RWAM Plan Administrator

Handle the day-to-day administration of benefits for your employees and access the reports you need to manage your benefit plan online. RWAM’s easy-to-use online Plan Administrator Services works in real-time and allows you to electronically manage your account on both the individual and the group level.  RWAM Plan Administrator Services is available for Groups with 10 lives or more. This service does not provide access to employee / member confidential claims information.

Expedite the Required Reporting of Changes

Process individual employee transactions:

Add new employees
Terminate an employee's coverage
Transfer employees between divisions
Update your employees' coverage, insurable earnings & hours worked

Note: Original, signed, hard copy enrolment / beneficiary change forms must be mailed to RWAM if your employee’s benefits require a beneficiary designation.  The employee’s signature on the enrolment / beneficiary change form must be in ink.On a group level, you can manage your benefit plan with access to several reports:

Benefits Confirmation Report
Monthly Billing Report
Certificate Listing Report
Signature Pending Report

You have a number of responsibilities related to the procedures and duties of administering your group insurance benefits plan, including required reporting to RWAM of changes which may affect benefit coverage.

Electronic Billing

Receive your monthly invoices electronically to your email inbox.  Electronic billing means you are never inconvenienced by postal mail delays and allows you to make timely remittances, ensuring your Group Benefits Plan remains in good standing.

Simply submit the Electronic Billing Registration online form or Contact Us to register for Electronic Billing.

Pre-Authorized Debit (PAD)

Convenient Pre-Authorized Debit of your monthly invoiced premium is also available.  Simply return the Pre-Authorized Debit form to us to enrol.

Simplify your benefits administration.

Encourage your employees to manage their own profile information using RWAM Plam Member Service

With Plan Member Services, employees can:

Update their mailing address, email address, and direct deposit banking information
Submit health and dental claims online
Download their Employee Benefit Booklet, print a replacement OneCard, and more

Learn more about RWAM Plan Member Services by visiting the Plan Members eServices page. Encourage your employees to register on the RWAM Plan Member Services website for online self-service access to their RWAM benefits.

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Video tutorials and helpful resources for RWAM Plan Administrator and RWAM Plan Members to help understand and manage your benefit plan online

RWAM Plan Member Services

Video tutorials and helpful resources for RWAM Plan Administrator and RWAM Plan Members to help understand and manage your benefit plan online

RWAM Mobile App Video

Discover the Benefits of the RWAM Mobile App.

FAQ:

Helping to Simplify the Process for Plan Administrators

We understand that managing claims, administrative, and disability issues can be confusing. We are here to help and have detailed some of the more frequently asked questions and subsequent answers. If you require additional assistance, please do not hesitate to contact RWAM directly.
Please note these frequently asked questions contain general information only, are subject to change, and may not apply to your specific situation. Your Employee Benefits Booklet outlines the specific coverages associated with your group plan as well as any requirements and exclusions specific to your plan.

01 Why do I need to submit the original enrolment if it has already been faxed?

For groups that have Life and/or AD&D coverage, in the event of a death claim, our carriers require the original enrolment form.  RWAM will make attempts to collect the original enrolment form.  If we cannot provide the original to our insurance carrier, there may be delays in the processing of the claim and the possibility of the proceeds being paid to the Estate rather than the intended beneficiary.

02 Coordination of Benefits - when more than one benefit plan exists, to which plan should I submit claims?

You should submit your claim to your own Insurer first (primary carrier). Your spouse should submit to his/her carrier. Claims for dependent children must be submitted to the plan of the parent with the earlier birth date in the calendar year. If the parents have the same birth date, then submit the claim to the plan of the parent whose first name begins with the earlier letter in the alphabet. This is referred to as Coordination of Benefits (COB). If you will be coordinating claims please complete the Coordination of Benefits form available on our Forms page. If any portion of a claim is not covered/paid by the primary carrier, the claim for the balance of expenses should be sent to the secondary carrier for consideration (the amount reimbursed cannot exceed 100% of allowable expenses). In situations where parents are separated / divorced, then the following order applies: 1) the plan of the parent with custody of the child; 2) the plan of the spouse of the parent with custody of the child; 3) the plan of the parent not having custody of the child; and 4) the plan of the spouse to the parent in item (3). Take photocopies of your claim and receipts. Submit your claim to your Insurer based on the above criteria. Once you receive your cheque and Explanation of Benefits (EOB) statement, complete a new claim form for the other carrier. Attach the EOB statement with photocopies of your original claim. Submit this information to the coordinating plan (your spouse's).

03 Can I cover my spouse and dependent children?

Depending on the benefits offered through your group plan, you may be eligible to elect family coverage. Your Employee Benefits Booklet contains detailed information as to spousal and dependent child eligibility requirements. Most plans allow for an extension of coverage for a dependent child over age 21 who qualifies as a full-time student. If you have a dependent child with a mental or physical disability, or any other special circumstances, please contact your Group Plan Administrator or RWAM Group Administration to determine if coverage is available or can be extended.

04 What does Non-Evidence Maximum (NEM) refer to?

Certain benefits (such as Life, Accidental Death & Dismemberment, and Disability coverage) may be wage-related. A Non-Evidence Maximum (NEM) refers to the maximum amount of insurance coverage which may be available to an eligible insured person without having to provide medical evidence of health (Evidence of Insurability). If a NEM applies to a particular benefit under your group plan, the NEM amount will be stated in your Employee Benefits Booklet on the applicable 'Schedule of Benefits' page. For some group plan benefits without a specified NEM, mandatory Evidence of Insurability may need to be provided. Check with your Group Plan Administrator. You should review your coverage regularly, especially if your salary increases, to determine if you are eligible to apply for additional coverage beyond the NEM.  Coverage approved over and above the NEM will be subject to an overall maximum coverage amount, stated on the 'Schedule of Benefits' page of your Employee Benefits Booklet.  If you are uncertain or have any questions about your eligibility, contact your Group Plan Administrator or RWAM Group Administration.

