When someone knowingly lies or falsifies information to obtain a benefit to which they are not entitled, they have committed fraud. This can include intentionally providing false information to ensure the payment of a claim, withholding information that would affect the payment of a claim, or submitting a fictitious claim.

Fraud hurts all plan members. Group plan funds are held in trust to ensure they are used only for the health and wellbeing of Saskatchewan’s health-care workers. Some aspects of the plans are fully paid by the employers, while others are cost shared between employers and employees. Whether intentional or inadvertent, when someone commits fraud they are not harming a big company, they are misusing funds paid for and meant for themselves, their co-workers, and their employer.

All incidents of fraud, suspicious activity, or other irregularities will be investigated. Police services may be contacted, and fraud cases will be reported to the employer and union, which could lead to disciplinary action.

You can do your part to protect your Employee Benefit Plans by double-checking the information you provide is accurate. To prevent investigation, we recommend:

• Reviewing your plan commentary booklet to fully understand your benefits;
• You are responsible for the information you submit, so review your forms and receipts to make sure everything is correct;
• Do not give a provider pre-signed claim forms, never alter or change a receipt, and keep your plan number and benefit ID secure; and
• Report suspicious situations by calling the Canada Life tip line at 1.866.810.8477.

If you have questions about your benefit plan, call 3sHealth at 1.866.278.2301 or email ebp@3sHealth.ca.