BENEFIT REPORT
BENEFIT REPORT
NEWSLETTER | SPRING 2013 | WWW.CLAC.CA
INTRODUCING THE CERIDIAN LIFEWORKS APP Ceridian LifeWorks has a new, free mobile app for members of the CLAC Employee and Family Assistance Program (EFAP). The app offers a convenient way to help you manage your life, health, family, money, and work, with topics ranging from stress to work-life balance. It’s a confidential source of information you can count on whenever you need it and from wherever you are. You can listen to podcasts and audio tracks, read articles and digital booklets, and see what’s new in the monthly features. It’s a great supplement to the service they offer through their website and their phone line. Are you ready to get started with Ceridian LifeWorks Mobile? 1. Search for “LifeWorks” in your device’s app store and install it for free. 2. Open the app, and enter your user ID (clac) and password (wellness) 3. Choose “remember me” when you log in, so you won’t need to log in again. Please note, once you’ve opened the app, you can click on “need assistance/help” and the toll-free phone number (1–866–714– 3129) will appear. One more click and you’ll be connected by phone with a consultant.
Western Benefits
Follow CLAC:
THE NEXT STEP IN GENERIC DRUG SUBSTITUTION We know that prescription drugs are an important benefit to you and your family. Our goal is to ensure we can continue to provide high-quality benefits today and for many years to come. To do so, we need to consider new ways to keep your existing drug coverage sustainable. Generic drug substitution is a very common cost-saving measure in many drug plans, including the CLAC benefit plan. This means that in most instances when a doctor prescribes a drug, the pharmacist dispenses the lowest priced equivalent (usually the generic) version of that drug if one is available. The only exception for generic substitution is where your doctor indicates “no substitution” on your prescription. In this case the brand name will still be covered. Generic drugs are clinically identical to the brand name drug, with the same active ingredients, and they usually cost significantly less. We may soon be taking the next step to cost sustainability with mandatory generic drug substitution. In the future, when your doctor writes “no substitution” on your prescription, you will be required to provide valid medical reasons to the insurance company for not substituting your brand name drug with a lowest priced generic equivalent. You could always still choose to receive the brand drug and pay the difference yourself. Please watch for further information as together we can work to ensure your benefit plan remains sustainable.
DID YOU KNOW? The average claim on brand name drugs is approximately $72 versus only $27 for generics. So which kind of drug— brand or generic—offers you and your plan the best value? Let’s look at an example.
Cost of one-month supply Plan pays 80% of lowest priced equivalent Difference (plan member cost)
Cost of lowest priced equivalent (generic – simvastatin) $30.18 $24.14 $6.04
Cost of brand name (Zocor) $90.57 $24.14 $66.43
From this example, you can see how generic drugs can quickly result in substantial savings for you. As noted above, cost sustainability is important to us, and we can work together to ensure you get the medication you need at the lowest price. In the future, if you are medically required to take the brand name medication, the increased cost to you, as shown in the chart above, can be avoided by having your doctor complete a form for the insurance company. In all other cases, the additional costs can be avoided by simply advising the doctor that your drug plan is mandatory generic. That way you should be provided the generic equivalent drug by the pharmacy.
UNDERSTANDING MY COVERAGE – UPDATE ON MASSAGE THERAPY CLAIMS IN ALBERTA Your CLAC coverage includes $600/person/year for massage therapy claims. If you are making a claim for massage therapy, you must include a doctor’s prescription and the therapist you see must be approved as an eligible paramedical practitioner. In Alberta, because massage therapy is not regulated by provincial legislation, independent associations were created to represent these practitioners and self-regulate the profession. Some massage therapists belong to the Natural Health Practitioners of Canada (NHPC). Since not all NHPC massage therapists have the required minimum of 2,200 hours of formal education, the NHPC developed a competency equivalency so that massage therapists with less than 2,200 hours of formal education can upgrade their credentials.
As of May 1, 2013, Sun Life will only recognize NHPC massage therapy members who: • • •
are in good standing with the NHPC; have at least 2,200 hours of formal training, or have completed the competency equivalent exam; or have been grandfathered.
