OCTOBER 6, 2020
Information updated under ‘Travel’ Tab.
SEPTEMBER 28, 2020
New information added under ‘Business Relief Measures’ Tab.
SEPTEMBER 24, 2020
New information added under ‘Visiting the Office’ Tab.
SEPTEMBER 3, 2020
In response to the COVID-19 pandemic, in March 2020, GroupHEALTH and DMI’s offices were closed to all but essential on-site team members.
Remote Work Arrangements
We focused on providing our clients and plan members with uninterrupted service and support while transitioning our team members to work remotely. Our clients have told us that they appreciate the continuity of service we have been able to provide during these disruptive times.
Returning to the Office
Because our team members appreciate the collaboration, tools, and camaraderie that they experience when they are working together in our offices, GroupHEALTH and DMI will begin a phased process for our team members to return to our offices beginning this fall.
Our priority is to ensure that our team member’s return to office is safe while ensuring that we continue to provide our clients and plan members with uninterrupted service and support. This includes continued flexibility for employees with health or childcare challenges, and physical safety measures that comply with provincial public health and safety protocols.
Our Next Steps
Initial phases of our plan are entirely employee-led: GroupHEALTH and DMI team members can volunteer to return to our offices, subject to safety standards, and many may take advantage of a “hybrid” office + remote work arrangement.
Our plans also include continued monitoring of public health advisories, and a contingency to reinstate mandatory offsite service should circumstances warrant.
Navigating What Comes Next
We know that many of our clients have also had to implement remote work arrangements for their employees, and we appreciate the complexity of these decisions. We’ve added some resources to the ‘Resources for Business’ tab, that GroupHEALTH and DMI have consulted for our planning, in the hopes that these may also be helpful to you and your business.
We will continue to monitor the evolving situation and follow the guidance of our federal and provincial governments and health authorities, making any necessary adjustments to our return to office plan as changes arise.
MARCH 26, 2020
Use this COVID-19 “hub” to get the latest information about COVID-19 and your benefits plan.
- GroupHEALTH has announced new relief measures to support Canadian organizations through challenging times. See the Business Relief Measures page.
- Read how COVID-19 might impact common disability scenarios on the Disability page.
- Prescription drug supplies remain strong, pharmacies are taking important measures to keep it that way. Read about these measures, and changes to home delivery options, on the Prescription Drugs page.
VISITING THE OFFICE
COVID-19 VISITOR HEALTH & SAFETY PROTOCOLS
GroupHEALTH has developed the following visitor health and safety protocols to ensure we protect the physical, mental health, and safety of both employees and visitors while adhering to all public health policies and guidelines. Hosts (an employee hosting a visitor) are required to advise visitors in advance of these protocols and should provide an advanced copy of this document to all visitors.
During the COVID-19 pandemic, wherever possible, business should be conducted virtually, however there may be occasions where visitors need to come to our physical office locations. Visitors also include any contract staff such as cleaners, trades and vendors. The following protocols must be followed:
Visiting Company Offices
To prevent the spread of COVID-19 throughout the workplace, in all cases the following visitors shall not be permitted to visit any GroupHEALTH workplace:
- Any visitor that appears to have COVID-19 symptoms (i.e. fever, cough, or difficulty breathing), until such symptoms have passed.
- Any visitor that has tested positive for COVID-19. Visitors are not permitted until the visitor tests negative for COVID-19 and has completed any self-isolation period mandated by public health authorities. If the visitor is unable to be tested, the visitor should not visit any GroupHEALTH office until they have completed any mandated self-isolation period and are free of symptoms.
- Any visitor that has been in close physical contact with another person diagnosed with COVID-19. The visitor should not visit any GroupHEALTH workplace until the visitor has completed any mandated self-isolation period and does not present any symptoms.
- Any visitor who has travelled internationally until the visitor has completed self-isolation/isolation requirements as outlined by either the Canadian Federal Government, or Provincial Health Officer in the Province of the office location.
Protocols While Visiting an Office
Because our team members appreciate the collaboration, tools, and camaraderie that they experience when they are working together in our offices, GroupHEALTH will begin a phased process for our team members to return to our offices beginning this fall.
- All visitors visiting any GroupHEALTH office are required to report to reception and identify themselves.
