INFORMATION SESSION Thompson Emergency Freight green shield canada
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INFORMATION SESSION Thompson Emergency Freight green shield canada PLAN MEMBER 1
YOUR MEETING TODAY green shield Canada Nichole del Sol, Client Service Representative, GSC 2
AGENDA • Benefits at a Glance – Plan Coverage Overview o Customer Service o Being an Educated Consumer o Plan Member Online Services • Health Promotion green shield canada • Employee Experience 3
Health – Benefits at a Glance Drug • Nil Deductible • Mandatory generic drug substitution applies • > age 65 -Ontario Drug Benefit co-pay/deductible is a benefit • Drugs covered include: legally requiring a prescription • Benefits do not include smoking cessation products and medication for the treatment of erectile dysfunction green shield canada • Nil Coinsurance 4
Health – Benefits at a Glance EXTENDED HEALTH SERVICES • Coinsurance 100% • Audio – covered at $300 every 5 years • Professional Services – up to $500 maximum per calendar year * Chiro - allows for $375 per covered person per calendar year • Vision - maximum of $125 every 24 months (12 months for dependents children 17 years and under) green shield canada • Deductible $25 single or $50 family per calendar year 5
Eyewear Discount green shield canada • We are pleased to announce that we’re expanding the Preferred Provider Network for Vision Care with the addition of Hakim Optical and Contacts. Express. ca. Here is a full breakdown of the Vision PPN: 6
• • • For the first 60 days per trip Emergency Maximum $1, 000/ covered person/calendar year Referral maximum $50, 000/ covered person/calendar year No Deductible/ No co-payments Must contact GSC Travel Assistance within 48 hours of commencement of treatment. • Emergency means a sudden, unexpected injury, illness or acute episode of disease that requires immediate medical attention and could not have been reasonably anticipated based upon the patient’s prior medical condition. green shield canada Travel –Benefits at a Glance 7
DENTAL BENEFITS • Deductible is $25 Single or $50 Family per calendar year • Basic services cover recalls once every 9 months, other exams and full mouth Xrays every 3 years • Comprehensive basic services cover denture relines once every 3 years • Major services cover standard dentures, crowns and bridges once every 5 years • Your eligible claims are reimbursed at the level stated above and in accordance with: • the current minus one year Provincial Dental Association Fee Guide for General Practitioners in the province where services are rendered • for independent Dental Hygienists, the lesser of, the current minus one year Provincial Dental Hygienists’ Association Fee Guide and Provincial Dental Association Fee Guide for General Practitioners in the province where services are rendered green shield canada • Coinsurance Basic Services/Comprehensive 100%, Major Services Restorative 50% • Your maximum for Basic services and Comprehensive basic services is $2, 500 every 12 months based on date of first paid claim • Your maximum for Major services is $1, 000 per calendar year 8
EMPLOYEE EXPERIENCE PLAN MEMBERS…SERVICE YOUR WAY Call Centre • Monday to Friday, Eastern Time - 8: 30 a. m. to 8: 30 p. m. • Simulated claims • Online services • Provider calls • Multilingual • Email us ONE CALL RESOLUTION 1. 888. 711. 1119 green shield canada • Low staff turnover < 3% 9
EMPLOYEE EXPERIENCE • Very high card recognition • Claims processed in real time • Claims managed at point of service • Extended Health Service providers can submit claims online! JOHN SMITH 1234567 -00 ABC Company green shield canada • Preferred Provider Vision Network 10 ONE CARD DOES IT ALL!
BE AN EDUCATED CONSUMER… • Call Customer Service before large expenditures • Check your invoice before provider submission • Explore provider discounts – enhance your benefit dollars • Protect your benefit plan, help keep it safe! • Sometimes we require additional claim information • Provider Profiling green shield canada PROTECT YOUR PLAN! 11
PLAN MEMBERS…SERVICE YOUR WAY green shield canada PLAN MEMBER ONLINE SERVICES 12
green shield canada EMPLOYEE EXPERIENCE (LOG IN) 13
green shield canada EMPLOYEE EXPERIENCE (MENU) 14
green shield canada Plan Member Online Services – Introducing the Drug Coverage Search Tool 15
green shield canada Plan Member Online Services – Introducing the Provider Search Tool 16
green shield canada We’ve got an App! GSC on the Go 16
green shield canada Helping You Achieve Better Health 18
green shield canada Thank you 19
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