COVID-19 – Group insurance

Due to the current situation, we've temporarily stopped printing and mailing insurance certificates for both new and existing clients.

You can find documents and information on your group insurance plan (such as your summary of benefits or your payment card) online anytime on the plan members' secure site under Your account. Your payment card is also available on the Claim 360° mobile app. If necessary, you can give your insurance information to the health professional verbally so they can process your claim. At the drug store, you can tell the pharmacist that our insurer Rx ID is 12.

Your plan administrator will be able to give you this information.

A dependent who is duly registered as a full-time student at an educational institution and who is unable to attend for reasons related to COVID-19 will not be penalized. They will keep their student status until the next school term.

Absolutely. However, given the current situation and the possibility of delays in postal and/or administrative services, we encourage you to use our online services.

How to submit claims online:

• You can submit claims for most health services via the plan members' secure site or the Claim 360° mobile app.
• If you can't find the care or service you want to submit a claim for in our online tools, you can submit healthcare claims (including your 19132 form and receipts) and dental claims (including your 19110 form and receipts) onlineExternal link. Opens in a new window.. We also encourage you to fill out the "Direct Deposit Service" section of the form so your reimbursements can be deposited directly in your bank account.
• You can also submit a disability claim onlineExternal link. Opens in a new window., along with the required forms (employee statementExternal link. Opens in a new window., employer statementExternal link. Opens in a new window., illness confirmation formExternal link. Opens in a new window.).

We already accept virtual consultations for a number of counsellors and health professionals. Given the current circumstances, we've expanded our list of counsellors and health professionals who are eligible for reimbursement.

Here is the list of professionals we will accept virtual consultations for. Single asterisks indicate professionals added temporarily and double asterisks indicate professionals added permanently.

We reserve the right to revise this list as the situation evolves. Only virtual consultations permitted by the professional association or order are eligible for reimbursements. In the case of dentists, the only eligible expenses are those incurred for an emergency consultation. Eligibility for reimbursement is subject to the provisions of your insurance contract.

Your health, safety and well-being are priorities for us. If you are having trouble getting the required form filled out by your treating physician, please call us at 1-844-410-6485 This link opens your default phone software..

Since Monday, June 15, pharmacists have been able to prescribe drugs the same way they used to before the COVID-19 pandemic, that is, according to the patient’s needs and available supplies. However, many drugs for treating chronic illnesses are still in short supply and the ongoing situation means we still have to be careful, particularly in preparation for a possible second wave of COVID-19.

Please check with your plan administrator to find out whether your organization’s plan covers them.

If your plan includes travel insurance, all eligible emergency medical expenses including those related to COVID-19 will be covered, even if the Government of Canada issues a Level 3 – Avoid non-essential travel advisory.

If the Government of Canada issues a Level 4 – Avoid all travel advisory, you will not be covered.

No. These tests are not covered because they are not related to an emergency requiring immediate medical treatment.

However, you can claim these costs under your Health Spending Account (HSA), if your plan includes one.

If you have one or more of the symptoms on this listExternal link. Opens in a new window., call our assistance service:

Our assistance service will refer you to a hospital or clinic for the appropriate care. Be sure to tell the healthcare professional if you have been to any high-risk areas or have been in contact with people with symptoms associated with COVID-19.

Since the Government of Canada has a travel health notice to avoid all travel (level 4) aboard cruise ships, you are not covered for any emergency medical expenses incurred while on a cruise ship.

Following the Government of Canada's official alert issued on March 13, 2020, advising Canadians to avoid non-essential travel outside Canada, the following provisions apply:

For trips booked on or after March 13, 2020:

If you haven't left yet (trip cancellation)

• If you need to cancel your trip due to COVID-19, you're only covered if the Government of Canada upgrades its travel advisory for your destination from Level 3 – Avoid non-essential travel to Level 4 – Avoid all travel before you leave.

If you've already left (trip interruption)

• If you need to cut your trip short, you're not covered if the Government of Canada's travel advisory level for your destination is the same as it was when you left.

