Use your vision care maximum Find what you’re looking for on … · Find what you’re looking...

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Find what you’re looking for on 3sHealth.ca Accessing your benefit plan booklets, claim forms, and answers to the most frequently asked questions is just a couple of clicks away. Go to www.3sHealth.ca. Click on the ‘Employee Benefits’ square. Click on the ‘Your Benefits at a Glance’ square. Select the union group you belong to. You will see sections on the Group Life Insurance Plan, the Long-term Disability Plan, and the Extended Health Care and Dental Plan for your union group. You will then see the most up-to-date plan booklet, which provides general plan information and what you need to know to get the most out of your benefits. The Extended Health Care and Dental Plan sections also include links that will take you to the: • Travel Assist Booklet for out-of-country medical emergency coverage • Extended Health Claim Form • Dental Claim Form • Great West-Life GroupNet for Plan Members • Answers to frequently asked questions, such as: • How can I update my personal information? • How much does the life insurance cost? • Who can I name as beneficiary for my life insurance? • How much disability coverage do I have? • What if I need to make a claim for disability benefits? • How do I sign up for direct deposit for claim reimbursements? The following schedule illustrates the pro-rated maximum amount for laser eye surgery, based on the reimbursement percentage that applies to you: If your reimbursement Your maximum percentage is: amount is: 100% $600 70% $420 60% $360 50% $300 Here are a couple of scenarios to help illustrate how the laser eye surgery benefit works: 100 per cent reimbursement level: • Your last purchase of glasses was on May 1, 2015 and you were reimbursed the full vision care benefit of $300. You are scheduled for laser eye surgery on June 1, 2017 and can expect to receive: • The full laser eye surgery maximum of $600. You will next be eligible for your $300 vision care maximum to purchase glasses, sunglasses, or contact lenses on June 1, 2021. • Following the above example, if you were at a 60 per cent reimbursement level, you would expect to receive the pro-rated laser eye surgery maximum of $360. You will next be eligible for your $180 vision care maximum to purchase glasses, sunglasses, or contact lenses on June 1, 2021. • You bought contacts and used $125 of your $300 vision care maximum on May 1, 2016 and have elected to have laser eye surgery on June 1, 2017. You can expect to receive: • The pro-rated laser eye surgery maximum of $475. This includes the remaining $175 vision care benefit from your current vision care plan year’s maximum and $300 for the next year’s maximum. You will next be eligible for your full $300 vision care maximum and able to purchase glasses, sunglasses, or contact lenses on June 1, 2021. • Following the above example, if you were at a 60 per cent reimbursement level, you would expect to receive $235. This is the pro-rated maximum of $360 less the vision care amount already used of $125 for a total reimbursement of $235. You will next be eligible for your $180 vision care maximum to purchase glasses, sunglasses, or contact lenses on June 1, 2021. Use your vision care maximum for laser eye surgery Did you know you can chose to use your vision care maximum towards laser eye surgery? Laser eye surgery is allowed once per lifetime per person to a maximum of twice your vision care maximum. To receive reimbursement for laser eye surgery, you must have all or some of your current-year vision amount available. When you elect to have laser eye surgery reimbursed, you are exchanging four consecutive years of vision coverage and using it towards the laser eye surgery instead of purchasing prescription eyewear. If you do not have any funds remaining under your vision care maximum, then you will not be eligible for reimbursement of laser eye surgery. Customize your claim forms When you log in to the Great-West Life GroupNet for Plan Members website, you have the ability to print personalized claim forms that are pre-populated with your name, address, plan number, and benefit ID number. The forms contain a mailing address for returning your completed form, and they include the 3sHealth dedicated toll-free number to Great-West Life. Click on the ‘Submit a Claim’ link, then choose paper claim, and select the appropriate claim form for the type of expense you’re submitting. Please note: Great-West Life supports the following browsers: • Microsoft Internet Explorer (version 8 and up) • Firefox (recent version) • Adobe Acrobat Reader (version 8.0 and up) Learn more about your dental coverage The maximum reimbursement amount for each procedure code covered under the 3sHealth Dental Plans was updated in January according to the 2017 Saskatchewan Dental Association Fee Guide. The Maximum Reimbursement Schedule is a complete list of all eligible dental procedure codes, fees, and reimbursement percentages covered under the 3sHealth Dental Plan. The amounts listed in the schedule are the maximum reimbursement amounts that will be paid for each procedure. • If you would like a copy of the 3sHealth Maximum Reimbursement Schedule, visit our website at www.3sHealth.ca. • If you would like to confirm the maximum amount you will be reimbursed for a procedure, ask your dentist to submit an estimate to Great-West Life before your dental work begins. • A pre-treatment estimate for any dental work exceeding $500 is recommended. Did you move recently? If you have a change in address, it is very important that you notify both your employer and Great-West Life. To notify your employer: If you have access to Gateway Online (GO), you can change your address in GO and it will automatically update with your employer. If you do not have access to GO, please ask your employer for an Employee Changing Information Form to update your address. To notify Great-West Life: The insurance company updates your address each time you submit a claim, so you can simply update it by submitting a new claim with the correct address; you can also log in to the GroupNet for Plan Members website or use the Great-West Life GroupNet mobile app and update your address under the ‘Your Profile’ link.

