Professional Service Partners

We are very pleased and excited that OFIS has partnered with the Community Services Benefits Trust (CSBT) to provide an improved benefits plan offering to OFIS members.

CSBT is a non-profit trust that was formed in January 2002 by a group of eight Executive Directors of community service organizations. They were frustrated with the benefits plans that they had purchased through traditional channels and decided that there must be a better way to provide benefits to their staff. Working together, these organizations created the Trust in order to provide an alternative to the status quo; a more cost-effective plan that would be customizable and locally accessible to social service organizations across the country.The CSBT program is structured differently than the industry standard. A pooled philosophy, substantial buying power through strength in numbers and best-in-industry technology all contribute to provide what we believe to be the best value in the insurance marketplace today.

The CSBT is a non-profit trust that was formed in January 2002 by a group of eight Executive Directors of community service organizations. They were frustrated with the benefits plans that they had purchased through traditional channels and decided that there must be a better way to provide benefits to their staff. Working together, these organizations created the Trust in order to provide an alternative to the status quo; a more cost-effective plan that would be fully insured and locally accessible to social service organizations across the country.

The CSBT was established based on the following key principles that continue to guide the Trust’s ongoing operations:

· The Plan is Fully Insured

Member agencies have no financial liability associated with the plan’s financial successes or challenges. Member agencies’ only financial requirements are to pay their monthly premiums.

· The Plan Engages and Consults with Participating Agencies

The CSBT has regular communication with member agencies and provides participating organizations with opportunities to provide feedback.

· The Plan Has No Infrastructure Requirements

As a non-profit trust, the CSBT does not directly employ staff, own buildings or assets. To meet this mandate, the CSBT has partnered with GroupHEALTH/GroupStrength who administers the plan.

Structured for High Efficiency and Value

The CSBT program is structured differently than the industry standard. What makes our plan different? A pooled philosophy, substantial buying power through strength in numbers and best-in-industry technology all contribute to provide the following four advantages:

1. Lowered Cost

Sustained cost savings can be achieved due to the strength in numbers of the pool and the more financially efficient CSBT model. Margins normally required by the insurers in the traditional benefits industry can be permanently reduced and savings can be passed on to your organization.

2. Rate Stability

The CSBT plan pools the participating organizations; claims are spread amongst the programs 29,000-plus plan members and greater stability results.

3. Enhanced Coverage

The substantial buying power of the Community Services Benefits Trust allows us to offer additional benefits, features and functionality not normally accessible to small and mid-sized organizations. We are happy that these enhancements can make meaningful differences in the lives of plan members and their families as well as for employers. A few of the additional value-added coverages and features that will be added to your new benefits program through the CSBT include:

Serious Illness and Critical Disease Benefits

Life is great at throwing us the unexpected. This benefit can provide up to 10% of the AD&D benefit amount as a lump sum payment for following covered serious illnesses: cancer, heart attack, stroke and kidney failure. This money can be very helpful when dealing with the challenges and costs that can arise due to the illness as well as the potentially high cost of treatment and medical supplies.

Employee and Family Assistance Program (EFAP)

Life’s ups and downs can make it a challenge to focus on work. Having the resources to deal with difficult situations makes life just a little bit easier for Plan Members. Our Employee and Family Assistance Program provides in-person confidential counseling during the day, evening and on weekends, with no fixed limit on the number of short-term counseling sessions. This benefit also provides:

i. Referrals to a network of community resources childcare, eldercare, financial and legal support and educational resources

ii. Management and supervisor consultation

Virtual Healthcare by TELUS Health

Over 50% of primary care concerns traditionally seen in a doctor’s office can be addressed through the TELUS Health’s virtual healthcare app and website, without ever having to leave home or work. This leads to a significant improvement in absenteeism and employees appreciate the convenient access to important services for themselves as well as spouses and children. Employees & their families can consult confidentially with an accredited doctor or nurse. Employers can help the 4+ million Canadians who don’t have a family physician get quality medical care.

Hospital Indemnity Benefit

Not many people enjoy being in the hospital. Non-medical expenses related to a hospital stay can quickly add up e.g., parking, meals etc. To help make a difficult time a little bit easier, we provide Plan Members with a $40 per day cash payment for each consecutive day of hospitalization.

