Group Benefits Admin Update

Q3
2 0 1 1
Group Benefits Admin Update
Important Plan and Product Information for Plan Administrators
Saving money with Coordination of
Benefits (COB)
Your plan members can recover up to 100% of their benefits plan expenses if they
coordinate claims with their spouse’s group plan. Encouraging your plan members
to sign up for COB can also save your company money because your plan will no
longer be primary payer for spousal claims and some dependent child claims.
How does COB work?
Claim is for… First…
Then…
Plan member
for any unpaid balance, the plan member
submit to Manulife
should send a copy of their Manulife
claim statement and the other insurance
company’s claim form to the other
In this issue
insurance company for processing.
Plan member’s
submit to spouse’s insurance
for any unpaid balance, the plan member
spouse
company
should send a copy of the other insurance
Saving money with Coordination
of Benefits
company’s claim statement with a
completed Manulife claim form to us for
processing.
Dependent children
send to the insurance company
submit any balance to the other
of the parent who has the
insurance company.
earlier birth month and day.
Plan Administrator Secure Site:
New feature to grant advisor access
Improving benefit payment efficiency
Revised eligibility forms
(If both parents have the same
birth month, then use the
parent with the earliest day
in the month.)
For more information about COB or to find out how to sign up your plan
members, please call Manulife Financial’s Customer Service Centre at
1-800-268-6195.
WWW.MANULIFE.CA
‘What’s on your mind?®’ launches
on Workplace Solutions for Mental
Health website
Orthopaedic shoes: New requirement
for claims after January 1, 2012
New ways to contact Client Financial
Services on October 1
Drug & Legislative summary
Plan Administrator Secure Site:
New feature to grant advisor access
In June a new feature was added to your Plan Administrator
Secure Site that allows access to be granted to plan advisors.
By allowing your plan advisor to access your site, they can
provide greater assistance and support with your online
transactions. Your plan advisor will also be able to assist in
answering questions questions you have about the site and
help you with troubleshooting.
Plan advisors are only able to view your site and will not be
able to submit changes and you, as the plan administrator, can
control the access and cancel it at any time.
The process for setting up and managing access for your plan
advisor is simple and easy. Simply call your plan advisor and ask
for their site ID. Look for the “Plan Advisor Access” page in
your left hand navigation and enter your advisor’s site ID on the
page to start using this feature. From this page, you can also
manage your site access, view a list of the accesses you have
granted and cancel the access for any plan.
As part of this new feature, please note that you will be prompted
to re-accept the terms and conditions on the site as they have
changed. If you aren’t already registered for the Plan Administrator
Secure Site, you can go to www.manulife.ca/groupbenefits
to begin enjoying the benefits of managing your plan online.
Improving benefit
payment efficiency
With the recent postal disruption, we have received an
increased demand for Electronic Funds Transfer (EFT) deposits
and are now offering plan members the option of switching
to direct deposit for their Life and Disability claim payments.
Plan members currently receiving their benefit payments by
cheque will be receiving correspondence directly from the claims
department offering them the option to switch to direct deposit.
We encourage you to promote EFT with your plan members as a
safe, fast and green option for receiving benefit payments.
Revised eligibility forms
We have updated our various eligibility forms and these will
be available shortly for your use. The forms ask you, as the
plan administrator, to confirm that each plan member enrolling
for benefits meets the eligibility criteria outlined in your
benefits contract. If you submit your eligibility through the
2
Plan Administrator Secure Site, you will be asked to provide
the same confirmation.
The following forms are being revised:
Enrolment forms
GL2971E/F - Enrolment or Re-enrolment Application
GL3574E/F - Enrolment or Re-enrolment Application
with Health Care Spending Account
GL4560E/F - Enrolment or Re-enrolment for
Self-Administered Groups
Change forms
GL3187E/F - Application for Change
GL4631E/F - Application for Change for Self-Administered Groups
Beneficiary forms
A more comprehensive stand-alone form has been created
to record beneficiary designations as well as contingency
beneficiary(ies) and trustee(s), if required.
GL1435E/F - Beneficiary Designation
GL4255E/F - Beneficiary Designation for Self-Administered Groups
The revised forms will be available in both paper and fillable
(Internet) formats during 2011's fourth quarter. If you have any
questions in the meantime, please contact your Manulife
Financial Representative.
‘What’s on your mind?®’ launches
on Workplace Solutions for Mental
Health website
New videos provide mental health
information for employees and employers
Manulife recently launched a new section on our
Workplace Solutions for Mental Health website called ‘What’s
on your mind?®’.
‘What’s on your mind?’ contains easy to understand
information and useful tips for employees and employers about
workplace mental health issues. It currently features short
information videos developed with Dr. Thomas Ungar, Associate
Professor at the University of Toronto and Chief
of Psychiatry at North York General Hospital in Ontario.
We will continue to expand ‘What’s on your mind?’ by adding
new material developed in association with various leading
mental health professionals.
We’re always interested in ‘What’s on your mind’. If you have
any ideas for content you would like to see featured on our
site, you can let us know by clicking on ‘Contact Us’ at the
bottom of any page on Workplace Solutions for Mental Health.
Visit Workplace Solutions for Mental Health at
www.manulife.ca/mentalhealth.