- Visitors will be asked to provide their name, telephone number, email address, date and time of visit, and name of the host. This information will be logged at reception and used to assist with any contract tracing efforts in the event of an outbreak.
- All visitors to GroupHEALTH offices are required to perform a temperature assessment at reception prior to proceeding with their visit. A visitor whose temperature check exceeds 38° Celsius (100.4° Fahrenheit) will be asked to postpone their visit.
- All visitors are expected to wear a face mask in all public and common areas (for example, hallways, bathrooms etc.). Visitors are not required to wear a face mask when attending an in-person meeting in a meeting room where physical distancing can be maintained.
- If a visitor prefers to wear a face mask in a meeting room, they may do so at their own choice. In circumstances where a visitor does not have a non-medical face mask, one will be made available at reception.
- Visitors must always be escorted by the host when beyond the reception area. Exceptions to this are any contract staff such as cleaners, trades and vendors who have received advanced permission, and access to areas beyond reception.
- When an employee is considering hosting a meeting, they must ensure that the meeting room chosen allows for 2 meters physical distancing and does not exceed the COVID meeting room capacity. Room capacity is posted outside each meeting room.
- An employee hosting a meeting should ensure that all surfaces in the meeting rooms are disinfected prior to the start of the meeting, and at the conclusion of the meeting. Disinfectant wipes are available in each meeting room.
The COVID-19 pandemic has impacted people in many ways. The level of sensitivity to health and safety concerns will vary depending on everyone’s personal circumstances and situation. As such, we ask that all employees and visitors make every reasonable effort to adhere to these Health & Safety protocols and respect one another.
Reporting of Deficiencies
Employees or visitors who encounter any deficiencies related to these protocols are encouraged to notify Human Resources as soon as possible.
WE’RE READY TO SUPPORT YOU
This is an unprecedented time for Canadians, as we come together to meet the challenge of COVID-19, the Coronavirus. We know that our families, friends and neighbors are anxious about what COVID-19 means for their health, their relationships and their livelihoods.
And we know that businesses and organizations across the country are making some difficult decisions to preserve what they’ve built for better times ahead.
We want you to know that we’re here to support you. Our commitment to you is that GroupHEALTH will continue to ensure that your employees and your business get the best benefits experience, even during challenging times.
Stay safe, stay connected, and stay well.
The GroupHEALTH Team
WE’RE A FULLY OPERATIONAL “VIRTUAL” TEAM
In order to ensure continued service, and in light of public health authority’s “social distancing” recommendations, GroupHEALTH’s team is now working remotely. While we have implemented measures to minimize service impacts, clients and plan members may experience slight delays as we adjust our processes during these unusual circumstances. Plan Administrators are encouraged to email questions or concerns to their regular contacts at GroupHEALTH for continued service.
OUR SERVICE PROVIDERS ARE READY TO SUPPORT YOU
GroupHEALTH is in regular contact with its partners and service providers to ensure continuity of service. They’re committed to ensuring that employee benefits plans are fully operational during these challenging times.
WE’LL STAY IN TOUCH
We’re committed to continuing communications with you as the situation changes. Where appropriate, we’ll email you with important updates. And you can always check this page for the latest information.
BUSINESS RELIEF MEASURES
Federal and Provincial governments may update employment and insurance provisions under Employment Standards and related Statutes due to the COVID-19 pandemic (for example, extending layoff provisions), and these may impact how the coverages in your benefits plan have to be administered. GroupHEALTH is prepared to support any and all administrative provisions outlined in Federal and Provincial regulations.
Where, through regulation or legislation related to the COVID-19 pandemic, eligibility for benefits has been required to be extended, existing layoffs provisions in each benefits plan will begin after the final date of government-protected layoff periods.
The following are all temporary changes to administrative practices or temporary adjustments to some policy conditions which apply to all SSQ, Empire and La Capitale policies (except where otherwise noted) administered by GroupHEALTH. We will not be changing group insurance policies or member handbooks. All these adjustments are subject to constant review as the COVID-19 related situation changes and may be changed at the Insurer’s sole discretion. Dates will be reviewed as the situation unfolds further. Updates of any changes will be provided.
