Transcript Your Benefits Plan - Manulife Repsource

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Your Benefits Plan
Plan Sponsor/Plan
Administrator/Your Name here
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Agenda
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Your Benefits Plan
Coverage Details
How to make a claim
Claim payment options
Coverage changes/requests
How to help your plan work for you
Where to get more information
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Your Benefits Plan (edit as appropriate)
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Basic Life Insurance
Accidental Death & Dismemberment (AD&D)
Dependent Life
Long Term Disability (LTD)
Short Term Disability (STD)
Extended Health Care (EHC)
Dental Care
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Coverage Details (Edit/delete as appropriate)
Benefit
Coverage
Basic Life
X times your annual salary
or $xx,xxx
AD&D
% of your Basic Life amount
Dependent Life
$x,xxx spouse
$x,xxx each dependent child
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Long Term Disability (Edit/delete as appropriate)
Benefit Amount
Xx% of your monthly salary
Maximum Monthly Benefit
$x,xxx
Waiting Period
Xx weeks
Benefit Period
To age 65 or x years
Definition of Disability
X year own occupation or any
occupation
Cost of Living Adjustment
X%
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Workplace Advisor (Edit/delete as appropriate)
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Short term counselling referral service
Totally confidential
Available to all employees
Support available by phone, email or faceto-face
• Access available 24/7
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Short Term Disability (Edit/delete as appropriate)
Benefit Amount
Xx% of your weekly earnings
Maximum Weekly Benefit
$x,xxx
Waiting Period
X day accident
X day sickness
X day hospitalized
Benefit Period
x weeks
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EHC – Drugs (Edit as appropriate)
• Drug card (remove if reimbursement)
• $x deductible (per prescription) or $xx
single, $xx family deductible
• Xx% reimbursement
• Generic/”Prescription only” drugs
• $xx,xxx annual drug maximum (remove if not
applicable)
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Other EHC (Edit as appropriate)
• Applicable to other EHC expenses
• $xx single, $xx family deductible
• Xx% reimbursement
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Other EHC (Edit as appropriate)
• Paramedical practitioners: (practitioners will vary based on plan
design chosen – edit slide as appropriate)
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Chiropractors
Physiotherapists
Psychologists
Massage therapists
Podiatrists
Osteopaths
Naturopaths
Speech Therapists
Acupuncturists
– $xxx annual maximum per practitioner and/or $xx per
visit
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Other EHC (Edit as appropriate)
• Other eligible EHC expenses include:
– Medical services and supplies (e.g. wheelchairs,
ambulance)
– Orthopaedic shoes/orthotics
– Hospital* (if applicable)
– Out-of-country coverage/travel assistance*
– Full details in your benefits booklet
*$0 deductible/100% reimbursement
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Vision Care (Edit/delete as appropriate)
• $xxx every 2 years
• $xx single, $xx family deductible
• Xx% reimbursement
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Dental Care (Edit/delete as appropriate)
Deductible
$xx single
$xx family
Reimbursement
Xx% Basic
Xx% Major Rest.
Xx% Orthodontia
$x,xxx Basic/Major Rest.
$x,xxx Major Rest.
$x,xxx Orthodontia
Annual Maximum
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Dental Care
(Edit/delete as appropriate)
• Basic Services include:
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Exams
Cleanings
Fillings
X-rays
Scaling
Root canals
Gum therapy
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Dental Care
(Edit/delete as appropriate)
• Major Restorative Services include:
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Crowns
Bridges
Major surgery
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• Orthodontia includes:
– Braces for dependent children and adults
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How to make a claim… (Edit/delete as
appropriate)
• EHC – Drugs (pay direct drugs)
– Present your card at the pharmacy counter
along with your prescription
– Pharmacist transmits claim directly to Manulife
– You pay only $x deductible and xx% of the
total cost of the prescription at the pharmacy
counter
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How to make a claim… (Edit/delete as
appropriate)
• EHC – Drugs (reimbursement)
– Pay for the prescription at the pharmacy
counter
– Complete an EHC claim form
– Attach all original prescription drug receipts
– Mail to address indicated on the claim form
**Keep a copy of all receipts**
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How to make a claim… (Edit/delete as
appropriate)
• EHC – Drugs (deferred drugs)
– Pay for the prescription at the pharmacy
counter
– Pharmacist transmits claim directly to Manulife
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How to make a claim… (Edit/delete as
appropriate)
• EHC – Other EHC expenses
– Pay the service provider
– Complete an EHC claim form
– Attach all original receipts
– Mail to address indicated on the claim form
**Keep a copy of all receipts**
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How to make a claim… (Edit/delete as
appropriate)
• Dental expenses
– Pay the dentist
– Dental office will electronically submit your claim (if
dental office has the technology)
– Otherwise, complete a dental claim form
– Attach all original receipts
– Mail to address indicated on the claim form
**Keep a copy of all receipts**
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Claim Payments
• Options:
– Cheque mailed to you with claims statement
(explanation of benefits) that details how the
claim was paid
– Direct deposit to your bank account
• You will receive an electronic claim statement via
email with this option
• You must register for this service online at
www.manulife.ca/groupbenefits
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Coverage Changes/Requests
• Please notify Plan Administrator Name
when:
– Your marital status changes
– You have/adopt a baby
– Your spouse obtains/loses coverage through
their employer
– Your dependent child (over 18 years old) is
moving on to post-secondary education
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Some handy tips…
• Shop around for the pharmacy in your area with the lowest dispensing
fees (grocery store chains, Walmart typically have very competitive
fees)
• If you are on maintenance medication (prolonged course of drug
treatment), ask for a three month supply and save on dispensing fees
• Take your prescription as prescribed and complete the entire
treatment, even if you feel better after a few days
• Coordinate your benefits with your spouse’s plan to receive up to
100% reimbursement of your eligible expenses
• When your dentist has proposed dental services over $300, submit the
treatment plan for an estimate of what will be covered by the plan –
no more surprises!
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Where to get more information
• Your benefits booklet
• www.manulife.ca/groupbenefits
• Plan Administrator’s Name
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Questions?
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