ClaimSecure has developed extensive expertise and capabilities in the following
key plan design areas:
Pharmacy and Dental Provider network management
Complex plan designs:
Sliding or tiered co pay and annual deductibles
Ingredient cost based on reasonable and customary levels
Customized formulary creation and maintenance by qualified pharmacists including national and provincial drug plan formularies
Varied dental fee guide options (current, specific year or current minus “x” years)
Grouping of dental categories (Basic, Major, Ortho) with variable maximums, deductibles, time definitions
Usual and customary price verification on EHC claims
Vision Preferred Provider Network - offering enhanced benefits to the plan members while providing effective cost containment and reporting to the plan sponsor
Flexible benefit plans
Health Service Spending Accounts (HSSA)
A comprehensive “billing” and invoicing system - designed to offer a “one-stop” shopping approach. This provides such features as:
Wallet certificates
Monthly premium billing statements
Claims management services
Life and disability plan administration and premium remittance