Ask your practitioner about their qualifications to make sure that your massage therapy claims will be honoured by your CLAC plan. If you have any questions, please contact our office.
GO PAPERLESS! We want your claim submissions and payments to be processed as fast and easy as possible. Why spend valuable time filling out a claim form, mailing it in, and waiting for your cheque to arrive in the mail? Sign in to mysunlife.ca and register for direct deposit. You can submit most of your claims online and get your money back quickly, typically within forty-eight hours. Save your time, get your money in the bank a lot faster, and help the environment, all at the same time!
CONTACT INFORMATION
FAQ Does my plan cover orthotics? Your plan covers custom-made orthotics up to $200/person/year. To be eligible for coverage, your orthotics must be: •
•
Custom-made from a three-dimensional cast of your feet, created from raw materials, and designed for your specific needs. They cannot be a pre-fabricated, commercial, over-the-counter product. Prescribed by a doctor, chiropodist, or podiatrist as a medically necessary treatment for a foot condition.
We encourage you to discuss these requirements with your provider to make sure your orthotic claim will be covered.
Can I submit my claim for physiotherapy or glasses electronically? Last September, Sun Life launched a new e-claims service which gave you the ability to have e-claims submitted on the spot by your physiotherapist, chiropractor, and optometrist. Your service provider needs to be registered with the TELUS Health eClaims network in order to take advantage of this service. Check with them the next time you use these services and ask about e-claims.
CLAC BENEFIT ADMINISTRATION OFFICE 14920 118 Ave. Edmonton, AB T5V 1B8 Telephone: 780–454–6181 Toll Free: 1–888–600–2522 Facsimile: 780–454–6180 [email protected]
SUN LIFE Telephone: 1–800–661–7334 www.sunlife.ca/member
CERIDIAN LIFEWORKS Telephone: 1–866–714–3129 www.lifeworks.com Username: clac Password: wellness
www.clac.ca
Calgary Edmonton Grimsby
•
•
•
Cambridge
Kelowna
Ottawa
•
•
Chatham
•
Fort McMurray
•
Langley
Saskatoon
•
Fort St. John
•
Mississauga
Winnipeg
NEWSLETTER | SPRING 2013 | WWW.CLAC.CA
INTRODUCING THE CERIDIAN LIFEWORKS APP Ceridian LifeWorks has a new, free mobile app for members of the CLAC Employee and Family Assistance Program (EFAP). The app offers a convenient way to help you manage your life, health, family, money, and work, with topics ranging from stress to work-life balance. It’s a confidential source of information you can count on whenever you need it and from wherever you are. You can listen to podcasts and audio tracks, read articles and digital booklets, and see what’s new in the monthly features. It’s a great supplement to the service they offer through their website and their phone line. Are you ready to get started with Ceridian LifeWorks Mobile? 1. Search for “LifeWorks” in your device’s app store and install it for free. 2. Open the app, and enter your user ID (clac) and password (wellness) 3. Choose “remember me” when you log in, so you won’t need to log in again. Please note, once you’ve opened the app, you can click on “need assistance/help” and the toll-free phone number (1–866–714– 3129) will appear. One more click and you’ll be connected by phone with a consultant.
Western Benefits
Follow CLAC:
THE NEXT STEP IN GENERIC DRUG SUBSTITUTION We know that prescription drugs are an important benefit to you and your family. Our goal is to ensure we can continue to provide high-quality benefits today and for many years to come. To do so, we need to consider new ways to keep your existing drug coverage sustainable. Generic drug substitution is a very common cost-saving measure in many drug plans, including the CLAC benefit plan. This means that in most instances when a doctor prescribes a drug, the pharmacist dispenses the lowest priced equivalent (usually the generic) version of that drug if one is available. The only exception for generic substitution is where your doctor indicates “no substitution” on your prescription. In this case the brand name will still be covered. Generic drugs are clinically identical to the brand name drug, with the same active ingredients, and they usually cost significantly less. We may soon be taking the next step to cost sustainability with mandatory generic drug substitution. In the future, when your doctor writes “no substitution” on your prescription, you will be required to provide valid medical reasons to the insurance company for not substituting your brand name drug with a lowest priced generic equivalent. You could always still choose to receive the brand drug and pay the difference yourself. Please watch for further information as together we can work to ensure your benefit plan remains sustainable.
