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 […]
Canada’s life and health insurers paid out a record $128 billion in health and retirement benefits last year, up from $114 billion in 2022, according to the Canadian Life and Health Insurance Association’s annual fact book. “The benefits that life and health insurers provide through workplace plans and individual policies contributed significantly to Canadians’ health […]
Sun Life Financial Inc. is appointing Jacques Goulet as executive chair and Jessica Tan as president of Sun Life Canada, effective Sept. 30. In his new role, Goulet will support a smooth leadership transition and help deliver on key elements of the company’s enterprise strategy. He’ll also continue as the chair of the board of […]
When considering whether to cover Wegovy, an obesity medication, it’s important for plan sponsors to weigh increased short-term costs with long-term savings, while considering alternative treatments that are also available, says Philippe Laplante, a principal at Eckler Ltd. Plan sponsors that decide to cover Wegovy, which launched in Canada last month, could see a significant cost […]
As more insurers turn to preferred pharmacy networks to decrease costs, their efforts are being met with some resistance by plan members who may be finding it difficult and inconvenient to switch pharmacy providers. In January, Manulife Financial Corp.’s move to a preferred pharmacy network with Loblaw Cos. Ltd.’s Shoppers Drug Mart was met with […]
While there are multiple opportunities for the use of artificial intelligence in the employee benefits space — including making the claims process more efficient and personalizing the plan member experience — one of the biggest advantages of the technology is the ability to streamline administrative tasks, allowing employees to focus on more value-added work in […]
While preferred pharmacy networks have been around for nearly a decade, most benefits plan members aren’t aware that these arrangements have become standard, says Suzanne Lepage, a private health plan strategist. Preferred provider networks are common arrangements that businesses across a variety of industries enter into to help deliver consistent value, quality and cost containment, said the Canadian Life […]
The estimated cost to transfer retiree pension risk to an insurer in a competitive bidding process decreased from 101.8 per cent of a plan’s accounting liabilities in November to 100.5 per cent of those liabilities in December, according to Milliman Inc.’s latest pension buyout index. The index uses the FTSE above median AA curve and […]
The Ontario Court of Appeal’s affirmation of a $1.5 million punitive damages award — reportedly the largest award of its kind in a Canadian long-term disability case — may signal greater exposure for employers and insurers that fail in their duty to treat such claims in good faith. “The court had no problem with the […]
In the year ahead, the Canadian Life and Health Insurance Association will continue its advocacy efforts to ensure the federal government’s proposed pharmacare plan extends coverage for those who lack benefits without disrupting workplace benefits that millions of working Canadians rely on, says Stephen Frank, the association’s president and chief executive officer. The right approach to […]