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Top 10 health and benefits stories of 2018

Trends, benefits fraud and drug coverage led the top health and benefits stories in 2018.  Benefits Canada rounds up the industry’s favourite health and benefits stories of the year: 1. Seven benefits trends to watch in 2018 2. Ontario unveils new drug, dental coverage for people without workplace benefits 3. TTC fraud update: More than 220 employees fired or have resigned, retired […]

  • By: Staff
  • December 27, 2018 September 13, 2019
  • 09:00
CLHIA’s CEO lays out some of the big industry topics for 2019

As 2018 draws to a close, and the benefits and pension industry looks ahead, what’s next for the year’s biggest topics? Stephen Frank, president and chief executive officer of the Canadian Life and Health Insurance Association, is expecting a shift from Canadian and global regulators in the way they govern how customers are treated: an […]

  • By: Ryan Murphy
  • December 21, 2018 September 13, 2019
  • 08:56
Health costs to rise 11.8% in 2018, survey predicts

Insurance companies expect health costs to rise by 11.8 per cent this year, according to an annual survey by Accompass Inc. The survey determines the anticipated year-over-year cost increase or decrease — or health trend factor — by asking insurers to examine their businesses and take various factors into account, including legislation, claims utilization, inflation, fee increases […]

  • By: Staff
  • May 25, 2018 September 13, 2019
  • 15:45
Have your say: Is benefits fraud a widespread problem?

With fraud prevention month underway, just how big of a problem is the issue for plan sponsors? “As an industry, we estimate that benefits fraud is costing . . . hundreds of millions in terms of the impact, so certainly not a small problem,” says Karen Voin, vice-president of group benefits and anti-fraud at the Canadian Life […]

TTC fraud update: More than 220 employees fired or have resigned, retired

Some 223 Toronto Transit Commission employees have been dismissed or have resigned or retired to avoid dismissal as part of an ongoing investigation into benefits fraud, the organization has announced. The TTC began investigating its benefits claims in 2014 following a tip that suggested service provider Healthy Fit Inc. was providing receipts to TTC employees with inflated […]

  • By: Staff
  • March 15, 2018 September 13, 2019
  • 10:01
TTC condoned benefits fraud, union argues in fighting staff terminations

The Toronto Transit Commission condoned the benefits fraud involving millions of dollars for orthopedic claims, the union representing workers is arguing in a number of grievances challenging their terminations. In an interim arbitration award earlier this month, arbitrator Lorne Slotnick outlined how the TTC is facing 103 grievances over the firings of workers connected to […]

  • By: Glenn Kauth
  • November 14, 2017 September 13, 2019
  • 15:30
A free purse with a benefits claim? How incentives can land providers, employees in trouble

While it might come as a surprise to some plan members, what may seem like a freebie or giveaway with the purchase of a medical device or service can actually count as benefits abuse. And in some case, offering incentives to customers will get a provider delisted by an insurance company. This week, for example, Shelley […]

  • By: Ryan Murphy
  • October 19, 2017 September 13, 2019
  • 10:37
TTC benefits case: Store owner sentenced to two years, Manulife facing lawsuit

The ongoing benefits fraud case at the Toronto Transit Commission continues to unfold as the owner of an orthotics store had pleaded guilty in the case. According to the TTC, Adam Smith, the owner of Healthy Fit Inc., pleaded guilty to two counts of fraud over $5,000 this week. The court sentenced him to two […]

  • By: Staff
  • September 22, 2017 September 13, 2019
  • 10:49
Ontario police officer charged with fraud over benefits claims

A Peel Regional Police officer is facing fraud charges over employee benefits claims. On Wednesday, Peel police announced that, following a four-month investigation, they had charged Const. Noel Santiago with two counts of fraud under $5,000 in relation to employee benefits claims. Police have suspended Santiago, who’s to appear in court on Sept. 11, with […]

  • By: Staff
  • August 10, 2017 September 13, 2019
  • 09:17
‘Sigh of relief’ as university professor’s firing for benefits fraud upheld

A labour arbitrator has served notice that employees who commit benefit fraud will have a hard time avoiding dismissal. Earlier this summer, arbitrator Eli Gedalof upheld the termination of Diana Spokiene, an associate professor of German studies at York University, for submitting more than 100 false benefit claims totalling more than $8,000 for paramedical services, including physiotherapy […]