Group Benefits Services

The Vendor is required to provide state life and health insurers for the provision of group benefits services.
- Corporation has a benefits plan with approximately 131 active employees and 55 retirees.
- Customer Service and Communication:
•    Provide high quality customer service for plan administrators and plan members, including ongoing communication. 
•    Communication services will include ongoing communications with members, plan administrators and providers through various methods such as, but no limited to, websites, online chat, call centers, and written communication products in both official languages, English and French.
- Claims Processing Services:
•    Provide for the processing of various benefits claims (e.g. life insurance, disability, electronic pharmacy benefit claims for prescription drugs, electronic and paper dental, medical supplies, medical practitioner services, vision, hospital, emergency travel, and out of country claims). 
•    The claims processing services include, but are not limited to, claims adjudication, issuing payments for adjudicated claims and the preparation and distribution of claims statements. 
•    Members and providers will have the ability to submit claims via the traditional mail methods, as well as digital services such as web, smartphone app and provider e-services. 
•    Claims processing will be continually audited by the provider to ensure claims are adjudicated in accordance with the plan provisions, including robust fraud detection processes.
- Administration:
•    Provide a comprehensive administration system for the plan administrator to enroll and terminate member coverages in the benefits plan. 
•    The insurer will lead training for the plan administrator and recommend the most efficient method to administer the plan. 
•    Members will positively enroll their eligible dependents, capture coordination of benefit information for themselves and their eligible dependents, collect consent for the use of their personal information, as well as bank information (for claim reimbursement), and email addresses (for electronic communications).
- Reporting:
•    Provide quarterly claims and premium reporting, as well as transactional level claims reporting for health and dental benefits. 
•    Reporting will be available on demand online where possible, with transactional level claims being sent by email or online portal to the corporation consultant on a quarterly basis.
- Implementation and Transition Services: 
•    Lead the implementation and transition of the benefits plan, including support for enrolment and communications.

- Contract Period/Term: 1 year
- Questions/Inquires Deadline: August 6, 2025