Living Benefit

Employees can access 50% of their group life insurance amount up to $50,000 upon diagnosis of a terminal illness (defined as given less than 24 months to live).

FormuCARE

As the cost of Specialty Drugs continues to rise, many companies struggle or can no longer afford to provide drug plans for their employees. FormuCARE provides a solution which protects the sustainability of your plan and the continued coverage of common prescription drugs.

Third-Party Disability Management & Advocacy Services

Experiencing an injury or illness outside of work can be a very overwhelming experience. Included with all LTD coverage through GroupHEALTH is professional disability management services that are intended to support plan members and plan sponsors. This service has proven to be very helpful for both staff and plan administrators; it has reduced disability times, reduced disability premiums and helped organizations avoid lawsuits/complaints regarding mismanagement of the disability process.

Extended Travel Coverage – 180 days out of country

Trip Cancellation Coverage of $5,000 per trip

Stillbirth Benefit included in Dependent Life Insurance Coverage

Virtual Fitness Program by LIFT Session

Extended Coverage for Dependents – Age 22, 26 if student

Service and Support

We know receiving great service is something that is very important to your organization. CSBT clients receive a personal service experience; a dedicated service representative (plus their back-up team) would be available to assist you with any questions or issues you may have. Your personal representative would be your main point of contact. Their focus is to ensure your questions are answered quickly and you and your employees receive the service and support you require. Other services we include to enhance the plan member and plan administrator experience include:

MyGroupHEALTH Portal – Smart Phone Claims Submission

We know how important claims turnaround time is to plan members; family budgets are tight these days and the quicker that funds can be reimbursed the better! Many claims can be processed immediately through our Pay Direct Drug Card; however, some practitioners are not set up for electronic transfer and claims must be submitted manually. For these claims we are proud to provide the Photoclaims reimbursement system. This system is great for plan members who use a smart phone or tablet as they can submit a claim in just four taps! (More details are included in an appendix later in this proposal.)

Industry Leading Online Administration System

You will be able to make administrative changes to your plan easily when it is convenient for you with our best-in-industry online administration system. Basic functions such as updating salaries, adding/deleting employees, and adding dependants are done easily, however this system performs much more sophisticated functions as well such as:

• Continuous electronic monitoring to ensure tax effective treatment of benefit premiums for both employers and employees

• Tracking of employees on leave and disabled employees – adaptive systems to ease the administrative burden associated with maintaining benefit coverage

• A virtual hands-off “triggers and alarms” approach to supporting you and your administrative staff

• Full audit “footprint” to manage retro and future transactions

Staff Connectivity / Experience

We believe that your staff should be well informed and have easy access to the benefits plan information they seek. It is key that from the staff member’s point of view, this plan is as user friendly as possible. For this reason, we are proud to offer the following staff communication pieces:

• Online access to booklet details, claim forms and benefit coverage

• E-Claims payment processing

• Photoclaims payment processing

• View personal claims history and balances

• Print consolidated statements for tax purposes

• Direct deposit for claims reimbursement

• Claim queries for Coordination of Benefits (COB)

• Health library access

• Smart phone app for mobile access

Staff Communications

To reduce workload on employers and ensure that plan members are fully aware of the features and benefits of their employee benefits program, we will customize a communications package for the employer to be sent to each plan member.

• Regular and frequent contact; as needed or desired

• Two purposes (branding typically differs by purpose):

• Address FAQs about Plan

• Cost containment

• Target is staff and family members

Benestats (Total Compensation Statements)

Benestats reports are a powerful communication tool providing each plan member with a personalized benefits statement. Benestats help plan members appreciate the true value of their benefit plans by giving a customized, annualized estimate of the benefits their employer provides, as well as an appreciation of the employer’s financial contribution. It can also communicate the value of non-cash compensation items if requested.

· Transition Process using Enrol-ME Online Employee Enrolment

We have streamlined this process to the greatest extent possible. Traditionally, transitioning to a new group benefits program was cumbersome and time consuming! Now, with our improved technology platform, we are able to enrol all staff online using Canada’s first electronic enrolment feature, Enrol-ME. On behalf of the employer, there are simply two forms requiring signatures from an authorized party to secure coverage effective the first day of the following month.