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About Claims Administration

One of HBT’s core responsibilities is to ensure employees who file a claim receive Health Benefits in a reliable and timely manner. For neutrality and optimal efficiency HBT outsources the claims adjudication process to reliable third parties: Canada Life for Long Term Disability (LTD) Benefits and Pacific Blue Cross (PBC) for Extended Health and Dental Benefits.

HBT in turn administers all services provided by Canada Life and PBC to ensure consistent, best-in-class service delivery at the lowest reasonable cost.

HBT pays for all Benefit services provided by Canada Life and PBC using funds held in the Trust. These funds are provided through a combination of employer/employee contributions and investment income. HBT holds a reserve fund in the Trust to cover all claims liability.

Managing Claims Costs

HBT works proactively with our member organizations to maintain or reduce the cost of claims. We focus our efforts on three primary areas:

  • Plan Design
  • Contribution Rates
  • Claims Adjudication Costs

Plan Design

A direct reduction in claim costs can be achieved through careful Benefit Plan design. This could include a number of options ranging from minor changes to a major re-design of the Plan.

HBT works closely with employers to provide expert guidance in the design of cost-effective Benefit Plans. We also develop standardized Benefit Plans that take into consideration market trends, claims cost drivers and employee needs.

To discuss or review your Benefit Plan design, contact us at 604.736.2087 or toll free at 1.888.736.2087 and ask to talk with one of our Client Consultants in Benefit Administration.

Contribution Rates

In 2011, HBT implemented a new contribution rate policy to more equitably set annual contribution rates. The new policy better aligns rates with the expected cost of claims for each employer; while still retaining the benefit of the Trust’s pooling and collective purchasing power.

Contribution rates are determined for each employer specifically by factoring in their own unique claims experience, employee demographics and Benefit Plan design. This means employers with good claims experience will have lower contribution rates than those with poor claims experience.

Claims Adjudication Costs

Every year, on January 1 HBT re-negotiates the terms and conditions of our Claims Adjudication Service Agreement with Pacific Blue Cross (PBC) and Canada Life to ensure the best possible rates and conditions for members and their employees. The Claims Adjudication Service Agreements go to tender every five to seven years.

The direct costs of claims (drugs, services and treatments) are monitored on an ongoing basis and HBT works in collaboration with both PBC and Canada Life to develop claims cost containment strategies.

HBT also works very closely with PBC and Canada Life to ensure their adjudication process is highly efficient while maintaining the highest service standards for members and their employees.