Plan administration is an important job! An eligible employee who is not insured correctly or who has not been offered benefits can not only have a negative impact on the employee’s well-being but it can also pose liability issues for you and the business.

What types of plan administration tasks do you need to remember?

Most such tasks apply to all employees so they should become an automatic part of your group benefits plan administration. Some of the most important tasks include the following:

• It is the employer’s responsibility to ensure that each employee is enrolled properly and on time. If an employee is enrolled late on the plan (typically 31 days after becoming eligible to join), his or her coverage is typically not guaranteed. The employee and his or her dependents will be considered late applicants, and will need to complete and submit forms about their health. They will then need to be medically approved before enrolling on the plan, at which point they will likely learn that their coverage is restricted or has been declined entirely. This not only has the potential to negatively impact the employee’s and/or dependents’ well-being but it also poses a significant liability risk to the employer. It is far better and easier for everyone for an employer to enroll an eligible employee properly and within the required timeframe.

• In almost all cases, it is to the employer’s and employees’ benefit to make participation in the benefits plan mandatory. If an employee was permitted to join a plan only when he or she anticipates needing a claim paid, this would make the plan financially non-viable; both non-claimers and claimers need to be contributing premiums into a plan to build up funds to cover claims (similar to home and other forms of insurance). This is why Wiegers Financial & Benefits recommends that employers make participation in their benefits plan mandatory for all eligible employees. If, though, you wish and are able to permit employees to waive all benefits coverage under your plan, it is important that you have those employees sign a group benefits plan waiver form that makes clear that you offered coverage to these employees but that they chose to decline it.

• Almost all group benefit plans permit an employee to waive Health and/or Dental coverage if he or she has comparable coverage through another plan (typically a spouse’s plan). The employee must be enrolled for all other applicable benefits on the plan as Life, Disability and other benefits are not offered to dependents.

• Changes to an employee’s coverage must be submitted to your group insurance carrier no later than 31 days after the event. Have your employees communicate regularly with you about changes that need to be made such as:
• Marriage, divorce, new baby, legal guardianship of child (requires proof)
• Overage dependents, enrollment in a secondary school with the required amount of classes
  Note: Dependents over age of 18 working more than 20 hours per week are not considered eligible for coverage under a parent and should be removed from the benefits plan

• If you have employees who are eligible to apply for additional Life and/or Disability coverage above what is automatically provided through your benefits plan, it is your responsibility to advise them of the option to apply. To apply, the employee must complete a health questionnaire provided by the carrier. If he or she chooses not to apply, Wiegers Financial & Benefits recommends that the employee sign a waiver confirming that he or she is aware of the option to apply for additional coverage but has decided against it.

Amanda Getzlaf,
Benefits Account Manager, Wiegers Financial and Insurance Planning Services Ltd.

WE know this sucks, but we are here to help and support you through this process! Here is an overview of the SGI claims process when you have had an incident that involves damage to your vehicle

1. Report the Incident: After an accident or damage to your vehicle, you need to report the incident to SGI as soon as possible. You can do this by calling their toll-free claims line or by visiting an SGI claims center.
   
   

2. Provide Information: During the reporting process, you will need to provide details about the incident, such as the date, time, and location of the accident, a description of what happened, and the contact information of all parties involved. You may also need to provide your policy details.
   
   

3. Assigning an Adjuster: SGI will assign an adjuster to your claim. The adjuster will review the information provided, assess the damages, and determine if the claim is eligible for coverage based on your policy.
   
   

4. Evaluation and Estimate: The adjuster may arrange for your vehicle to be inspected by an authorized repair facility or request photographs of the damages. They will evaluate the extent of the repairs needed and provide an estimate of the costs.
   
   

5. Coverage Determination: Once the adjuster completes their assessment, they will determine the coverage under your policy. This could include coverage for repairs, replacement, or reimbursement based on the terms of your policy and the adjuster's findings.
   
   

6. Choosing a Repair Shop: If your claim is approved for repairs, you can choose a repair shop that is approved by SGI. SGI has a list of accredited repair facilities you can select from- of course we say you should choose to bring  it to Your Trusted Saskatoon Auto Body Experts at Preferred  Collision and Glass on 51st
   
   

7. Repair Process: Contact us and book in a time that suits you to bring your vehicle to Preferred. You will need to provide us with the necessary information, including your claim number. We  will work directly with SGI to coordinate the repairs and billing! 

   
   

8. Payment and Deductible: Depending on your policy, you may need to pay a deductible. SGI will cover the remaining approved costs directly with the repair shop.
   
   

9. Additional Information: Throughout the process, you can contact your SGI adjuster or claims representative to get updates on the progress of your claim or if you have any questions.

   
   

Remember, this is a general overview, and the specific details and steps may differ based on your policy and the circumstances of your claim. It's always advisable to review your policy documents or contact SGI directly for precise information regarding your claim and coverage.

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Aurora Workplace Solutions design & create custom group benefits plans that meet custom organization goals. Read more about their Group Benefits Plans or contact them today to get started!