Employee Insurance Benefits Services

The Vendor is required to provide flexible and customizable group benefits plans such as optional coverage, tiered benefit levels and add-on services to meet the needs of diverse member organizations.
- Crown corporations, government enterprises, and other entities that are owned or controlled by these entities through ownership interest, such as utilities, public housing, ferries, liquor, cannabis and gaming, health, insurance, pension, public transit, port authorities, natural resources, culture and education, economic development, regulatory boards (Workers’ Compensation, etc.).
- Include coverage for:
•    Extended health care (e.g., prescription drugs, paramedical services, out-ofcountry medical, hospital, medical supplies and services, out of province medical referrals).
•    Vision care.
•    Dental care (e.g., preventative, restorative, and orthodontic).
•    Life insurance (basic and optional).
•    Dependant life insurance.
•    Accidental death and dismemberment (AD&D) (basic and optional).
•    Critical illness (basic and optional)
•    Short-term and long-term disability.
•    Employee assistance programs (EAPs).
•    Spending accounts (health, wellness, flex etc.)
•    Wellness and mental health support initiatives
•    Group Retirement (RRSP, TFSA, Pension)
•    Specialized providers and services (Diagnostic Imaging, Resilience,
•    Private/Global Medical)
•    Virtual Health Services
•    Disability Management Services
- Cost Management and Containment
•    Provide competitive and transparent pricing models.
•    Include strategies to manage and contain costs, such as pooling or annual rate guarantees.
- Enrollment and Onboarding
•    Ensure a smooth implementation process, including transition from existing benefits providers if applicable.
•    Provide user-friendly online tools and portals for employees, plan administrators, plan advisors.
•    Include training, communication materials, and ongoing support to facilitate the adoption of the benefits plan.
•    Offer ongoing support for member organizations, including timely updates on plan changes or enhancements.
•    Outline change management processes to support organizations transitioning to the new benefits provider.
- Claims Management
•    Deliver efficient claims processing and reimbursement with minimal turnaround time.
•    Provide clear communication and tracking for claims submission and status.
•    Maintain a secure platform for claims processing and data management.
- Disability Management
•    Assign a dedicated disability management team
•    Offer a comprehensive disability management program to address both short-term and long-term disability needs
•    Provide strategies for early intervention and prevention and effective return-to-work programs
•    Provide clear communication and education to employees to understand their benefits and the claim process.
•    Provide additional support services such as mental health resources, vocational rehabilitation, etc.
- Data Analytics and Reporting
•    Collect and report on comprehensive data on all aspects of group benefits such as but not limited to claim submissions, claim outcomes, service utilization (by employee, spouse, dependent).
•    Provide reporting and analytic capabilities to members and agency Benefits to help monitor and manage benefits programs and measure program effectiveness and pinpoint areas for improvements.
•    Provide detailed reporting and analytics on disability management claims and program performance to identify trends, measure outcomes, and continuously improve the disability management program. Analytics should include claim frequency, duration, cost and outcomes.
- Technology and Digital Tools
•    Provide a user-friendly digital platform to facilitate seamless integration with existing HR systems for enrollment and onboarding, provide real-time updates and offer intuitive navigation to enhance the user experience.
•    Offer an easy-to-use online system that allows employees to review balances, submit claims, track the status of their submissions, and receive timely updates on reimbursements.
•    Offer a dedicated mobile application to provide employees with convenient access to benefit information including plan details, claim submission, support services, etc.