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1. What information is required by ClaimSecure to quote?
ClaimSecure requires the following to response to a Request For Quotation (RFQ):

• Name of the company
• Number of employees (single/family)
• Plan design
• Proposed implementation date
• List of ASO benefit lines required
  • Drug
  • Dental
  • Major medical
  • Hospital
  • Cost plus
  • Health spending account
• List of pooled benefits required
  • Out of country with trip duration
  • Drug stop loss with dollar attachment level
  • Health stop loss with dollar attachment level

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2. What is the minimum group size ClaimSecure will accept?
ClaimSecure's minimum group size is 25 primary certificates.

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3. What steps are required to implement a new group?

• Review plan design to identify any deviations
• Complete master application
• Determine division/unit breakout for reporting and invoicing
• Calculate and collect the deposit
• Receive an electronic logo, design health card, prepare a samples, and gain approval
• Load eligibility
• Complete applications for out of country and stop loss (if required)
• Determine services expectations (# of visits, call centre)
• Agree on invoice and payment frequency
• Agree on internet access requirements (reporting, eligibility maintenance)
• Issue implementation Kit 7-14 days prior to effective date (employee listing, health and travel cards, brochures)

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4. Does ClaimSecure charge for issuance of health cards?
Customized pay-direct cards, in ClaimSecure's standard format and colours, are included in the quoted claims processing fees. A family receives two cards, a single member one card and an overage dependent one card. The cost of replacement cards can be on a per card basis or can be included through an adjustment to the claims processing fee.

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5. How much lead-time is required to implement a new group?
If the contract involves health and dental claims adjudication, the Group Administration Department must have all completed documentation (i.e. eligibility, master application, logos, etc.) in hand a minimum of twenty-one (21) days prior to the effective date of the program. If the contract involves drug only, this timeline can be shortened to ten (10) days

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6. Who are ClaimSecure’s providers from Stop Loss and Out of Country coverage?
ClaimSecure stop loss and out of country re-insurance is underwritten by Royal & Sun Alliance Insurance Company of Canada and administered by Expert Travel Financial Security (E.T.F.S.) Inc., a member of the ETFS Financial Group.

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7. Does ClaimSecure adjudicate all lines of benefits?
ClaimSecure adjudicates claims for:

• Drugs (on-line real-time and paper)
• Dental (on-line real-time and paper)
• Major Medical
• Hospital
• Vision. (traditional or preferred provider)
• Cost Plus
• Health Spending Accounts

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8 . Does ClaimSecure provide booklets?
Yes, ClaimSecure does provide Health and Dental booklets on a fee for service basis. There is nominal set up fee required for each unique plan design, along with a competitive per unit cost. We also offer a competitive 10 business day turnaround time provided approvals and required signoffs are received in a timely manner. Please contact a ClaimSecure Sales representative to learn more about this and other unique services. Note: ClaimSecure requires payment in full to be received prior to booklets being developed.

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9. How does ClaimSecure accept eligibility data?
ClaimSecure prefers to accept eligibility electronically, but can also accept paper enrollment forms for smaller groups or if time permits. A charge may apply for paper enrollments.

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10. Does ClaimSecure have web-based and call-centre administration services?
ClaimSecure offers many web-based and call-centre administration services. They include:

• Personal information updates
• Enrollment status
• Plan design information
• Eligibility verification
• Claim forms
• Claim reports
• Claim inquiries
• Claim submission
• Health resource library

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11. How do I contact you?
For sales inquiries please call:

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12. Will ClaimSecure guarantee its rates for more than one year?
ClaimSecure will guarantee their health and dental ASO adjudication rates for a new client for three (3) years. The pooled benefits (out of country and stop loss) rates are reviewed annually.

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