How to Submit a Cost Plus Claim

Wondering how to submit a cost plus claim through your Chambers of Commerce Group Insurance Plan?

Check out this simple step-by-step video from the Chamber Plan!

Still have questions? Give us a call or send us an email! 

Late Entrants

The Chambers of Commerce Group Insurance plan requires all new full-time staff to serve a three month waiting period before they are eligible for benefits. Once the employee has served the three month waiting period, he/she must complete an employee application within 30 days or he/she will be considered a late entrant. 

Late entrants are required to complete a medical questionnaire that will require approval from the insurance company before benefits can be granted. Even with an approved application, dental benefits for late entrants are limited in the first 12 months of coverage. 

To protect your firm and your employees, we suggest that you complete and submit the enrollment application when a new employee is hired. The Chambers Plan will process the application with the employee's coverage commencing at the end of their waiting period.


Enrollment timing is just as important for insured employees. Changes in marital status, adding dependents, or a spouse losing duplicate coverage must be reported to the Plan within 60 days. If the employee misses this deadline, any request for these changes will need to be medically reviewed and approved by the insurance company.  

10 Features of a Chambers of Commerce Group Insurance Plan

10. No Minimum Firm Size

Your company is eligible to apply even if it's a one person operation. The Chambers Plan was introduced to assist small businesses consisting of up to 50 employees

9. No Industry Restrictions

All for-profit businesses are eligible to participate in Chambers Plan as long as they are members of a participating Chamber. Whether you own a farm or a home-based business, you are entitled to take advantage of the customized cover the plan offers. 

8. Guaranteed Approval

With three or more full-time people, you can choose options that guarantee cover to you and your employees. Businesses that operate with three or four fill-time employees are eligible for guaranteed coverage. Organizations with five or more employees can choose extensive dental coverage and groups of ten or more can add children's orthodontics. 

7. Guaranteed Renewable

Chambers Plan guarantees your firm can renew coverage as long as you pay your premium each month. Once your business is insured by the Chambers Plan, your coverage is automatically renewed. 

6. Rate Stability

Claims are averaged over more than 25,000 companies just like yours. Higher than usual claims one year? You won't be singled out for a price increase. Chambers Plan pools your claims with other participants so premiums are based on the average claims of all participants.

5. Not-For-Profit

Chambers Plan operates under the direction of the not-for-profit Chamber Insurance Corporation of Canada.  Keeping your interests at the forefront, Chambers plan operates under the guidance of volunteer directors who are also Chamber members. 

4. Outstanding Service

The Plan's service centre works in concert with your exclusive, local Chambers Plan advisor to provide answers to all of your questions. Our advisor present yo with options that reflect the size and requirements of your 

3. Fast, accurate payments

Most health and dental claims turn around in 48 hours. You can opt for a pharmacy card and electronic dental claim submission, and even direct deposit to employee bank accounts. 

2. You Choose the Coverage

Every firm participating in Chambers Plan has a custom benefit program, based on the coverage the owner selects. In addition to competitively priced health, dental, and vision benefits, our impressive list of extensions includes travel insurance, an automatic RRSP payroll deduction program, and options for employers over 65, such as prescription drug, ambulance, and semi-private hospital coverage. 

1. You Control the Cost

Why pay for a package with benefits you don't want when you can customize?

We recognize that small business owners are constantly struggling to keep costs down. By choosing options based on your company's needs and carefully selecting the amount of coverage provided, you can create a plan that doesn't break the bank. 

 


Changes in the New Year

Paramedical Services 

The Chambers of Commerce Group Insurance Plan has been working hard to serve you better, with that in mind there will be some changes to all Health Options in 2016. 

Chambers of Commerce Health options currently include paramedical services from the following practitioners: 

  • Massage Therapists 
  • Physiotherapists 
  • Chiropractors
  • Podiatrists/chiropodists
  • Naturopaths 
  • Osteopaths 
  • Acupuncturists
  • Clinical Dietitians 
  • Psychologists/Social Workers 
  • Speech Therapists 
  • Audiologists

Some of these services used to be viewed as alternative practices, however they are becoming increasingly popular to treat medical conditions. Instead of using these services for specific conditions, people are using them as preventative measures and to increase their overall mental and physical well-being.

In order to maintain sustainability for these products, the Chambers of Commerce Group Plan is applying an annual overall maximum to Health Option benefits. Effective January 1, 2016, all Health options will include a combined overall paramedical maximum of $2,500 per family per year. Based on claim figures over the past two years, 99% of current plan holders will not see any change in the amounts reimbursed by the Plan, however it will allow the Chambers Plan to continue to offer a broad range of service at sustainable rates. 

Your firm's Plan Participants are able to print this Change Notification at http://www.chambers.ca/existing-clients/employers/plan-news-and-publications.html

Plan participants using my-benefits can find the Change Notification under Forms & Tools/News & publications/ Amendments

Happy Holidays!

Merry Christmas From Our Office to Yours 

Our Holiday office hours are as follows: 

December 24:   9 AM - 12 PM
December 25:   CLOSED
December 28:   CLOSED
December 31:   9 AM - 12 PM
January 1:   CLOSED


We resume regular office hours on January 4, 2016


For all of our clients who bank with ATB,

 
The Chambers of Commerce Group Insurance Plan has been added as a billing payee with ATB. Effective December 21, 2015,  you will be able to make direct online banking payments to your Group Insurance Plan.