05 How do I apply for additional coverage over the Non-Evidence Maximum (NEM), assuming I'm eligible to do so?

You must complete and submit a Group Health Evidence form (also known as Evidence of Insurability) to RWAM for additional coverage over and above the Non-Evidence Maximum (NEM). Please ensure that the correct insurance carrier's form is submitted (providers are listed at the back of your Employee Benefits Booklet). Health evidence forms for the various insurance carriers are available on our Forms page.

06 Do I need to report changes in my personal status?

Yes. You should contact either your Group Plan Administrator or RWAM Group Administration directly to report any changes in your personal status or life circumstances which might affect your coverage, including:

 

  • Marital status (divorce, marriage, separation, common-law)
  • Changes in your name or that of your dependent(s)
  • Birth of a child, adoption, student coverage, disabled child


Whenever you have a major life change, it is advisable for you to review your beneficiary designation to see if it is up to date and reflects your current wishes. Refer to your Employee Benefits Booklet for more information under the heading 'Changes Affecting Your Coverage'.

07 I'm leaving my employer and will no longer have any group Life, Health and/or Dental insurance. What options are available to me?

If your group Life insurance coverage is being terminated because your employment has terminated or you are no longer eligible for group insurance coverage, you may be entitled to convert your existing group Life coverage to an individual Life insurance policy. To convert group Life coverage to an individual policy, you must apply to the Insurer (via RWAM) within 31 days after the date your group Life coverage terminates. You should contact RWAM's Group Life Insurance Department immediately for information and necessary forms.

With group Health and/or Dental insurance, you may be eligible to convert your coverage to an individual plan. This must be done within 60 days of the applicable termination date. Please contact RWAM's Group Accounting Department for further information.


For Out-of-Province/Out-of-Canada options, please call SecuriGlobe directly at 1-844-370-2065.  SecuriGlobe has access to 14 different carriers to obtain the best possible rate for an individual or family, depending on their specific needs.  Single and multi-trip annual emergency medical plans are offered, along with trip cancellation, trip interruption, snowbird, sport travel and special risk coverage.

08 Who is eligible for group insurance coverage?

To be deemed eligible, an employee must:  
  • Be actively working
  • Be employed by your company on a permanent basis
  • Work the required minimum number of hours per week on a regular basis (as specified in the Employee Benefits Booklet).  RWAM does not determine eligibility if an employee is part-time or full-time but on the number of hours worked per week.
  • Complete the waiting period (as specified in the Employee Benefits Booklet)
  • Belong to a division and class of employees eligible for your plan, and
  • Be insured under a provincial government health plan and reside in Canada
 

09 When is an employee eligible for benefits?

According to your group insurance contract, employees are eligible for coverage as of a specific timeframe chosen by the employer. This is referred to as the waiting period. A waiting period must be completed with continuous employment or can be waived within 31 days of the employee's permanent full-time hire date as a condition of employment. An employee cannot serve a partial waiting period. A waiting period for group insurance coverage is separate from a probationary period for employment purposes.

10 What is the difference between issue date and effective date on my RWAM OneCard?

The issue date that appears on the front of your RWAM OneCard is the date that the card was printed. Please check with your Group Plan Administrator to confirm the date your coverage is effective.

11 What is the difference between 'Refusal' vs. 'Waiving' of benefits?

You may waive Extended Health Care and/or Dental benefits if you are currently covered under your spouse's or common-law spouse's plan. You are still eligible for any other benefits your group plan may have (i.e. Life insurance and Disability insurance, if applicable).

A refusal of all coverage is discouraged, as a certain level of participation of eligible employees must be met. In some cases, you may have the option to refuse all coverage but cannot choose some benefits and refuse others. If you refuse all coverage, you can apply for coverage in the future but health evidence will be required. You should not refuse coverage solely because you are covered for comparable Extended Health Care and/or Dental benefits under your spouse's plan.

12 How are severance/benefit extensions handled?

Employers must contact RWAM's Group Administration Department before negotiating or committing to any severance package that includes any offer to extend group insurance coverage.Coverage extensions outside the provisions of the insurance contract, which do not receive prior written approval by RWAM and/or the insurer, will not be honoured if a claim arises and the employer essentially can be held responsible for these benefits.Generally RWAM adheres to the current applicable provincial minimum Employment Standards rules. However, after RWAM's consultation with the insurer, consideration may be given to written requests to extend certain benefits beyond the group insurance contractual terms and/or minimum Employment Standard rules.

13 When should I advise RWAM of a change in an employee's insurable earnings or a change in their hours worked?

Employers are responsible for the prompt reporting and updating of each employee's insurable earnings to RWAM, so that benefit coverage is kept current, and if applicable, increased to the maximum allowable.  RWAM requires:
  • The effective date of the change in earnings
  • The new earnings rate (excluding any bonuses, overtime pay, dividends, expense allowances or other extra compensation)
  • Any increase or decrease in earnings due to a change in hours worked per week, or for any other reason

15 What type of group is eligible for RWAM Online Administration using the Plan Administrator Services website?

RWAM encourages online administration for groups over 10 employees. Typically, there are more opportunities to use the online system for larger groups to add new employees, terminate coverage, amend salary, or coverage changes. Of course, changes can still be submitted to RWAM manually for processing.