelligence tool, used to analyze millions of benefits claims, flagged that a plan member and the person’s dependant had used up all their maximum coverages within a short period of time. When the plan coverage rolled over […]
While gender affirmation and fertility benefits coverage still isn’t included in all group benefits plans, around half of Canada’s group benefits providers include gender affirmation coverage (50 per cent) or fertility benefits coverage (59 per cent) in some of their plan offers, according to an exclusive survey by Benefits Canada. The survey, which polled Canada’s […]
As technology advances and plan members’ needs become more diverse, the relationship between benefits plan sponsors and providers is adapting to fit these changes. Sarah Beech, chief executive officer of benefits and consulting at Arthur J. Gallagher & Co., believes the trend of employees wanting more from their employers is the starting point for this […]