What is Third Party Administration?
Third Party Administration refers to a Revenue Canada approved third party administrator to adjudicate group claims for accuracy and compliance.
Who can register with Advanced Benefit Solutions?
- Corporations of 15 or more employees
- Small Businesses
If you wish to enroll your company, contact our offices 0n our toll free number 1-866-335-4052 to arrange for one of our representatives to meet with you.
Who designs the benefit plan?
Our company has had fourteen years of experience with group benefits. Our knowledge of federal regulations as well as our extensive experience will all be available to help design the most efficient program.
What happens if the allowable benefits are not used during the year of coverage?
Advanced Benefit Solutions leaves any unused funds in your trust account for future use by your company. Traditional group plans may reduce your following year’s premium but they retain any unused premium money.
What happens if the allowable benefit costs are exceeded in the year of coverage?
Cash reserves may cover the shortfall; otherwise a one time financial injection may be required. In a traditional plan the premiums will increase.
Which medical and dental services are eligible for coverage?
CCRA (Canada Customs and Revenue Agency) dictates which services can be covered.
This extensive list is available on the government website.
Is there a drug card?
Advanced Benefit Solutions provides each covered employee with a drug card. Wherever drug cards are accepted, the employee may use the card for payment.
Is there any company liability beyond the premiums paid?
Stop-loss insurance limits liability to $3500 per employee each year. The monthly cost is $10 per family or $4 for an individual. This reinsurance will protect your plan and your employees against any catastrophic loss.
How are employees reimbursed?
There are three ways.
- In cases where the drug card is accepted, the card may be used.
- Where medical specialists require upfront payment, the employee submits the bill to Advanced Benefit Solutions.
- Sometimes the medical practitioner submits the bill to Advanced Benefit Solutions on behalf of the employee.
What is the recommended coverage?
Advanced Benefit Solutions can design a plan with the same limits and deductibles as you might have in any traditional group plan.
Are there limits to coverage?
For corporations there are no annual limits. However, for the unincorporated and their families there is a limit of $1500 per adult per year and $750 per child per year.
How are expenses kept track of?
Advanced Benefit Solutions will keep track of expenses for you or as otherwise requested. This statement will detail money received and all claims paid. At year-end, you will have one comprehensive statement to take to your accountants for income tax filing purposes.
Can a cap be put on the amount spent by an employee?
It is possible to have one umbrella coverage limit for all usages. This amount can be determined by what your company feels it can afford to offer its employees.
Companies of 15 employees or more qualify for this program.
Who gets the information about our company and their employees?
Our company will not release any information regarding your company or your employees unless requested by an employee for use by a medical professional in the interests of providing coverage.
Do plans cover life and disability insurance?
Advanced Benefit Solutions will broker these contracts out to the insurance companies and assist you in choosing the coverage that best suits your needs and budget.
Are there premiums?
There are no set premiums. The level of funding on your plan can be changed
at any time to adjust for the level of usage.