Transcript of Use your vision care maximum Find what you’re looking for on … · Find what you’re looking...

Page 1: Use your vision care maximum Find what you’re looking for on … · Find what you’re looking for on 3sHealth.ca Accessing your benefit plan booklets, claim forms, and answers

Find what you’re looking for on 3sHealth.caAccessing your benefit plan booklets, claim forms, and answers to the most frequently asked questions is just a couple of clicks away. Go to www.3sHealth.ca.

Click on the ‘Employee Benefits’ square.

Click on the ‘Your Benefits at a Glance’ square.

Select the union group you belong to. You will see sections on the Group Life Insurance Plan, the Long-term Disability Plan, and the Extended Health Care and Dental Plan for your union group.

You will then see the most up-to-date plan booklet, which provides general plan information and what you need to know to get the most out of your benefits.

The Extended Health Care and Dental Plan sections also include links that will take you to the: • Travel Assist Booklet for out-of-country medical

emergency coverage • Extended Health Claim Form • Dental Claim Form • Great West-Life GroupNet for Plan Members • Answers to frequently asked questions, such as:

• How can I update my personal information? • How much does the life insurance cost? • Who can I name as beneficiary for my life

insurance? • How much disability coverage do I have? • What if I need to make a claim for disability

benefits? • How do I sign up for direct deposit for claim

reimbursements?

The following schedule illustrates the pro-rated maximum amount for laser eye surgery, based on the reimbursement percentage that applies to you:

If your reimbursement Your maximum percentage is: amount is: 100% $600 70% $420 60% $360 50% $300

Here are a couple of scenarios to help illustrate how the laser eye surgery benefit works:100 per cent reimbursement level: • Your last purchase of glasses was on May 1, 2015

and you were reimbursed the full vision care benefit of $300. You are scheduled for laser eye surgery on

June 1, 2017 and can expect to receive: • The full laser eye surgery maximum of $600.

You will next be eligible for your $300 vision care maximum to purchase glasses, sunglasses, or contact lenses on June 1, 2021. • Following the above example, if you were at a

60 per cent reimbursement level, you would expect to receive the pro-rated laser eye surgery maximum of $360. You will next be

eligible for your $180 vision care maximum to purchase glasses, sunglasses, or contact lenses on June 1, 2021.

• You bought contacts and used $125 of your $300 vision care maximum on May 1, 2016 and have elected to have laser eye surgery on June 1, 2017. You can expect to receive: • The pro-rated laser eye surgery maximum of

$475. This includes the remaining $175 vision care benefit from your current vision care plan year’s maximum and $300 for the next year’s maximum. You will next be eligible for your

full $300 vision care maximum and able to purchase glasses, sunglasses, or contact

lenses on June 1, 2021. • Following the above example, if you were

at a 60 per cent reimbursement level, you would expect to receive $235. This is the pro-rated maximum of $360 less the vision care amount already used of $125 for a total reimbursement of $235. You will next be eligible for your $180 vision care maximum to purchase glasses, sunglasses, or contact lenses on June 1, 2021.

Use your vision care maximum for laser eye surgeryDid you know you can chose to use your vision care maximum towards laser eye surgery? Laser eye surgery is allowed once per lifetime per person to a maximum of twice your vision care maximum. To receive reimbursement for laser eye surgery, you must have all or some of your current-year vision amount available. When you elect to have laser eye surgery reimbursed, you are exchanging four consecutive years of vision coverage and using it towards the laser eye surgery instead of purchasing prescription eyewear. If you do not have any funds remaining under your vision care maximum, then you will not be eligible for reimbursement of laser eye surgery.

3sHealth

NEWS3sHealth

Careers3sHealth

Bene�tsSHEPP

Pension PlanEmployee and FamilyAssistance Program

EFAP

Great-West Life

GROUPNETfor Plan Members

Gateway Online

Customize your claim formsWhen you log in to the Great-West Life GroupNet for Plan Members website, you have the ability to print personalized claim forms that are pre-populated with your name, address, plan number, and benefit ID number. The forms contain a mailing address for

returning your completed form, and they include the 3sHealth dedicated toll-free number to Great-West Life. Click on the ‘Submit a Claim’ link, then choose paper claim, and select the appropriate claim form for the type of expense you’re submitting.

Please note: Great-West Life supports the following browsers: • Microsoft Internet Explorer (version 8 and up) • Firefox (recent version) • Adobe Acrobat Reader (version 8.0 and up)

Learn more about your dental coverageThe maximum reimbursement amount for each procedure code covered under the 3sHealth Dental Plans was updated in January according to the 2017 Saskatchewan Dental Association Fee Guide. The Maximum Reimbursement Schedule is a complete list of all eligible dental procedure codes, fees, and reimbursement percentages covered under the 3sHealth Dental Plan. The amounts listed in the schedule are the maximum reimbursement amounts that will be paid for each procedure.

