Claims Section Industry Associates
Claims Section Industry Associate status is offered to organizations that provide products and services related to the management and administration of life and health insurance claims.
- the opportunity for brand visibility and participation at member rates in the Claims Section Annual Conference;
- a link to the Associate's website from CLHIA's website;
- participation on special committees related to the Claims Section;
- access to valuable resource materials through CLHIA's Member Centre;
- a subscription to CLHIA's monthly industry update, In The Loop; and more.
To find out more, please contact CLHIA.
CLHIA welcomes the following companies as Industry Associates of the Claims Section:
Accerta is a social enterprise that was established in 1959. Accerta is a leading partner in administering government sponsored social benefits. Solely engineered for government, Accerta’s fully customizable claims management system allows for cost-effective plan implementation.
Established in 1982, ClaimSecure is a technology based healthcare firm that specializes in providing claims management and plan administrative services to Canadian corporations. Our foundation consists of a National real time drug and dental adjudication system that is supported by an experienced sales/service team, Healthcare Advisory Panel, bilingual Customer Response Centre (CRC) and a highly skilled data processing centre. Our services are delivered to our customers utilizing real time systems, reimbursement programs, and retrospective analysis - all of which are further enhanced by our innovative web-based applications.
Express Scripts Canada
Express Scripts Canada, a registered business name of both ESI Canada and Express Scripts Canada Services, each an Ontario partnership indirectly controlled by Express Scripts, Inc., is one of Canada’s leading providers of health benefits management services. From its corporate headquarters in Mississauga, Ontario, just outside Toronto, Express Scripts Canada provides a full range of integrated pharmacy benefit management (PBM) services to insurers, third-party administrators, plan sponsors and the public sector, including health-claims adjudication and processing services, Home Delivery Pharmacy Services, benefit-design consultation, drug-utilization review, formulary management, and medical and drug-data analysis services, to better facilitate the best possible health outcomes at the lowest possible cost.
Funds Administrative Service Inc.
Funds Administrative Service Inc. has been providing professional health and pension benefit administration services to clients across Canada since 1968. FAS Inc. is a full service Third Party Administrator whose focus is on administration only which makes us unique in the industry. Our head office is located in Edmonton, Alberta and we have a client service office in Burlington, Ontario. FAS prides itself in providing efficient and effective administration services to our multi-employer and corporate clients.
instream is a trusted solution provider to the Canadian dental community having the confidence of insurers, software vendors and associations. instream’s primary mission is to eliminate the inefficiencies of current claims submission and payment systems between insurers and dental offices.
Founded in 1880, Johnson Inc. is one of Canada's leading Insurance and Benefit Consulting firms providing diverse programs and services to many Employers, Associations and Trusts across Canada. With locations from the head office in St. John’s, Newfoundland and Labrador to Langley, British Columbia, Johnson has approximately 1,500 employees in more than 65 locations across the country providing personalized service to our client organizations. Johnson is a leading provider of third party administration (TPA), specialized benefit and actuarial consulting and claims payment services (TPP). We have been offering these services for nearly 50 years, and we have several long-standing client partnerships spanning decades.
Johnston Group Inc.
Johnston Group provides benefit services to more than 28,000 businesses and their employees. With over $350 million in premiums under its administration, and over 40 years of experience, Johnston Group’s strength lies in its administrative capabilities.
Manion, Wilkins & Associates Ltd.
Manion, Wilkins & Associates Ltd. (MWA) is an independently owned Canadian firm that provides third party benefit administration, benefits payment and consulting services. We have been in business for over 30 years; initially specializing in the administration of multi-employer benefit plans and expanding to include claims payment and benefits consulting.
MDM Insurance Services Inc.
Incorporated since 1984, MDM Insurance Services Inc. (MDM) is a fully integrated Third Party Administrator and Adjudicator of Short Term Disability (STD), Extended Health Care (EHC), Drug, Dental, Health Spending Account (HSA) and Personal Spending Account (PSA) benefits. An HSA can be established on a stand-alone basis, or, if in conjunction with a benefit plan, we offer client choice to allow for real-time integration. Our web based applications are designed for ease of use by Plan Members, Plan Administrators, Consultants and Providers.
MDM’s pay direct card is accepted nationally. As a Pharmacy Benefit Manager we provide active formulary management , and in partnership with RxInfinity and SelectRx, a voluntary, national pharmacy Preferred Provider Network (PPN) and an active drug diversion program.
Our tailored software allows complete customization of benefit plans. This, combined with competitive rates and unparalleled service offers clients a full solution option. MDM is committed to making the client our priority.
NexgenRx is an Independent Canadian provider of ASO (Self-Funded) Drug, Dental and Extended Health benefit plans supported by technology. Incorporated in 2003 our head office is in Toronto, Ontario. We support our clients with a dedicated team of staff members, pharmacists, dental consultants, physician consultants and a bilingual call centre. We operate our own Pharmacy Benefit Manager (PBM) network, and our NexgenRx benefit/drug card is accepted at over 10,000 pharmacies and 18,500 dental offices across Canada. NexgenRx developed and operates a proprietary claims adjudication system along with our health care provider portal for real time claim submissions and processing. We are more than just a payor of claims we are also a technology partner. We not only adjudicate claims but also outsource our state-of-the-art technology and work with our clients to understand and meet their needs. We also offer a web based benefit administration solution which allows for one point entry of all benefits, regardless how many carriers you utilize for your pooled benefits. We offer an effective and customer sensitive approach to controlling cost in a world where health benefits are becoming more expensive for plan sponsors to offer.
Ontario Teachers Insurance Plan (OTIP)
OTIP is a non-profit trust, directed by representatives from the four Ontario education affiliates, serving the education community for over 25 years.
The PBAS Group
The PBAS Group has served, and protected, the interests of benefit-plan sponsors for several decades. With regional operations in seven major locations, the member firms deliver consulting, actuarial, full administration (including claims adjudication and payment), disability management and related services to clients of varied type, structure and size, both local and national in scope. As well, PBAS personnel continue to advance the interests of the benefits industry through government relations, teaching and other leadership roles.
RWAM Insurance Administrators Inc.
RWAM has serviced and provided protection to Canadians from coast to coast for over 30 years. Our advantage of partnering with multiple insurance providers allows us to offer comprehensive, customized and cost-effective employee benefits programs. RWAM prides itself on a dynamic and responsive approach as we continually face shifting market conditions.
TELUS Health Solutions Inc.
A leading North American eBusiness company, supplying solutions to the financial, insurance, Canadian health care and government sectors, TELUS Health Solutions Inc. is the largest pharmacy benefit management provider and largest private network for adjudicating drug claims and transmitting dental claims.