Cost management

Discover our solutions to keep your employees and organization healthy.

Disability management

When employees have to miss work, for however long, it affects your bottom line. We've got solutions to help employees stay at work and reduce the impact of an absence.

Disability management program

The longer an employee is away from work, the less likely they are to return. We evaluate factors that can influence a disability so we can coordinate a lasting return to work.

We assign you an experienced team.
We step in at the right moment.
We adapt our strategies to your situation.

Disability management advisory services

If you've chosen to keep short-term disability benefit payments in-house, our advisory services can be very helpful.

From the first days of an employee's absence, we can:

Evaluate the employee's situation
Estimate how long they'll be off work
Create an action plan
Put them in touch with our medical or paramedical experts and treatment providers to get them back to work as soon as possible
Set up talks with you, your employee and their attending physician to help them get back to work

Drug cost management

We offer a number of drug cost management solutions. Note that most require a payment card.

Good to know

Some solutions are included in our prescription drug coverage, while others are offered as add-ons. For more information, talk to your group insurance representative.

Plan member education

It's important for plan members to understand the impact their drug purchase decisions have on plan costs. So we put together some tips on how they can keep drug costs down.

Drug utilization review program

With this program, pharmacists can identify possible irregularities with a prescription before they fill it.

For example:

Dangerous drug interactions
Repeat drug purchases at multiple pharmacies
Improper use of a drug (including overuse)
Inappropriate supply

Can reduce drug claim costs by 2% to 3%. 1

Integration programs

Ensures that your plan doesn't pay for drugs that should be covered by a provincial or hospital plan.

Can reduce drug claim costs by 1% to 2%. 2

Prior authorization program

Ensures that plan members receive the most suitable and cost-effective treatment.

Can reduce drug claim costs by 1% to 2%. 1

Generic substitution

Generic drugs can cost between 35% and 70% less than their brand name equivalents.

So we recommend making generic substitution mandatory. This means reimbursements are calculated based on the cost of the least expensive generic equivalent available.

Can reduce drug claim costs by up to 4% (if combined with a pharmacy mark-up and dispensing fee cap). 1

Tiered plan with dynamic therapeutic formulary

This plan offers 2 levels of reimbursement for prescription drugs. This encourages plan members to choose equally effective, lower-cost drugs while ensuring they still have access to other prescription drugs covered by their plan.

Can reduce drug claim costs by up to 7%. 1

Active Pharmacy

Maintenance drugs for chronic diseases such as asthma, diabetes, high cholesterol and high blood pressure account for more than 50% of drug claims.

Active Pharmacy can reduce maintenance drug expenses by encouraging plan members to make more cost-effective choices.

Can reduce maintenance drug expenses by up to 10%.

This solution is not available in Quebec.

Patient support program for specialty drugs

This program is designed to make things easier for plan members with complex illnesses. It brings together all the services they might need to deal with their condition and achieve the best possible treatment results. It also gives them confidential telephone access to a pharmacist, 24/7.

As well as making patients' lives easier, this program:

Improves treatment adherence and productivity
Reduces absenteeism
Lowers the risk of disability

This solution is not available in Quebec.

Drug cost simulator and pharmacy price finder

This tool is available on the secure site and the Omni app. It shows plan members how drug prices can vary and promotes the use of generic drugs.

Fraud prevention

Fraud and abuse in the healthcare sector result in financial losses that can lead to higher premiums.

That's why fraud and abuse prevention is a key part of our quality assurance program. We make sure that:

You only pay for services that were actually provided
Invoiced amounts are reasonable
Services or drugs prescribed are necessary

To report fraud or abuse confidentially and anonymously, call us at 1-866-692-7227 Phone number to report fraud or abuse. This link opens your phone app..