Products Offered
- Group Life Insurance
- AD&D
- Group Disability Insurance
- Extended Health Benefit
- Dental Benefit
- Adjudication/Consulting Services Only
- Additional Expense Benefit (Cost Plus)
- Health Spending Account
- Administrative Services Only
Group Life Insurance
Group Life Insurance can be an important component of an employee’s financial security program. Although it is not a substitute for personal life insurance, it does provide for a base of life insurance for final expenses, repayment of debt and replacement of earnings.
Wawanesa offers Group Life Insurance in a number of ways:
Employee (Basic) Life Insurance can be designed to provide for flat amounts of coverage or for multiples of annual earnings. The latter option relates the coverage to the need and continually updates the coverage for changes in earnings. There can be one or more classes with different levels of coverage and non-evidence limits are available.
Dependent Life Insurance insures the dependent spouse and children of the employee/member under the group plan.
Optional Life Insurance offers cost effective supplemental coverage to be elected by employees/members according to their needs and budget. Optional Life is usually offered in units of $10,000 with premiums related to the insured’s age, gender and smoker status. Programs can include Optional Life for spouses of employees/members.
Accidental Death and Dismemberment
Accidental Death & Dismemberment Insurance (AD&D) is a cost-effective supplement to the Employee Basic Life Insurance coverage. It insures the employees under the group plan providing for an additional payment, generally equal to the Employee Basic Life Insurance coverage, in the event of death caused by an accident. Benefits are paid for injuries and losses due to accidents.
To further supplement the coverage, additional benefits under AD&D include Coma Benefit, Repatriation Benefit, Rehabilitation, Home Alteration and Vehicle Modification and Spousal Occupational Training.
Group Disability Insurance
Although disability is a more likely event than early death, employees/members are often inadequately insured for disability. The group disability insurance under an employer’s benefit plan provides affordable coverage that may not otherwise be available.
Wawanesa Life offers Short and Long Term Disability coverage. Group Plans may include Short Term Disability or Long Term Disability or both, depending on the nature of business of the employer.
Through Active Disability Claims Management, Wawanesa Life’s Group Operation ensures that all disability claims are handled promptly and professionally thereby facilitating a smooth and efficient transition back to work by the employee.
Short Term Disability (STD) covers short absences from work due to accident or sickness.
The policyholder chooses from a selection of taxable or non-taxable plans, elimination periods, maximum benefit duration, percentage of weekly earnings to be reimbursed and the maximum weekly benefit payable. Plans will be tailored at the policyholders request to qualify for the Employment Insurance premium reduction. The benefit formula may be arranged on a graded scale.
Long Term Disability (LTD) provides monthly benefit coverage for extended disabilities. Coverage can be tailored to co-ordinate with payments received under a Short Term Disability plan. The policyholder chooses from a selection of taxable or non-taxable plans, elimination periods, maximum benefit duration, percentage of monthly earnings to be reimbursed and the maximum monthly benefit payable. The benefit formula may be arranged on a graded scale and can be designed to include Cost of Living adjustments. The LTD benefit amount is integrated with all income sources.
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A unique Critical Illness Feature has been added to the Long Term Disability Benefit offered by Wawanesa Life Group Operation. The Critical Illness Feature is standard to the Long Term Disability Benefit, offering coverage for 10 insured conditions. It provides for a benefit payable on the first insured condition for which a diagnosis is made or surgery is performed. (Specifics are provided within the Policyholder’s contract.)
Wawanesa Life’s Long Term Disability benefit plan includes both a partial disability program and a rehabilitation provision which are intended to assist the employee in the return to work process.
Early intervention is a key component of disability management. At Wawanesa, included with all Long Term Disability Benefit plans are the following two programs provided by a strategic partner with expertise in this arena:
Posaction Plus
A program intended for Managers/Supervisors to assist them in preventing disabilities by providing management training tools and early intervention services. This program is offered at no additional cost as part of the Long Term Disability Benefit. It is not an EAP (Employee Assistance Program). Posaction Plus adopts a proactive rather than passive approach to disability prevention.
Themaxis
Themaxis is designed to help managers and team leaders prevent and minimize absenteeism by providing them with hands-on strategies to obtain the best possible results when managing people.