PLAN MEMBER REDUCTION TO WORK HOURS
We are making an exception for employees who are working reduced hours due to COVID-19. Until further notice (or until May 31, 2020 for La Capitale policies), we will not apply our standard requirements related to the minimum number of hours worked to be eligible for benefits.
MINIMUM NUMBER OF EMPLOYEES
We are making an exception until further notice (or until May 31, 2020 for La Capitale policies) for groups that fall below the minimum number of employees when an employer has reduced the number of employees due to COVID-19 below the minimum required.
COVERED BENEFIT AMOUNTS
Unless instructed otherwise by plan sponsors, benefits that are salary based will be adjudicated based on the coverage for which the premium is being paid. Employer and employee premium rates will remain unchanged as we are committed to covering the current amounts on record.
If plan sponsors want to insure employees at their reduced hours for a corresponding decrease in benefits they must submit an earnings change in WEBS online.
- Customers that currently have a layoff provision in their group insurance contract can retain their current provision as is: to allow all benefits (except short-term and long-term disability) to be extended for the period stated in the contract.
- New option available for a limited time (or until May 31, 2020 for La Capitale policies) as a result of COVID-19:
Customers that currently have a layoff provision in their group insurance contract which already includes short-term and/or long-term disability can allow short-term and long-term disability benefits (as applicable) for all their employees to continue in the layoff period but subject to a maximum period of three months (or 60 days for La Capitale policies) (or the extension period for other benefits, if shorter).
- Given the urgency related to COVID-19, We will, upon request, consider implementing the new layoff provision retroactively (no earlier than March 16th)
Until the end of July 2020 we are allowing a person to satisfy the elimination period for both short- and long-term disability while on temporary layoff. Exceptionally, short-term but not long-term disability benefits may commence during the period of layoff if the elimination period ends during the period of layoff. For La Capitale policies only, for LTD for any disability with a date of disability during the first 60 days of temporary layoff, satisfying the elimination period will not commence until the planned return to work date.
Standard reinstatement provisions apply. If a member returns to work within 12 months from the last day worked, they are eligible on the plan as of the day they return to work without medical evidence required. For reinstatements outside 12 months, medical evidence may be required.
PREMIUM PAYMENT GRACE PERIOD
COVID-19 is putting a financial strain on many Canadian businesses. To help our customers during this challenging time, we will, upon request, extend the grace period for the March, April and May 2020 premium payments to 60 days.
Please note that claims suspension may be applicable during extended grace period.
SUSPENSION OF BENEFIT PLAN
Some customers may wish to temporarily suspend their entire benefits program or specific benefits, due to economic uncertainty. We are prepared to allow such suspension to the end of June 2020 with no penalty to reinstate, on a case by case basis.
The pre-existing condition clauses will not restart once the plan is reinstated. No late entrant rule will apply to those that were hired during the period of suspension if they are added as soon as they are eligible after the suspension period is ended.
The following options are available up to end of June 2020 (or until May 31, 2020 for La Capitale policies):
- Suspend the entire program for all employees. The policy will remain active with no benefits available to any employees (active or laid-off).
- Suspend specific benefits (by class for groups over 10 lives, where the class was defined prior to 15 March).
- You can choose to suspend Dental or Extended Health or both
- Please note that Life, ASI or AD&D, and Dependent Life must remain in place if they are currently included in your contract if you wish to suspend only specific benefits. *Note coverage will follow RAMQ guidelines.
During a period of suspension, it is important to note that any claims incurred, including disability claims, will not be covered.
Note: Employers should check with Employment Standards in their province and be aware that the Termination or Suspension of Benefits may result in Constructive Dismissal and/or have other legal implications. GroupHEALTH strongly advises that any changes in this regard be reviewed by a Labour lawyer prior to implementation.
AMENDMENTS TO ADD OR INCREASE WEEKLY INDEMNITY / SHORT TERM DISABILITY COVERAGE
All policy amendment requests to add or increase short-term disability benefits submitted prior to March 16, 2020 are being processed. Requests received on or after March 16th will be declined due to the risk of anti-selection.
Further details regarding the measures above will be made available shortly. Insurers may at their sole discretion change or cancel any of the above measures at any time without prior notice. All terms of the group policy continue to apply.
