Third Party Adjudication

The Canadian Benefit Providers is a Third-Party Payor for Assumption Life of Canada and Aetna of Canada. In addition, Administrative Services Only (ASO) are provided for health, dental, vision and short-term disability claims.

Administrative Services Only (ASO) can be budgeted or claims in arrears. To mitigate risk in group health benefits Canadian Benefit Providers has an individual stop loss program backed by Lloyds of London. Deductibles can be as low as $5,000.

Because we adjudicate ALL health, vision and dental claims we have the data. (Our data security has been vetted by our insurance partners who gave it top marks.) This allows us to give accurate renewals which are based on fact not insurers assumptions. All of this in real time

Canadian Benefit Providers has one benefit card for health, dental, vison, HCSA / Flex, cost plus top up and travel coverage.

Group Benefit plans are very customizable.

Here’s some of the things that Canadian Benefit Providers does every day.

    • Group dental coverage with an overall family maximum
    • Group dental coverage and health coverage combining either an individual or family maximum
    • Allowing HCSA / Flex to automatically pay deductibles or co-insurance
    • Automatically pay cost plus top up for executives
    • Canadian Benefit Providers structures plans and their adjudication so that the client is allows serviced at the least possible cost. We actually do claims Management by utilizing third party programs.
    • Create a Preferred Provider Network (PPN) for specific Plan Advisors in their local community.
    • Being a Pharmacy Benefit Manager (PBM), Canadian Benefit Providers can customize drug formularies to suit your clients needs (Generic, LCA, Some biologics, No biologics, Caps on biologics)

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