Orthopaedic shoes: New
requirement for claims after
January 1, 2012
As your benefits provider, we constantly monitor market trends
and fine-tune our practices to ensure we pay claims consistent
with the intent of the benefit. We’ve just completed a review
of orthopaedic shoes and found that many vendors are
promoting off-the-shelf walking or sports shoes as orthopaedic.
In response to this market trend, we are making some changes
to manage utilization and prevent abuse or fraud.
What’s changing?
As a reminder, here’s a summary of the information required
for all claims for off-the-shelf medically necessary orthopaedic
shoes. The only new requirement is # 2, the manufacturer’s
name and the brand name and model number of the shoes or
boots. This information should be provided with a completed
and signed Extended Health Care Claim form.
From a physician:
1. the diagnosis of a medical condition and a prescription for
shoes or boots as treatment for that medical condition.
From the supplier of the footwear:
2. the name of the manufacturer, and the model name and/or
model number of the shoes or boots.
3. details if the shoes or boots:
Starting in November, our explanation of benefits statements
will carry a message to flag the change to plan members
making orthopaedic shoe claims and our Customer Service
Centre team will also be explaining the claims changes to
members calling in.
It’s our usual practice to return incomplete claims to members
so that they can provide the missing details and resubmit their
claim. Plan members are responsible for any costs associated
with providing this information as part of their claim.
We want to help plan members understand what
footwear is eligible.
We want plan members to understand their benefits and we can
help if they call or write to us before they buy orthopaedic shoes.
After they have a physician’s diagnosis, members need a
chiropodist, pedorthist or podiatrist to recommend shoes. When
they have details of the footwear, any modifications and
proposed costs (described in items 2 to 4 in the previous list), they
can call or send us a predetermination request so that we can
confirm if those shoes or boots will be eligible under your plan.
You can help plan members by sharing information about
this change.
You can help your plan members by sharing this information
and informing them of the January 1, 2012 implementation
date. We’ve posted some information about our claims
requirements on the Secure Plan Member Site at
http://groupbenefits.manulife.com/canada/GB_V2.nsf/public/
pm_welcome.
Questions?
If you have questions about this new requirement or
the orthopaedic shoe benefit in your plan, please
contact the Customer Service Centre or your Manulife
Financial Representative.
- are attached to or part of a brace or
- have been altered/adjusted by the supplier for the specific
medical needs of the wearer, including a description of the
alterations.
4. details of all costs, with costs for the footwear shown
separately from costs for any alterations to them.
5. the date the shoes or boots were picked up from the
supplier.
6. the original sales receipt showing the date and method of
payment.
3
Q3
2 0 1 1
New ways to contact Client Financial
Services on October 1
For questions and information
So that we can provide immediate assistance for your questions
about premiums and billings, we will be directing all general inquiry
calls and emails to the Group Benefits Customer Service Centre. The
toll-free telephone and email contact information for the Customer
Service Centre is on your Plan Administrator Secure Site.
On October 1, 2011 we will disable these email
contact addresses
[email protected], [email protected],
[email protected], [email protected],
GB_CFS_Premium [email protected],
[email protected].
To notify us about wire payments
Send all notifications about wire payments to us at this new email
address: [email protected].
To send us your self-admin premium statement
Send self-admin premium statements to us at this new email
address: [email protected].
Drug & Legislative summary
For more details, go to www.manulife.ca/gbnewsletters
Generic drugs and price reductions
Effective July 4, 2011 B.C. PharmaCare reduced the markup for applicable generic drugs in the Low Cost
Alternative (LCA) categories, as part of its Pharmacy
Services Agreement.
New Brunswick
Government and pharmacy stakeholder discussions
Discussions are underway in New Brunswick on proposed
changes to pharmacy services in the province.
Nova Scotia
Dispensing fee
On July 1, 2011 the public plan increased its dispensing
fee, as agreed to between the province and the Pharmacy
Association of Nova Scotia.
Ontario
Expanded vaccine coverage
As of August 1, 2011 the Ontario government initiated
coverage under its publicly-funded immunization schedule
for two new vaccines in the province, one to protect against
rotavirus and the other a combined measles-mumps-rubella-varicella
(MMRV) vaccine. Ontario also expanded coverage for the vaccines
varicella and pertussis, already covered under the program.
Smoking cessation coverage
Effective August 4, 2011 smoking cessation products Champix and
Zyban were added to the Ontario Drug Benefit (ODB) Plan. These
drugs are available to ODB-eligible residents only.
Quebec
Coverage of insulin pumps for type 1 diabetes
The Province of Quebec has announced that it will begin
to provide coverage for the cost of insulin pumps for children and
adolescents with type I diabetes.
Drug coverage 2011-12
The Régie de l'assurance maladie du Québec (RAMQ) has
announced that there will be no change in the coinsurance
(maximum out-of-pocket expense) for plan members,
the coinsurance remains unchanged at 32% of the
prescription cost.
What’s on your mind?®, Group Benefits products and Secure Sites are offered through Manulife Financial (The Manufacturers Life Insurance Company). © 2011 The Manufacturers Life Insurance Company. All rights reserved. What’s on your mind?, Manulife, Manulife Financial, Manulife
Financial For Your Future logo and the block design are trademarks of The Manufacturers Life Insurance Company and are used by it and its affiliates under license. www.manulife.ca
09/2011
01340
British Columbia