Sirius Benefit Plans

Where Client Service is the Top Priority

Established in 1996 in Winnipeg, Sirius Benefit Plans is a national industry leading Third Party Administrator (TPA) and Third Party Payer (TPP) that administers the employee benefit programs of small and medium-sized companies, both private and public, from coast to coast.

The company, with 31 employees, administers more than $40 million in annual premiums. Sole owner and President Ed Melna came on board in 2004 with a minority ownership stake, at which time Sirius was still a very small company. However, there was a five-year plan that would see him take complete ownership. Today, with Melna guiding the way, the successful enterprise has business clients all across Canada, including the Niagara Region of southern Ontario where he grew up.

Throughout its 18-year history, Sirius Benefit Plans has continued to expand its presence while building a solid reputation as a noted leader within the industry.

“Back in 1996 we broke away from another national third-party administrator and third-party claims payer.” Melna explains.  They were administering two national associations and conflicts began to arise in balancing the plans, so it was decided to split the associations.  The new company, which was known as Association Group Marketing, had a primary objective to sell benefit plans to association groups.

“Most insurance companies really don’t like association programs,” Melna states. “They certainly don’t like start-ups because it’s time consuming. Also, most association groups don’t have the traditional ‘employer/employee’ relationship which most insurance companies want to see.”

Meanwhile Melna had been working at London Life in Toronto but had then been hired by Imperial Life to spearhead the opening of a group benefits office in Winnipeg.

“The first person I met was my ex-partner at Association Group Marketing ,” Melna says. “I got to know him then and we always kept in touch.”

A New Direction

There came a time when Melna’s ex-partner wanted a qualified professional to come in and take the reins of the business. By this time, Melna had moved on from Imperial Life and joined Manulife Financial where he was tasked with carrying out the duties of regional manager. He says it took many people by surprise when he left such a great position behind to take a calculated risk and branch out on his own.

“I knew that I wanted to get out and do something on my own,” he notes. “There were many mergers and acquisitions going on with the result being a number of people I knew ending up on the short end of the stick of those M&As and I wasn’t going to allow that to happen to me. I’d rather rely on myself; that way if I fail, it’s my own fault as opposed to someone pulling the rug from under me.”

At the time, it took a lot of courage and a huge leap of faith, but the gutsy decision has certainly paid off for Melna, who has succeeded in cultivating the growth of his company by leaps and bounds during his 10 years with Sirius. After five years of hard work, Melna became sole owner of Sirius Benefit Plans in March 2010, buying out his ex-partner.

It was right around the same time when Melna took over complete ownership of Sirius that the company moved into its new building, which is also owned by Melna.  In many ways it provided a parallel in terms of fresh starts.

“It’s a trust and relationship business,” Melna remarks. “There are a lot of third-party administrators out there, but there aren’t a lot that are also third-party claim payers, which is what we are. In the eyes of the client, we are the insurer. We’re not the insurance company and we’re not the broker but from the start to the end of the service cycle for the client we do everything. We do the billing, we collect their premiums and all their administration including booklets and drug cards.”

Client Satisfaction

In dealing with Sirius Benefit Plans, the wording within a client’s policy mentions who the insurance company is, but the client usually never deals with the insurance company itself, but rather with a representative from Sirius. This is viewed as a major advantage for clients, who quite often don’t want to have to deal with aggravations associated with many large insurance companies and the inevitable queue awaiting them for service. Frustration may stem from a combination of long wait times on the telephone to poorly trained individuals in the customer service departments.

“Everyone always says bigger is better, but I always laugh and joke because since I’m about 6’8” and 300lbs I say bigger is better, but from a business perspective it’s not,” Melna chuckles.  “At Sirius we try to make it more of a personal experience and build relationships with the clients and their employees and make it comfortable for them to be able to call and ask about their benefit program.”

Sherri Norris-Dyck, Sirius’ Director of Client Services, adds, “Unlike a conventional call centre, the client  and employees may call in and select an extension or a department and they will receive personal service from one of Sirius’ experienced staff members.  As well, our teams work closely together to provide a high level of support to our clients.

Where insurance companies can lose site of the end client, we are able to respond quickly, adapt to a firm’s specific needs and always strive to exceed their expectations.”
Melna notes that once his company is able to convince someone to take the leap of faith by leaving the big providers they soon realize how much better service they can get with a company such as Sirius Benefit Plans. And excellent service is something Melna assures, no matter the company’s size.

“Regardless of whether it’s a 10-life group or a 100-life group, we’re going to treat them the same,” Melna promises.  “We’re smaller and a drop in the bucket to those big carriers, but clients and their employees will get a much better service experience with us.”

Changes in the Industry

Starting his professional career in this business back in 1990, Melna says he can recall that very few companies in this sector did business with companies who had less than 10 employees. That’s when a vast majority of the pooled association plans were assembled in an effort to help small business because they simply  couldn’t afford benefits on their own.

