Medical insurance fraud widespread, as employees, providers rip off benefit plans

I know I can sound like a broker record, but fraud keeps showing up in plans.  If it is large enough or widespread enough in an organization, we can often identify, flag it, and offer suggestions to stop it.  BUT, in many cases smaller levels (that still add up) can fly under our radar.

Recently we have seen some providers take advantage of employees and that is the reason we are raising awareness.  We hope your staff know better, but don’t want them being involved in an investigation, loss of their benefits, or being charged with fraud, and hope this education will help.


Can an employee be terminated while on disability?

A good article on what happens when staff are off for a prolonged absence.

The question of whether an employee can be terminated while on disability is a common concern, especially if there’s a chance the claimant’s impairment or illness may not be permanent but likely to persist into the indefinite future. Unfortunately, the answer can be complicated and sometimes difficult to understand for both disability claimants and employers.


Ontario Employment Standards Act Changes

Please see the following Bill 47 update – changes to the Ontario Employment Standards Act, 2000 receiving Royal Assent.

This provides a quick list of the changes in employment law that will take effect January 1 2019.

On November 21, 2018, Bill 47, the Making Ontario Open for Business Act, passed third reading and received Royal Assent.

With respect to the Employment Standards Act, 2000, there were no further changes to the version of Bill 47 that was introduced in the Legislature on October 23, 2017. The only item that has now been clarified is that many of the changes will take effect on January 1, 2019, as was anticipated. This date is significant for a number of reasons:



An interesting article on “dependent contractors”.  Whether the person(or company) is deemed an “independent contractor”, a “dependent contractor” or a “personal service business”, employers need to make sure that both parties are clear on what they are. Obtaining good advice on the structure they choose is the key to avoiding larger and more expensive problems for both parties.

Employers are generally familiar with the distinction between an employee and an independent contractor.  A third category of worker, known as the “dependent contractor”, is beginning to be more widely recognized by Canadian courts…


Articles like these may have unintended consequences

I always see red when I read articles like these.  They encourage employee to “use up” their coverage with total disregard to their employer that is paying the bill.

Would someone suggest claiming against any other insurance to avoid “wasting money”?  Would someone make that minor car insurance claim each year for the shopping cart ding or minor scrape?  Likely not, unless you are good with your rates skyrocketing.  So why is it okay here?

An employee benefit plan is a perq that good employers provide (and should be used that way), not as a way to get more from an insurer (that isn’t really paying).

I pay for benefits monthly and I’ll be damned if I’m going to miss my opportunity to squeeze the most from them. Otherwise, it’s wasted money.