Keyword: benefits fraud

31 results found

Over the last decade, the group benefits space has been all about digitizing documents and data, embracing a mobile-first mindset and urging plan sponsors and members to ditch paper and go online for a more customized experience. The next decade will build on all of that, pushing group benefits plans into the era of hyper-personalization, […]


Over the past couple of years, I’ve been relentlessly pestered by my dentist’s office. I’ve lost track of the frequency of texts, emails and phone calls. When the overt neediness increased even more at the end of last year, I realized it had barely been six months since our last date. Is it just me […]

What dental benefits topics should plan sponsors be considering?

With prescription drugs and paramedical benefits taking up an increasingly large portion of employers’ benefits spend, dental benefits often avoid the spotlight. But consultants and insurers are emphasizing a few dental issues for plan sponsors to consider in 2020. Over-billing Though GE Canada isn’t focusing on dental benefits in this year’s renewal process, Diana McNiven, […]

Since the point of an editorial is to create a discussion on the trends and issues affecting our industry, I was glad to see my latest — in the January/February issue — sparked a good debate. The print edition of Benefits Canada doesn’t have a Letters to the Editor section, so I’m compiling all the […]

  • By: Staff
  • March 13, 2020 December 3, 2020
  • 09:00

The Toronto Transit Commission has settled a 2016 lawsuit against its insurer for the alleged failure to detect a benefits fraud scheme involving orthotics store Healthy Fit Inc. To date, 10 people — nine former TTC employees and Healthy Fit owner Adam Smith — have been convicted in relation to the scheme. More than 250 TTC employees resigned or […]

  • By: Staff
  • November 15, 2019 December 3, 2020
  • 09:15
Toronto hospital dismisses 150 staff for alleged benefits fraud

About 150 employees at Baycrest Health Sciences have been dismissed for benefits fraud. Last year, in the course of establishing an approved provider network for its employee benefits, the Toronto geriatric hospital said concerns were raised about some of the extended health-care claims employees were making under the benefits plan. “As a result, we retained a third […]

  • By: Staff
  • July 11, 2019 November 12, 2020
  • 10:00
Awareness key in benefits fraud detection and prevention

As benefits fraud schemes become more sophisticated, group insurers must continuously evolve their strategies to keep up to date, according to Shelley Frohlich, director of fraud risk management at Sun Life Financial Inc. A group insurer’s role is to help protect the integrity of the benefits plan by reducing the financial and reputational risks to an […]

Since recreational cannabis was legalized across Canada six months ago, related workplace problems have mainly been notable by their absence. “It’s been a surprising lack of significant issues arising in the workplace,” said Angelo Tsebelis, president at Starseed Medicinal Inc., during a panel at Benefits Canada’s 2019 Benefits and Pension Summit in Toronto on Wednesday. This […]

Benefits fraud is a top concern among plan sponsors and insurance carriers, as it makes the cost of providing benefits plans more expensive, leading to higher insurance premiums. At Benefits Canada’s 2019 Benefits and Pension Summit in Toronto on April 17, Shelley Frohlich, director of fraud risk management in Sun Life Financial Inc.’s group benefits division, will […]

Head to head: Who’s responsible for detecting benefits fraud?

With benefits fraud a growing issue for plan sponsors, the recent spate of fraudulent activities at large organizations has prompted the question of who’s responsible for identifying benefits fraud in the first place. Is it insurers, plan sponsors or plan members? Mark Russell, director of investigative services at the Toronto Transit Commission: Five years ago, […]