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group insurance

Analysis of the current situation and needs

  • In the scope of our mandate, we will firstly proceed with an analysis of the current plan structure and benefits along with an analysis of history, utilisation and the costs of your benefits in recent years (at least over the last three).
  • Furthermore, we will analyse, with the plan sponsors (Human Resources Manager, Unions and any other pertinent parties), all requests, observations, complaints or all other relevant information which will allow a clear and unambiguous way of establishing the objectives.
  • This stage is of utmost importance because the goal is to determine adequately the needs and expectations of the employees and the employer. Moreover, numerous information will be necessary (employee data, master policies, rates and claims history, all available statistical reports, disabled employees, etc.) to help in determining the group’s profile.

Preparation of a specifications book

At this stage, we will use all elements at our disposal in order to prepare a specifications book for the insurance companies that will be representative of the client’s needs and requirements.

The specifications book establishes the situation (with regards to guarantees, as well as rates and claims history) of recent years.

In addition, different options will be analysed that will allow the client to have all the information on hand to make an informed decision.

Market analysis

At this stage, we approach all insurers likely to submit a project, depending on the group size, industry and other relevant factors. Upon receipt of the insurer’s proposals, we analyse the market results, in order to present to the client the plan that best suits his needs, in terms of costs and benefits, along with our recommendations.

As consultants and because we have such an important volume distributed among all insurers on the market (over 125 million annual premiums), our analysis and recommendations are always objective and our client’s interests take precedence over any other considerations.

  • 46M
    2003
  • 55M
    2006
  • 65M
    2009
  • 75M
    2011
  • 100M
    2014
  • 108M
    2017
  • 125M
    2022
  • 136M
    2023
  • 150M
    2024
  • 195M
    END 2024

The first part of the analysis presents the costs of the current plan and optional plans separately. This information is first presented in a global format, on a monthly basis for the whole group and then in a personalized format, per employee per pay.

The personalized format reflects the employer/employee distribution (including a calculation of provincial and federal taxable benefits as well as code 85/235). Moreover, in some cases, a fiscal analysis can be made to evaluate the impact of indirect costs (QPP, CSST, etc.) through various scenarios.

The second part will present a detailed analysis of the benefits (of the current plan and options) and every clause and exclusions to ensure that the client has all the necessary elements to make his decision.

Finally, the renewal methodology will be analysed in detail and some factors (administration fees, reserves and credibility) will be negotiated and guaranteed.

Implementation of the plan

In the event of a change of insurer, our enrolment department follows an established procedure to ensure that the implementation of the plan is done in a simple and effective manner for a flawless transition. Here are the different steps:

  • Confirmation of the selected plan
  • Meeting with the plan administrator within the company to sign the proposal and begin the process of the employees enrolment
  • Preparation of a memo informing employees about the change of insurer and about the modifications to the plan, if necessary
  • Following receipt of the required documents, a verification of the file will be done by our department and a per pay deduction chart will be produced
  • Transmission of all documents to the insurer so that they may proceed with the file registration
  • Reception, at our office, of documents (master policy, booklets, initial billing, drug cards, certificates, etc.) for final verification
  • Meeting with the plan administrator (and employees if applicable) and distribution of documents

Customer Service

In today’s highly competitive business world, it is a necessity for clients to obtain an efficient and personalized customer service.

Our customer service team’s primary role is to be an intermediary between the company‘s plan administrator and the insurer.

Its involvement is oriented towards obtaining a fluid, efficient and personalized communication. With the greater specialization of resources dedicated to this department, our customer service is second to none in the industry.

With this in mind and in order to create a long term trustworthy relationship, every client is assigned to a customer service representative.

Our services are:

  • Administrative assistance: Assistance with procedures to follow in order to minimize the risk of errors and processing delays (documents to complete such as: enrolments, terminations, changes in salary, disabilities, etc.)
  • Claim problems: Due to our high volume of premiums with insurers, an insurer’s representative is directly assigned to our firm. This helps us intervene quickly and more efficiently for any problem.
  • Information regarding the benefits under the contract: We keep at our office a complete file (current master policy and previous insurer policy, copies of the booklets, copies of enrolment forms, etc.) which allows us to answer, at any time, any question relating to the terms of the contract.
  • Technical assistance: We can intervene when a problem occurs with claims regarding short or long term disabilities in order to demonstrate the peculiarity of distinct cases or context in order to have the insurer reassess the situation.
  • Breakdown by pay period and employer/employee contribution:
    • Identification of taxable benefits:
      • Provincial:
        • Basic life insurance, AD&D, dependent life insurance (box L on the Relevé 1)
        • Health insurance, dental coverage, eye-care coverage (box J on the Relevé 1)
      • Federal:
        • Basic life insurance, AD&D, dependent life insurance (box 40 on the T4)
    • Detail of the portion paid by the employee for health and dental insurance in order to calculate the tax credit for medical expenses (Code 85/235).
    • Upon request, simulation of various scenarios for one or more employees.
    • Charts or customized Excel files for an autonomous management of deductions per pay are provided to the plan administrator within the desired timeframe. The major advantage of this service is that there is no retroactive premium to remove from the pay during a change (new employee, salary change, coverage change, etc.).

Renewal

At this stage, Group Censeo as the agent receives the renewal conditions proposed by the insurer. The analyst assigned to the file will study the renewal terms proposed by the insurer and by his mandate, will validate, negotiate and produce a renewal report which will be presented to the client by his advisor.

We have our own renewal assessment model that guarantees our customers the most competitive conditions while ensuring stability of costs in the long term.

We do comprehensive analyzes of the use of your plan, including an analysis of the types of medications most used by your employees, as well as an analysis of the consumption profile allowing us to create a Personalized Health Profile.

The renewal format and philosophy are the same as those that prevail during the initial market analysis.

Our report is divided into several sections:

  • Renewal analysis (Current guarantees and plan structure summary and observations, presentation of technical results and proposed options);
  • Statistics and reports;
  • Costs summary (the analysis presents the costs of the current plan and optional plans. This information is presented first in a global format on a monthly basis for the whole group and subsequently in a personalized format, per employee per pay, including taxable benefits);
  • Tool for measuring results: we have developed a tool that allows us to clearly measure the impact of our financial and preventive approach on long-term results of our clients.
  • Newsletters and other relevant documents.

In addition, as part of the renewal, our firm can prepare memos or bilingual presentations for employees, which constitute effective and simple communication tools, and are greatly appreciated by plan administrators.

During the year, in order to adequately prepare the official renewal and make adjustments during the period if necessary, we prepare a biannual analysis for the files whose parameters meet the analysis criteria (group size, credibility, etc.).

To that end, the analyst appointed to the file requests an experience report to the insurer for the period being analyzed. Upon receipt and based on factors (costs, reserves, credibility, pooled premiums and inflation) already established and confirmed, a simulation of the renewal is produced and presented to the client by his advisor.

Invoicing

Group Censeo offers, at the client’s request, a complete administrative service for invoicing (multi-employer group, association’s plan or plans subscribed with more than one insurer).

This service is also used when the insurer cannot manage certain features of the contract (invoice frequency other than monthly, direct debit, invoice management by various divisions and classes, etc.).