An SEB company
The Group Benefits industry in Canada is dominated by approximately ten major insurance companies, three of which control approximately 67% of the estimated $31.2 billion of premiums spent in 2010. Over 95% of all claims processed are health and dental, all of which require input into an adjudication environment, either via on-line (in case of drugs and dental) or manual (in case of massages, vision, etc). Six adjudication technology platforms are present in the industry of which two have dominated. In both, the adjudication technology platforms use older software operating in a mainframe environment, have difficult interfaces, and are unwieldy to change and customization.
TPAs participate in an estimated 13% of the Group Benefits industry, providing varying degrees of administrative services, but typically have no adjudication capability. SES is unique in that it owns the entirety of its administration, reporting and adjudication technology, providing it with a superior opportunity to participate in all major profit centers of the insurance industry, along with the capability to provide optimum flexibility on plan design and service to Group Benefits clients. SES can also offer turn-key solutions to joint venture partners.
SES’s objective is to acquire within its fully integrated technology environment, a benchmark up to 13% of premium revenues to manage the complete group benefits supply chain processes between client, broker and the Insurer.
To visit this SEB Brand: SES Benefits Website