Employee Benefits Program Frequently Asked Questions
To help answer any questions you may have about your coverage or the processing of your claim, we have created a Frequently Asked Questions section for you.
1. Who is eligible for Employee Benefits?
Employees who are working on a full-time and full-pay basis, working a minimum of 30 hours per week and nine months of the year, or as stipulated in your Collective Agreement.
2. When are employees eligible for benefits?
Employees are eligible for coverage the first day of the following month from the date they complete their waiting period. Waiting period can be either 3 months, 6 months, or that which is stipulated in your Collective Agreement. Each employee must complete an employee
enrolment form and send the form to HED Insurance and Risk Services within 31 days from their effective date of coverage.
3. Does the Employee Benefits program include travel coverage?
Yes, travel coverage is included under most of the Extended Health Care options of the program. The coverage is 100% for out-of-country emergency medical expenses up to a maximum of $1,000,000 per calendar year. Maximum trip duration is 60 days.
4. What will I receive from HED?
You will receive an administration guide that includes claims and administration forms, as well as answers to frequently asked questions.
Each employee will receive an employee benefits booklet, a personalized certificate that provides details of their coverage, and a pay-direct card(s). Pay direct drug cards are used for point of sale claim submission at the dentist or pharmacist. This creates less paper work and reduces out of pocket expenses. Additional cards can be ordered by contacting your support specialist. Your pay direct cards also contain the emergency travel contact information.
5. Where do I send my claim forms?
Please send all claim forms directly to Green Shield Canada. All address information can be found on the claim form.
6. Who is Green Shield Canada?
Green Shield Canada is the claims payment provider for the TotalGUARD Employee Benefits Program. All health and dental claims are sent to Green Shield directly. They are located in Windsor, Ontario.
Enrolment Form Frequently Asked Questions
1. Which coverage designation should be selected?
-
Single – Coverage for the employee only. No coverage for dependants (child/spouse/common-law spouse).
-
Family – Coverage for employee and their dependants (child/spouse/common-law spouse – after 12 month cohabitation). Also, select this option for employees who coordinate benefits with their spouse (submit expenses to each other’s plans).
-
Partial – Employee has health & dental coverage elsewhere and chooses to waive these benefits. Employee will have all other coverage (for example: life insurance, AD&D, dependent life and disability, if applicable).
2. Does employee’s spouse have coverage elsewhere?
HED requires confirmation of spousal coverage by providing HED with their spouse’s group/policy number and name of insurance company.
3. What are optional benefits?
Employees can obtain this benefit above their standard benefits plan, for an additional cost.
Additional life insurance is available in units of $25,000 to a maximum of $250,000.
A quote and medical questionnaire will be provided to those employees who complete the optional benefits section on their enrolment form.
If approved, the premium for this benefit will be included on your monthly invoice.
4.
Family information
Please include full name, date of birth and relationship to employee for all dependants (child/spouse/common-law spouse) who are to be covered under the plan.
Children between the ages of 21 and 25, who are attending an accredited educational institution full time must submit a copy of their student schedule to be enrolled.
5.
How should the beneficiary section be completed?
The employee may allocate the life insurance to several individuals, provided the total allocated amounts equal 100%.
If a beneficiary is under the age of 18, a trustee that is of legal age must be designated.
If the employee leaves this section of the form blank, the life insurance will be paid to the employee’s estate. Proceeds of an estate are accessible to creditors.
For any other questions you may have, please visit our Contacts page for a complete contact listing; your question will be answered as quickly and accurately as possible.
|
