Growth Strategy

The SEB group of companies has very unique features.  The Benefits Division owns a complete technology environment for managing group benefits processes including claims processing.  This includes a fully-integrated administration – adjudication – claims billing/paying – reporting environment.  Various modules can be used on a standalone basis or as a fully-integrated system.  The “holy grail” of this technology environment is the rules based adjudication platform.  With over 1,000 preprogrammed rules objects, administrators, not programmers, can create an infinite number of very detailed and complex rules which can immediately be integrated into the adjudication engine and administration environments.

Additionally, SEB continues to enhance a very comprehensive fully-integrated administration, adjudication, billing/payment and reporting environment that will provide group benefit clients solutions and services not otherwise available in the marketplace today.

SEB’s roots are in technology.  Emphasis has been on adapting technology to client environments. While group benefit environments are a major focus of SEB, the technology is equally applicable in managing other health claims and processing environments.

The total healthcare claims processing environment in Canada is in excess of $60.0 billion with $37.0 billion of premiums in employee group benefits and over $25.0 billion in government sponsored benefits.

Client

SEB’s Client Acquisition Strategy is initially via acquisition, and then organic via transitioning of the clients to the fully integrated SEB technology platform. The result is the capture of service dollars that are currently being spent on multiple service providers, (including for administration, adjudication, claims billing/paying and reporting).  The increase in revenue over a typical TPA environment, as a result of consolidation of services to one technology provider/platform, is up to 700% depending on the client.  Technology solutions in the market today are not only extremely fragmented, but run on old technologies.  SEB’s technology platform provides the most flexible and automated administration and adjudication system in the industry today.  The key attributes of the technology are:

  • Rules Based Adjudication in one technology environment for all benefit types versus the industry norm of multiple environments. Rules creation is an administration, not a programming exercise.  Rules can be implemented on both an individual and group basis and by detailed benefit.
  • A fully integrated technology environment that is the most automated in the industry and is able to implement and adjudicate the most detailed and flexible group benefit plan designs in the industry.
  • Administration software that is seamlessly integrated with adjudication, payment processing and reporting.  Enhances efficiency for all users. Unique in the industry.  Can be deployed as a module.
  • Reporting is the most detailed in the industry and the only platform with self service functionality including real time access to standard reports and data mining capability for customized reports.
Acquisition

Three groups are targeted for acquisition/investment:

  1. Third Party Administrators (TPAs - Acquire 50% to 100%) 
  2. Consultants/Brokers (Minority Investments)
  3. Technology/Healthcare Service Providers (Acquire 50% – 100%)

There are dozens of TPA environments in Canada, hundreds of brokers/consultants and dozens of technology/healthcare service providers that fit into the SEB acquisition/investment business model.

A summary of the SEB Growth Strategy is as follows:

  1. Acquisition/Investments:  make Acquisitions/Investments that result in “control of, or influence over where client service provider dollars are spent.”
  2. Organic:  transition the above clients from “multiple service supplier environments” to “one SEB fully-integrated environment”.

SEB operates a “Services Business Model” enabled with a technology backbone that will cause major structural changes in targeted segments of the insurance and healthcare business such as employee group benefits and government funded health benefits.