 


We hope you enjoy a holiday season full of family, friends, and grandma's old recipes! 

Best Doctors

Did you know that the Best Doctors program is included at no extra charge with every Chambers of Commerce Group Insurance Plan? 

So what is the Best Doctors program? 

  • It gives your employees access to the top 5% of practicing physicians, allowing them access to the top medical minds in their area 
  • Your employees can confidentially contact Best Doctors to talk to a Registered Nurse who will point the employee in the right direction, leading them on the path to recovery 
  • In 60% of cases, Best Doctors has modified the treatment that a patient should receive 
  • In 27% of cases, Best Doctors has completely changed a diagnosis - providing your employees with the right answers
  • Employers find that the Best Doctors program leads to an increase in employee retention and repositions employee health insurance benefits by offering them more than just financial support

Overall, the Best Doctors program allows your employees to seek the best possible medical care, leading to a happier and healthier lifestyle! 

 


Group Benefits are still an option over the age of 65

Due to the economy, or personal choice, more and more employees are choosing to work past the age of 65. As the workforce changes we aim to change along with it, which is why employees who have surpassed the traditional age of retirement are still able to receive group benefits. 

The Chambers of Commerce Group Insurance Plan allows your company to apply for Group benefits once you have been in business for six months. Each plan is customized to suit your needs.

 coverage for employees from 65-80 can include

  • Health care - including prescription drug, ambulance ad semi-private hospital coverage
  • Emergency Medical Travel - the first 90 days of trips for certificate holders age 65-69, 60 days for certificate holders age 70-74, and 30 days for certificate holders age 75-80 
  • Life benefits with Accidental Death & Dismemberment payments 
  • Dependent Life coverage for spouses and dependent children 
  • Dental benefits
  • Best Doctors - access to worldwide medical specialists for diagnostic and treatment planning services 
  • Preferred Vision eye wear and hearing devise purchase discounts
  • Health Access telephone line offering information on health, nutrition and regional resources
  • Employee Assistance Service - counselling services for confidential help dealing with personal issues 
  • Business Assistance Service - providing owners access to legal, accounting and human resource services. 

If you or someone in your company is considering working past the age of 65, it is important to ensure that they are provided with valid coverage on your group plan. The Chambers of Commerce Group Insurance Plan will work with you and your company to provide the best coverage to every employee at your firm. 

The Importance of Enrolling On Time


When an employee begins working full time, an employer has 3 months to submit an employee application online through my-benefits, or to mail in the application. After this 3 month period, the employee is considered a late entrant. 

For example, if an employee began working with your company on April 1st, we have until July 31 to get the new application into head office. 

There are two penalties for late entrants:

  1. The employee and his/her family members are forced to complete a medical questionnaire and pre-existing health conditions might not be covered. If you enroll employees on time, a medical is never required. 
  2. The employee and his/her family members would see their dental maximum lowered to $250 in their first 12 months of coverage. 

Your employees still have to go on t he plan even if they have spousal coverage. 

Even if your employee has coverage with another carrier, or through his/her spouse or common law spouse, he/she is not covered for: 

  1. Life 
  2. Accidental Death & Dismemberment 
  3. Long Term Disability 
  4. Short Term Disability 
  5. Critical Illness 

Important Tips: 

Waiver form: 

If an employee chooses to opt out of benefits, he/she needs to complete the Group Benefit Plan Waiver. This will protect your company in the event of an accident. 

Employer Responsibilities: 

As the plan sponsor, it is the responsibility of the employer to ensure all eligible employees are enrolled in the plan. We suggest that new employees complete and submit enrollment applications when they are hired. The Chambers Plan will process the employee's coverage when his/her waiting period has expired. 


Health and Dental Coverage for Disabled Employees

Chambers of Commerce Group Insurance Plan 

What happens when one of your employees becomes disabled and has been approved for Long Term Disability (LTD)? Do their health and dental benefits continue indefinitely? How do you balance your corporate responsibility and your fiscal responsibility?

Whatever your firm's position is, it is important that you have a formal continuation of benefits provision that clearly states what the policy is for all employees.

As an employer, ask yourself: 

  • Should health and  dental benefits terminate for an employee who becomes terminated?
  • Disabled employees tend to have a greater need for health coverage than active employees; would you end benefits for someone in that situation?
  • Will the cost of carrying the benefits for disabled employees impact your ability to provide an affordable program for active employees?
  • What are the legal and moral implications of your policy?

The Chambers of Commerce Group Insurance Plan allows the employer to continue health and dental benefits for disabled employees, however it is important to consider the length of time your company will provide these benefits for. 

Options to consider: 

  • Continue the benefits on the same basis as if the disabled employee was a full-time active employee
  • Provide benefits for a disabled employee for a specific period of time (i.e. one or two years from the date the employee completes the LTD elimination period) 
  • Provide benefits based on years of employment. As the duration period can vary, please see the following example

Whatever you and your company decide to do, your development of a formal company policy will be based on the relative importance you place on these three issues:

  • The ongoing financial resources you are willing to commit to disabled employees
  • Your corporate responsibility as an employer to look after employees during extended periods of disability 
  • The impact that a policy could have on employee morale and employees' attitudes towards you as an employer

Though it can be difficult to establish a policy, you can fulfill your corporate and fiscal responsibilities in a manner that will be seen as fair and equitable for everyone.