Extended Health Benefit
Wawanesa Life understands the policyholder’s challenge of controlling health care costs while meeting the plan member’s needs for services. Extended Health Benefits are designed to supplement the basic health care coverage provided under provincial government programs. Through claim audits, claims management and adjudication practices, active fraud/abuse detection and prevention practices, Wawanesa Life takes an active role in assisting the policyholder in designing plans that encourage healthy choices and keep benefits effective and affordable.
The Group Operation offers plans which allow the policyholder to include coverage for prescription drugs, professional services, medical supplies, ambulance services, accidental dental, hospital and convalescent hospital coverage, out of country referral coverage, emergency out of country coverage, travel assistance program, and vision care. Reimbursement is based on a range of selected coinsurances, deductibles and maximums that may apply to certain eligible expenses.
Additional expertise and services are provided in the areas of Pay Direct Drug Cards and Travel Assistance Benefits through two strategic partners.
Dental Benefit
To cover the cost of dental work, The Group Operation allows the policyholder maximum flexibility in its choice of deductibles, co-insurance, recall options, annual benefit maximums and coverage levels.
The core benefit – Level 1, Basic Dental, provides for preventative and routine restorative procedures and includes treatment for gum disease, root canal therapy and some denture services (relining and rebasing). Level 2, Major Restorative, services can be added. Major Restorative provides for removable dentures, fixed bridgework and crowns. Level 3, Orthodontia, is usually for dependent children under the age of 19 but the plan can be designed to provide coverage for adults.
Adjudication/Consulting Services Only
Adjudication/Consulting Services Only is a fee for service offering whereby Wawanesa Life provides the expertise of their Disability Claims Management Team to self-insured groups. This services allows for an employer to self insure it’s employees for Disability coverage without having the expense of in-house expertise to manage and adjudicate the benefit.
Additional Expense Benefit (Cost Plus)
Additional Expense Benefit (AEB) is a “cost plus” benefit that provides top-up coverage for most Health, Dental and Vision Care expenses not covered under the standard contract but Canada Revenue Agency approved. AEB allows the employer to strengthen the coverage offered while providing valuable tax savings. AEB can be used to provide enhanced coverage to key employees in a way that is more tax-efficient than salary increases.
Additional Expense Benefit can provide coverage for all plan members within the group or it can be tailored to provide coverage for a specific class of plan members such as managers or executives. If AEB is for a specific class, all plan members within that class must be eligible for the coverage.
Health Spending Account
Health Spending Accounts (HSA) are an effective method for policyholders to provide employees/members with a high level of involvement and flexibility in their benefit plan. Health Spending Accounts are individual accounts established for each employee/member. The policyholder deposits an amount for each employee/member. The employee/member can draw on the account by submitting qualifying expenses that are not insured under Extended Health or Dental Benefits.
The eligibility of expenses is controlled by the Income Tax Act. Types of expenses can include, but are not limited to: deductibles and coinsurance amounts, expenses that exceed group insurance plan maximums, eye glasses, contact lenses and laser eye surgery, medications, vaccines over the counter and lifestyle drugs, and dental work such as implants, dentures, or orthodontics.
Health Spending Accounts can be a cost-effective way to fund medical and dental expenses that can be anticipated to recur each year. The policyholder’s contribution to the account is not taxable to the employee/member but is deductible by the policyholder, making it tax-effective.Administrative Services Only
Administrative Services Only (ASO) is an arrangement whereby Wawanesa Life agrees to provide full administration and claim adjudication services to a policyholder but bears no liability arising from claims against those services. The policyholder self-insures the cost of providing the health and dental benefits.
Administrative Services Only arrangements are most often chosen where annual aggregate claims can be reliably estimated and the policyholder has the financial resources to assume the risk that claims will be higher than expected. Therefore, it is most suitable for large policyholders.
By choosing an Administrative Services Only arrangement, the policyholder hopes to achieve economies of scale by outsourcing the administrative function while retaining the financial benefits of good claims experience. The policyholder also benefits from Wawanesa Life’s claims management, thereby controlling claim costs which comprise the most significant portion of overall benefits costs.