CHANGING COST SHARE ARRANGEMENTS
GroupHEALTH plans must continue to meet the minimum requirements of 50% paid by the employer (with some exceptions resulting from employee paid non-taxable disability). However, clients can change cost-share arrangements, as long as the minimum 50% paid by the employer requirement is met.
GroupHEALTH will allow a change from taxable to non-taxable disability benefits; note that this will have plan design and possible rate impact, per standard amendment processes.
COMMON DISABILITY SCENARIOS
|What Happens If
||Source of Income Replacement
|My company shuts down and I am laid off?
||Programs such as Employment Insurance (EI) are designed to cover wages lost as a result of a company shut down, for whatever reason.
|Schools are closed and I need to stay at home to look after the kids?
||This varies from company to company. If you do not have personal days or vacation days your employer may make an exception. Various levels of government are working on assistance programs and we will know more in the coming days.
|I need to self-quarantine because I have flu-like symptoms?
||If your company provides a short-term disability benefit and you are sick and unable to work, you may be eligible for benefits. Employment insurance(EI), also has a sickness benefit available to everyone who pays into EI.
|I have been diagnosed with COVID-19?
||If you are diagnosed with COVID-19 (with or without symptoms), are unable to work and have STD you can access your short-term disability benefit. For these claims only, the waiting period will be waived.
|I need to self-quarantine, because I just got back from international travel?
||If you can work from home while self-quarantined, that’s great. If you cannot work from home and your employer will not continue to pay you, you can apply for employment insurance.
OUT OF COUNTRY COVERAGE
Effective immediately, both essential and non-essential travel up to 90 days to countries with a Government of Canada “Avoid non-essential travel” advisory will be covered under the terms of your policy at no additional charge.
Conditions covered include COVID-19 (the “Coronavirus”).
Travel to countries with a Government of Canada “Avoid all travel” advisory will remain as an exclusion under your plan.
Should a plan member travel to a country in which the Government of Canada travel advisory changes from “Avoid non-essential travel” to “Avoid all travel” while the member is there, the plan member will continue to receive coverage but will be expected to return to Canada as soon as possible. Plan members who are in quarantine within Canada will be covered under this exemption provided their out of country travel begins seven days or more after they come out of quarantine.
As usual, please refer to your benefits handbook for specific details of your coverage, including who insures your plan’s out of country coverage. Each insurer has further information available on their websites.
Provisions regarding trip cancellation will remain unchanged: any booking of travel to countries with a Government of Canada “Avoid non-essential travel” or “Avoid all travel” advisory at the time the booking is made will not be eligible for trip cancellation insurance.
If Your Employee Benefit Plan Includes Managed Rx and Maintain Rx (Alliance Pharmacy), or Postscripts (Rexall)
Prescription Drug Supplies and Distribution
Pharmacy distribution channels and supplies are strong, but to help preserve inventory levels some maintenance medications will be limited to a thirty day supply, rather than the usual 90 day supply, in keeping with the recommendations of health authorities. Details regarding limits will be available from your pharmacy at time of order/re-order.
Prescription Drug Delivery
Due to changes in delivery services by Canada Post and FedEx in response to COVID-19, new protocols are in place for parcel delivery:
- Service guarantees are suspended
- Post office and pick-up location hours of service will be reduced. Parcels will be held for an extended period at post office and pick-up locations.
- Door Delivery: Knock, drop and go approach will be implemented. In some cases, a package may be routed directly to a pick-up location and a delivery notice card may be left at the door OR in your mailbox/community box.
Where appropriate, delivery will be directed to post office or courier locations. Pharmacy employees can assist with identifying a pick-up location near you and will ship directly to that specific location.
If home delivery is more appropriate, due to isolation or health vulnerabilities, a “knock, drop and go approach” will be taken with home deliveries. You should be alert to deliveries and immediately safeguard your packages. Tracking inquiries are very challenging at this time as delivery providers are overwhelmed with increased shipment volumes. In the event of a missing package pharmacies will do our best to try and accommodate replacements on a case by case basis.
SPECIAL AUTHORIZATION & COVERAGE NAVIGATION
ClaimSecure will continue to accept Special Authorization and Coverage Navigation Service forms. However, all responses are only being communicated through email at this time. Plan members should include their email address when submitting forms.