“We still do that today and it’s a big part of our business, serving companies with less than 10 employees,” Melna proudly states.  “But today, and over the years, every single insurer that is still doing group insurance is now in the under-10 business.”

Fact of the matter is that there are more small businesses in Canada with less than 50 people than there are the larger companies, and all those smaller businesses add up to millions of employees. It’s often said small business is the engine that runs our nation’s economy, which is quite accurate. The other negative about dealing with larger companies is the profit margins are razor thin, especially once you get beyond the 100 employee threshold.

“The carriers have to hope to make money on the life insurance and disability benefits,” Melna reveals. The competition to land those large companies as clients can be fierce and often results in fighting for half a percentage or a quarter of a point here and there.

As with all businesses, hiring the proper employees is crucial to success. Melna says he’s fortunate to be embedded in a high-quality hub of insurance professionals in Winnipeg.  “People often get lost in big companies,” Melna replies. “We hire a lot of claims adjudicators and group administrators from the insurance companies, because they like our philosophy of quality over quantity. Because of the sheer volumes of those bigger companies they have to process so many claims each hour. That’s not necessarily the best thing to be doing because errors may occur.”

When a job opening comes up with our company we are able to fill it immediately,” Melna emphasizes. “We also cross train everybody here so everyone knows how to pay health claims, dental claims – everything.”

At larger companies it is not uncommon for employees to have been stuck doing the exact same job for 15 years or more, yet they are completely unaware of how to expedite other parts of the insurance business, such as hospital claims or out of country claims, for example.  At Sirius, each employee is exceptionally diversified in their knowledge base.  Variety, it’s often said, is the spice of life.  It also comes in very handy during staff vacations or if an employee is off sick. There’s no problem at all slotting another employee seamlessly into that role at Sirius.

Top-notch Client Services

Despite being headquartered in Winnipeg, Melna reveals that the biggest pocket of corporate business for Sirius is British Columbia. Ontario and Manitoba are not far behind, followed by Alberta and then it’s back to the eastern Maritime provinces, where the company has recognized significant growth in recent years and the trend continues into 2014.

“We deal with a select group of brokers across Canada,” Melna says. “I don’t want to deal with just anybody who’s got a licence and a pulse. We don’t want a client for the wrong reasons. I choose my brokers first, because at the end of the day it’s the broker’s clients that we’re serving. The philosophies need to match so we have a long-term relationship.”

Kim Comeault, Manager of New Business and Renewal Pricing, has been with Sirius for 9 years. Kim agrees that the broker relationship is important and adds, “We strive to build a solid relationship with our brokers.  We work closely with them on pricing their clients’ rates as competitively as possible in the marketplace.  This fosters a long-term relationship built on respect and mutual success.”

As a third-party administrator and payer, Sirius Benefit Plans does virtually all the leg work from start to finish throughout the process for each of the small and medium-sized businesses they serve.  That includes billing, collecting the premiums, daily administration requirements such as addition or subtraction of employees or changes in marital status; all the record keeping on behalf of the insurance companies.  Sirius also adjudicates all Extended Health Care and Dental claims, and facilitates the Life Insurance and Disability claims for the client.

“We have third-party administrator agreements with various insurance companies,” adds Sandra Miller, who is the Director of Corporate Initiatives at Sirius. “These agreements place all the responsibility on us for the management of the program and the adjudication of claims.  It is a responsibility we take seriously; it is a trust that is given to us based on our experience and expertise.”

Because Sirius Benefit Plans holds all the information regarding a company’s policy, and also deals with about six different insurance companies, making a move from one insurance company to another is completely seamless. Most often it will be dissatisfaction with rates being charged that will precipitate a desire for change.   “We can shop the market for them and move them to another insurance company and they (the client) don’t have to fill out any forms because we’ve already got all the information,” Melna asserts.

Technology also plays an important role in Sirius’ ability to service their clients.  They have a proprietary web based administration system that they designed several years ago.  The system is consistently undergoing enhancements, which enables Sirius to adapt and respond to the clients’ and the marketplace’s changing needs.  They utilize the Symbility Solutions claims system, which is also web based.  This system provides them with real time electronic processing of claims, as well as a mobile app feature and online claims access for employees.

The noticeable increase in success at Sirius has been quite evident. Looking into the future Melna  envisions intelligent, quantified strategic growth and creating additional alliances with brokers who have developed proven and established benefit businesses and who also carry the same corporate philosophies.
So what is the main attribute that differentiates Sirius from its competitors?

“I say with all confidence, it’s just service,” Melna replies. “Getting the proper service that a client should get and deserve. It’s all about the personal touch.”
It seems like a simple enough recipe, but making it actionable is something that Sirius Benefit Plans has proven it does more effectively and efficiently than any of its competitors.