  You are covered if the Government of Canada upgrades its travel advisory for your destination to Level 4 – Avoid all travel while you are there, but you must leave the affected area as soon as possible.

To see which countries and regions are affected, refer to the Government of Canada's website External link. Opens in a new window..

Following the Government of Canada's alert issued on March 13, 2020, advising Canadians to avoid all non-essential travel outside of Canada, all destinations outside of Canada are affected until further notice.

If you would like to submit a claim, you can do so using our online claims service. To better serve our clients, we will be prioritizing trips that are due to depart in the next 30 days, or that require a deposit in the next 30 days.

To submit a claim, please go to the online claims page External link. Opens in a new window.. We suggest that you contact your travel agency or airline carrier first to find out what their policies are on this issue.

To better serve our clients, we will be processing claims for trips that are due to depart in the next 30 days, or that require a deposit in the next 30 days. Given the exceptional circumstances, we ask you to delay submitting your claim if your departure date is later than that.

Unfortunately, no. Your group insurance contract stipulates that a travel credit issued by a travel service is considered a reimbursement. Therefore, your trip cancellation insurance can't reimburse you for the travel credit, even if that is your preference. However, if you're unable to use the travel credit, you can submit a claim once it expires with proof that you didn't use it. You have 12 months from the travel credit expiration date to submit a claim.

We're currently unable to send confirmation of receipt emails for claims sent to us by mail. However, rest assured that we are processing all claims. We're giving priority to cancellations of trips with a departure date scheduled in the next 30 days and trips that require a deposit in the next 30 days.

If you've been tested for COVID-19 and you meet the following criteria:

• The results came back positive.
• You're unable to go to work or work from home.

You are eligible for short-term disability benefits according to the provisions specified in your group insurance plan.

The required documents to submit with your claim:

• Employee statement form (PDF, 1.1 MB) Opens in a new window
• Employer statement form (PDF, 1.6 MB) Opens in a new window
• Initial attending physician’s statement (PDF, 1.2 MB) Opens in a new window
• Illness confirmation form (PDF, 923 KB) Opens in a new window

If you are not able to send us your physician’s report or another health professional’s report, you can send us the Illness confirmation form. We reserve the right to request medical information as fits the situation.

To avoid any delays due to a reduction in postal services, please submit your documents online Opens in a new window.

If you haven’t had a COVID-19 test or if your COVID-19 test results came back negative, and you are not able to go to work or work from home, you can submit a claim for short-term disability. The same terms that apply to other medical conditions will apply.

Required documents to submit with your claim:

• Employee statement form (PDF, 1.1 MB) Opens in a new window
• Employer statement form (PDF, 1.6 MB) Opens in a new window
• Initial attending physician's statement form (PDF, 1.2 MB) Opens in a new window

To avoid any delays due to a reduction in postal services, please submit your documents online Opens in a new window.

If your doctor, employer or a government agency told you to go into preventive quarantine, or if you put yourself into preventive quarantine, you are not eligible for short-term disability insurance benefits.

In this situation:

• We encourage you to talk to your employer about the possibility of working from home.
• If you can't work from home, your employer's salary continuation measures will apply. Please talk to your employer.
• If neither of these measures are possible, we encourage you to contact Service Canada External link. Opens in a new window to see if you’re eligible for government benefits.

We’ll be flexible in assessing each claim on a case-by-case basis, keeping your particular situation in mind.

If you're unable to provide your attending physician’s report, you can send us a medical report and information from another healthcare worker who is a member of a professional order (e.g., nurse, psychologist, physiotherapist, occupational therapist, chiropractor, podiatrist).

Scenario 1: Your employer decides you can work from home or pays you even if you don’t

We’ll continue to pay disability benefits for days not worked until the total disability ends (date scheduled for return to full-time work). Once it ends, we encourage you to contact Service Canada External link. Opens in a new window to see if you are eligible for government benefits.

Scenario 2: You can’t work from home, or your employer can’t pay you

We’ll continue to pay full disability benefits until the total disability ends (date scheduled for return to full-time work). Once it ends, we encourage you to contact Service Canada External link. Opens in a new window to see if you are eligible for government benefits.