• If you would like a copy of the 3sHealth Maximum Reimbursement Schedule, visit our website at www.3sHealth.ca. • If you would like to confirm the maximum amount you will be reimbursed for a procedure, ask your dentist to submit an estimate to Great-West Life before your dental work begins. • A pre-treatment estimate for any dental work exceeding $500 is recommended.

Did you move recently?If you have a change in address, it is very important that you notify both your employer and Great-West Life.

To notify your employer: If you have access to Gateway Online (GO), you can change your address in GO and it will automatically update with your employer. If you do not have access to GO, please ask your employer for an Employee Changing Information Form to update your address.

To notify Great-West Life: The insurance company updates your address each time you submit a claim, so you can simply update it by submitting a new claim with the correct address; you can also log in to the GroupNet for Plan Members website or use the Great-West Life GroupNet mobile app and update your address under the ‘Your Profile’ link.

Page 2: Use your vision care maximum Find what you’re looking for on … · Find what you’re looking for on 3sHealth.ca Accessing your benefit plan booklets, claim forms, and answers

Still have questions?Your employee benefits team is happy to help. We are available from 8 a.m. to 4:30 p.m. Monday to Friday and can be reached by live chat from the 3sHealth website, by email at [email protected], or by calling toll-free 1-866-278-2301.

Verify your child’s student status annuallyIf your child is over the age of 21 and attending an accredited college or university, you must verify your child’s student status with 3sHealth Employee Benefits every year.

Each August, you will receive a letter and a Dependent Verification Form. You must complete and return the Dependent Verification Form in order for coverage to be continued for your child while he/she is attending a post-secondary institution. Coverage automatically ends on the child’s 26th birthday. If your child stops attending a post-secondary institution, he/she is no longer covered under the 3sHealth Benefit Plans.

Is your beneficiary information up-to-date?

Please review your statement carefully to ensure that you have the right person or list of people designated to receive the proceeds of your life insurance policy. If you would like to add or change your list of beneficiaries, please fill out the Beneficiary Designation Form and mail it to 3sHealth. Originals are required.

Get access to your benefits 24/7Want to know if your dental claim is paid yet? Need to know when you’re eligible for glasses? Want to submit your massage claim while still in the office?

There’s an app for that!

Great-West Life has simplified the process for submitting claims, viewing coverage balances, verifying the eligibility of an item, or checking on the status of reimbursement.

Download the Great-West Life GroupNet mobile app today and make your life easier! Once you download the app, you will need your plan number (335663) and your benefit ID number. You will then have immediate access to your benefits any time, day or night.

The Canadian Life and Health Insurance Association (CLHIA) developed The Co-ordination of Benefits Guidelines to ensure consistency within the industry in situations where a person can submit a claim to more than one group insurance plan.

Payment on a particular claim cannot exceed 100 per cent of the eligible expenses. Eligible expenses are determined by reasonable amounts established by the insurer, plan maximums and contractual fee guide limits. When you are insured by more than one plan,the established order of benefits is: • You – always submit your claim to your 3sHealth Benefit Plans first,

and then submit the remainder under your spouse’s benefit plan. • Your spouse – will submit claims to his/her employer’s

benefit plan first, and then submit the remainder under the 3sHealth Benefit Plans.

• Dependent children – submit claims to the plan of the parent with the earlier birth date (month/day) in the calendar year. Then submit the remainder under the other spouse’s benefit plan.

• If you and your spouse are separated or divorced but share custody of the dependent child, then the date of birth rule still applies.

• If one parent has sole custody of the child, then their plan will be the first payer. Then submit the remainder under the plan of the parent without custody.

• If you or your ex-spouse has a new spouse and share custody of the child, the order of benefit is the parent with the earlier date of birth, the parent with the later date of birth, the spouse of the parent with the earlier date of birth, then the spouse of the parent with the later date of birth.

For further information regarding the Canadian Life and Health Insurance Association Inc. (CLHIA) coordination of benefits guidelines, please refer to: https://goo.gl/CLcPIH.

Get your Great-West Life health and dental question answered quickly and easilyGreat-West Life has a dedicated toll-free number for 3sHealth plan members. The number links plan members to knowledgeable representatives at Great-West Life and helps them meet their service level commitment to answer 80 per cent of all members’ calls within 60 seconds. Great-West Life also performs monthly reviews of members’ calls to measure and improve the quality of service.

The 3sHealth dedicated toll-free number to Great-West Life is 1-866-408-0213. Service is available weekdays between the hours of 6:30 a.m. and 6 p.m. local time.

The 3sHealth Employee

Benefit Plans aim to create

better health and well-being

for its plan members. This

newsletter contains important

information to help you make

the best use of the coverage

available.

For more information about

the benefits and services

available visit 3sHealth.ca.

Spring 2017Members’ Annual Statement

newsletterEmployee Benefits

Are you or a dependent insured under more than one policy?