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Posted by Marie-France Hamon, Group Insurance Plan Advisor, mars 17 2016
Plan Implementation
Group Insurance: Avoid Derailing the Process from the Start!

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Selecting a group insurance plan requires much effort to analyze the employer’s needs, compare quotes (rates and benefits offerings) and assess the services provided by insurance carriers. Thus, once you reach the implementation stage, it may be tempting to consider the paperwork as a mere formality. But if this step is neglected, problems may arise with benefits, claims or billing. As the employer invests substantial amounts to provide benefits to employees, it would be unfortunate if the implementation of the plan were to adversely affect employee perceptions of their new group insurance plan.

You must not skip any steps. First of all, the required documents must be properly completed within the time limits set by the parties (insurer and administrator). Employees must be informed of changes and their questions must be answered. The documents produced by the administrator must be validated as part of the planning of a successful transition between insurers that will ensure continuity in plan administration.

Documentation

The first step is to complete accurately the various documents required to formalize the company’s commitment toward the new insurer(s), including the insurance application, the deposit cheque, the list of absent employees and the employee application forms. Improperly completed or late documents may delay the implementation or lead to problems with claims or billing. In the case of an existing plan, a cancellation letter must be sent to the former insurer. This is crucial, as the company could be forced to pay two group insurance premiums to two different insurers if this letter is overlooked or forwarded late.

Communication to employees

Once the documents have been sent to the insurer and the new group insurance plan is official, it is important to effectively communicate the changes to employees. It is generally recommended to organize meetings with employees. With the employer’s consent, the advisor can facilitate such meetings and explain several aspects of the plan, such as the benefits provided under the plan, the rates and their impact on the pay, the administrative platform, the claim procedures, the web or phone access to get information or answers to their questions, etc. Employee meetings also represent a good opportunity to explain the value of the benefits offered by the employer and raise the employees’ awareness of the best practices to help control the costs of the plan.

Making the transition

Implementing and administering a group insurance plan is an important task which requires much attention to detail. Therefore, it is essential to validate that the plan administrator systems have been correctly set up and the documents produced (contract, brochure, etc.) meet the employer’s expectations. This task should normally be performed by the advisor.

Switching insurers brings about changes that have an impact on employees, such as the website used to submit claims or the way claims are processed. Moreover, depending on the transition date, some data on maximum annual out-of-pocket amounts, annual deductibles, certain maximum amounts and exception drugs can be forwarded to the new insurer, so that employees do not pay their deductibles twice or do not receive the wrong reimbursement amounts. For a fee, the insurers can share this information between themselves, thus making the transfer less inconvenient for the insured.

It is much easier to switch insurers with the AGA +Plus service. To learn more, click here.

In conclusion, great care must be exercised when implementing a new group insurance plan or when switching insurers in order to avoid getting off to a bad start. It is critically important to ensure a smooth transition and prevent any problems with claims, coverage or billing. Thus, the employees will keep a positive image of the group plan you are offering and consider it as a value-added asset.

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Group Insurance Plan Advisor | Since 30 years, Marie-France takes care of AGA Benefit Solutions’ clients and finds simple and clear solutions to financial problems as well as claims and administrative issues. Marie France is rigorous, available and she listens carefully to her clients to understand their needs and issues.
Marie-France Hamon, Group Insurance Plan Advisor