Health Benefits Systems

Solution Summary for C-DAT Health Benefits Admin System v3

  • On premise installations or hosted solution
  • Latest in enterprise web technologies: ORACLE Database 11g R2, ORACLE Weblogic 11g R1, compatible with ORACLE Solaris 11 or Oracle Solaris 11 Express, ORACLE Linux 5.5 and higher, and Microsoft Server 2008 and higher. Benefits include highly scalable, flexible and secure environment with powerful business analytics and ad hoc reporting capabilities.
  • Complete and seamless integration with either pension or health benefits administration application and web-based management system (web platform members and employers access)
  • Integration capabilities with 3rd party applications including accounting, payroll, HR.

Manage. Process. Pay.

Managing and processing yards of data is serious business; especially when the data relates to a family's health. Your administration system needs to act fast and produce exact results. We work closely and collaboratively with our clients to build a system that supports your work processes.

Sometimes data entered is inaccurate resulting in inaccurate information output. Our Benefits System provides control measures helping the user catch inaccuracies, whether these errors are user or Employer generated.

We are always building upon our past installations. With over half a dozen Health Benefits System installations over the past 10 years, our production standards have consistently improved. This means better software powering your administration.

A Total Health Benefits System

Our full cycle Health Benefits System starts with the everyday administration tasks through to the adjudication of all benefits including:

  • Dental
  • Extended Health
  • Weekly Indemnity (Short Term Disability)
  • Long Term Disability

Health Benefits Plan Administration

  Member Data Maintenance Maintenance of all data relating to the Member and their Dependents
  Establishing Eligibility Establishing member eligibility based on plan rules. Examples include hours-based, salary-based, or contributions-based.
  Employer Data Maintenance Maintenance of all data relating to the Employer including contribution rates, contacts, outstanding balances
  Accounting All accounting processes including invoicing, receipt of cash, funds deposits
  Ad Hoc Reports Produce any number of ad hoc reports through running a data request selecting only those fields you wish to analyze.
  Monthly Reports Standard set of monthly reports including Invoice reports, remittance reports, register reports
  Expense Cheque Writing Module Organize and automate cheque writing by following a few simple steps
  Bank reconciliation Reconcile with your bank or custodian's bank records
  T4A processing Process T4A forms for taxable benefits right from the Administration Program Screen

Health Benefits Adjudication

  Dental Dental and Denturists Fee Guides for up to 26 different jurisdictions

Claims paid to Member, or Dentist

Pre-Authorizations

Integration with Co-ordination of Benefits

Reserve Analysis

Dental Statistics

Cheque payment or Electronic Funds Transfer to Dentist or Member
  Extended   Health Drug Card option (currently interfaced with ESI Canada)

Co-ordination of Benefits

All Extended Health benefits as dictated by Plan rules

Reserve Analysis

Extended Health Statistics
  Weekly Indemnity Cheques issued on a weekly or bi-weekly basis according to plan rules

Reserve analysis

Statistical analysis
  Long Term Disability Cheques, or EFT payment

Established from WI Claim

Reserve Analysis

Statistical analysis

Contact Us to discuss your unique challenges.