DID YOU KNOW? The average claim on brand name drugs is approximately $72 versus only $27 for generics. So which kind of drug— brand or generic—offers you and your plan the best value? Let’s look at an example.
Cost of one-month supply Plan pays 80% of lowest priced equivalent Difference (plan member cost)
Cost of lowest priced equivalent (generic – simvastatin) $30.18 $24.14 $6.04
Cost of brand name (Zocor) $90.57 $24.14 $66.43
From this example, you can see how generic drugs can quickly result in substantial savings for you. As noted above, cost sustainability is important to us, and we can work together to ensure you get the medication you need at the lowest price. In the future, if you are medically required to take the brand name medication, the increased cost to you, as shown in the chart above, can be avoided by having your doctor complete a form for the insurance company. In all other cases, the additional costs can be avoided by simply advising the doctor that your drug plan is mandatory generic. That way you should be provided the generic equivalent drug by the pharmacy.
UNDERSTANDING MY COVERAGE – UPDATE ON MASSAGE THERAPY CLAIMS IN ALBERTA Your CLAC coverage includes $600/person/year for massage therapy claims. If you are making a claim for massage therapy, you must include a doctor’s prescription and the therapist you see must be approved as an eligible paramedical practitioner. In Alberta, because massage therapy is not regulated by provincial legislation, independent associations were created to represent these practitioners and self-regulate the profession. Some massage therapists belong to the Natural Health Practitioners of Canada (NHPC). Since not all NHPC massage therapists have the required minimum of 2,200 hours of formal education, the NHPC developed a competency equivalency so that massage therapists with less than 2,200 hours of formal education can upgrade their credentials.
As of May 1, 2013, Sun Life will only recognize NHPC massage therapy members who: • • •
are in good standing with the NHPC; have at least 2,200 hours of formal training, or have completed the competency equivalent exam; or have been grandfathered.
Ask your practitioner about their qualifications to make sure that your massage therapy claims will be honoured by your CLAC plan. If you have any questions, please contact our office.
GO PAPERLESS! We want your claim submissions and payments to be processed as fast and easy as possible. Why spend valuable time filling out a claim form, mailing it in, and waiting for your cheque to arrive in the mail? Sign in to mysunlife.ca and register for direct deposit. You can submit most of your claims online and get your money back quickly, typically within forty-eight hours. Save your time, get your money in the bank a lot faster, and help the environment, all at the same time!
CONTACT INFORMATION
FAQ Does my plan cover orthotics? Your plan covers custom-made orthotics up to $200/person/year. To be eligible for coverage, your orthotics must be: •
•
Custom-made from a three-dimensional cast of your feet, created from raw materials, and designed for your specific needs. They cannot be a pre-fabricated, commercial, over-the-counter product. Prescribed by a doctor, chiropodist, or podiatrist as a medically necessary treatment for a foot condition.
We encourage you to discuss these requirements with your provider to make sure your orthotic claim will be covered.
Can I submit my claim for physiotherapy or glasses electronically? Last September, Sun Life launched a new e-claims service which gave you the ability to have e-claims submitted on the spot by your physiotherapist, chiropractor, and optometrist. Your service provider needs to be registered with the TELUS Health eClaims network in order to take advantage of this service. Check with them the next time you use these services and ask about e-claims.
CLAC BENEFIT ADMINISTRATION OFFICE 14920 118 Ave. Edmonton, AB T5V 1B8 Telephone: 780–454–6181 Toll Free: 1–888–600–2522 Facsimile: 780–454–6180 [email protected]
SUN LIFE Telephone: 1–800–661–7334 www.sunlife.ca/member
CERIDIAN LIFEWORKS Telephone: 1–866–714–3129 www.lifeworks.com Username: clac Password: wellness
www.clac.ca
Calgary Edmonton Grimsby
•
•
•
Cambridge
Kelowna
Ottawa
•
•
Chatham
•
Fort McMurray
•
Langley
Saskatoon
•
Fort St. John
•
Mississauga
Winnipeg
