Doing the math is a good starting point but the purpose of negotiating a renewal is to determine the justifiable premium funding based on future claims and projections.  With one of our client renewals, we determined that 2 employees who had recently turned 65 were using expensive drugs and their pharmacists hadn’t registered them on the ODB plan.  After 4 months of relentless work, we were able to renegotiate a 48% increase down to 15% back to the renewal date.

While transitioning a plan from one carrier to another, we discovered that one employee had a work accident a few years ago and would never return to work due to his paralysis.  We reached out to the insurer, initiated paperwork to secure his life insurance and recovered 2 times his annual income for an accidental claim – a much needed payment for his well-being.

The pandemic forced everyone to hit pause on so many aspects of their lives but insurance contracts can sometimes be unbendable.  A client’s daughter was unable to have her scheduled wisdom tooth extraction before her 25^th birthday due to the dental clinic closures.  We were able to get an pre-approved exception to pay the claim through the benefit plan even though she was no longer considered eligible when the services were performed.

At the end of a successful renewal meeting, the owner was praising the achievements of his son who was venturing to China on a school exchange program.  All the details had been finalized except for one – insurance while he was studying abroad.  He had assumed that the group insurance plan had it all covered.  With a call to the insurer and some paperwork, we were able to extend his coverage outside of the country and beyond the contractual 60 days.

We always focus on the benefits plan as overall Wellness platform so we gave high praise to one of our clients who wanted to offer new employees immediate coverage for the Employee Assistance Program while they waited to satisfy the 3 month probationary period for the other benefits.  It was a great recruitment strategy and brilliant idea that reinforced their wellness culture – and something we will promote to our other clients.

Well, maybe its not as scientific as that but when we noticed an unusual amount of orthotics and surgical stockings, we dug into the claim reports and uncovered some possible fraudulent activity.  When we brought it to the attention of the insurer, they took over with an audit, reversed the claims activity from the client renewal, and launched an investigation with the supplier.

We all know that sometimes we mess up but the recovery is what matters.  A communication piece to employees outlining the benefit overview of a new plan was fault with one typo that presented a richer drug benefit. We owned it and discussed it with the insurer who honoured it even though the premium was based on a lesser benefit.  Our strong and collaborate partnership with our insurers allows us to provide our clients with the best results even we mess up.

As a result of an acquisition, one of our clients was terminating their policy to join the parent company group plan.  Three days before the transition, an employee had a tragic and fatal accident at work.  We stepped up when we received a frantic call from their new human resources team in the U.S.  We initiated the paperwork for the life and accidental death claim, addressed the need for them to inform the new insurer of a survivor benefit continuation, and launched a communication to employees who may require bereavement counselling.