Aspects of the benefit program that should 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.).
Medical and Dental:
- 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.