Risk Management

Aspects of the benefit program that must be managed

• Competitive cost advantage (long-term cost containment).
• Contribution to the corporate culture through employee understanding and appreciation.
• Affordability (short-term cost containment).
• Compliance with legislation (Employment Standards, Human Rights etc.).

Benefits Quagmire

• Hyperinflation due to cost shifting, aging workforce, and price increases.
• Employee dissatisfied with claim payment.
• Required medication or service not covered.
• Claim declined because it was submitted too late.
• Perceived breach of confidential medical information.

• Letters of offer inaccurately describe benefits.
• Letters of offer describe benefits too specifically.
• Confusing eligibility dates (new, rehired, changes in hours).
• Inconstancy between insurance policies and HR policies.
• Letters of termination extend benefits inaccurately or without approval.
• Conversion of life insurance at termination or age 65 not documented.

• Short-term disability plan abused.
• Performance problem evolves into a disability claim just before termination.
• Disability wording too narrow to facilitate rehabilitation.
• Life insurance waiver of premium not applied for.

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