FORMS CAN BE SENT TO:
Fax: 905-949-3029 Attention: Special Authorization
Fax: 905-949-3029 Attention: Coverage Navigation
EMPLOYEE ASSISTANCE PROGRAM WITH LIFEWORKS
For those GroupHEALTH benefit plans that include LifeWorks, even during “social distancing” you have access to the support you need to manage stress, anxiety, grief, and financial concerns.
LifeWorks has taken the steps to ensure that they will continue to be available to provide members with 24/7 assistance. Professional counselling is available through tele-counselling, video counselling, and group virtual sessions for those that require support in dealing with COVID-19.
Log in on the LifeWorks website or mobile app and search COVID-19 to find the latest resources available to support you and your plan members.
HOW TO ACCESS LIFEWORKS
Login to the LifeWorks app or at lifeworks.com:
User ID: health | Password: Support
By telephone, toll-free:
Call 1-866-331-6851 (English) or 1-800-565-9973 (French)
VIRTUAL HEALTH PROVIDERS
COVID-19 has impacted the ability for health practitioners to be able to provide in-person services to their patients. Practitioners are now looking for virtual solutions for their services, some of which may be covered under employee benefits programs. Always consult your benefits handbook to see if services offered by various practitioners are covered in your plan. Note that claims are subject to reasonable and customary limits.
To be eligible for claims reimbursement, practitioners must be able to demonstrate that they are meeting the standards for virtual healthcare services:
- Practitioners must be providing a service for a patient that has a clinical file, including a record of an initial assessment conducted in the preceding 12 months
- Practitioners must maintain clinical records for all provided services in accordance with all the requirements for in-person care
- Practitioners must ensure that communication technology used and the physical location of the practitioner and patients does not compromise the privacy and confidentiality of the patient’s Personal Health Information
- Practitioners must provide follow-up consultations and care as appropriate
- Receipts from practitioners should clearly state the service was provided through telehealth
Below is a list of those health practitioners who are eligible to claim for virtual services and those that are not.
Eligible Virtual Health Practitioners:
- Naturopathic Doctor
- Occupational Therapist
- Psychologist/Social Workers/Registered Clinical Counselors/Psychotherapists
- Speech Therapists
Ineligible Virtual Health Practitioners:
- Massage Therapist
The standards of service and the eligible health practitioners are subject to change as federal and provincial orders and regulations change.
VIRTUAL HEALTHCARE WITH AKIRA
Always check your benefits handbook to confirm your coverage
Many GroupHEALTH employee benefit plans include virtual healthcare, powered by Akira, an online service that provides on-demand access to medical assistance wherever you are and whenever you need it. Over 50% of primary care concerns traditionally seen in a doctor’s office can be addressed through the Akira virtual healthcare app and website, without ever having to leave home or work. Akira connects you with primary care providers without the need to see a health practitioner in person.
PROTECT YOURSELF USING VIRTUAL HEALTHCARE
Virtual healthcare can be especially useful during times like these:
- Use Akira’s online self-diagnosis tool
- Contact Akira virtually if you’re concerned that you may have COVID-19 symptoms
- Use Akira for other medical inquiries, to avoid in-person doctor and clinic visits
If your GroupHEALTH employee benefits plan includes virtual healthcare powered by Akira, start here.
YOUR EMPLOYEE BENEFITS PLAN DOESN’T YET INCLUDE AKIRA?
You can still access Akira, for a fee, at akirahealth.ca.
HOW YOU CAN GO DIGITAL
FOR PLAN ADMINISTRATORS
Billing is Now Paper Free
To accommodate remote work arrangements for our team members in response to public health authority recommendations, effective immediately GroupHEALTH will not be mailing paper bills to clients. Bills are available to all clients via WEBS.
Read more about Paper Free billing here.
FOR PLAN MEMBERS
Go Paper Free for quicker claims processing
In order for plan members to experience the quickest turn-around time for claims processing and payment, we encourage them to use the electronic claims submission and direct deposit options that are available to them through their claims submission platforms and apps.
If you have questions on setting up these services, reach out to us at:
RESOURCES FOR PLAN MEMBERS AND THEIR FAMILIES
RESPONDING TO COVID-19
MENTAL HEALTH RESOURCES