Extended Health Care Benefits

The Chambers of Commerce Group Insurance Plan offers a number of different Extended Health Care benefits. Some of the commonly forgotten about options include coverage of medical equipment and supplies as well as paramedical practitioner coverage. The following is a list of services that are covered by the extended health benefit. 

Medical Equipment and Supplies: 

  • Up to $25,000 per person towards home nursing care 
  • Emergency group or air ambulance to the nearest hospital
  • Up to $700 per person towards the purchase and installation of hearing aids 

Paramedical Practitioners

  • Audiologists 
  • Chiropractors 
  • Podiatrists and Chiropodists
  • Massage therapy 
  • Acupuncture 
  • Physiotherapy
  • Licensed speech therapy 
  • Naturopaths, not including food or vitamin supplements 
  • Osteopaths 
  • Clinical dieticians 

Make sure you make the most of your health care plan by becoming aware of all the services that your plan covers, and ensure that you submit all of your claims for reimbursement. 

Hints for Navigating Your Healthcare Plan

It can be easy to forget about keeping our office up to date on changes to your health care plan, but we want to make sure you get the most of your benefits. Here are some tips to help you navigate your Group Benefit Plan: 

  • You have 30 days to notify your plan administrator if you experience any life changes that will affect your coverage (marriage, birth of a baby, lost coverage through your spouse's plan, etc). If you miss the window of opportunity, there will be penalties/restrictions to your or your dependent's coverage. 
  • Your plan covers up to the cost of both brand name and generic drugs that are listed on our national formulary. If you prefer to have the brand name option of a drug when there is a generic available, please ensure that your doctor writes "No Substitutions" on your prescription. This will ensure that you receive the maximum amount of coverage possible on the brand name drug. 
  • Ambulance transportation is covered by your plan. There is a $250 charge for "paramedical assessment" if you call an ambulance (or someone else calls an ambulance on your behalf) and you are nor transported anywhere. this charge is not covered by the plan, so whenever possible, please let the ambulance take you to a hospital so that you're not stuck with the paramedical assessment fee. 

Your employee book contains a brochure with information about our online site called my-benefits. You can use the site to submit claims, check to see how much room you have remaining for each service type, and your next eligible service date, print off new cards, check on the status of all of your submitted claims, and much more. 

 

If you need additional help, please call or email our office and we would be happy to assist you! 

Coordinating Health and Dental Benefits

In many cases, getting the highest coverage may mean coordinating benefits with other insurance plans. Coordinating benefits is common with dental and drug claims, and happen if an employee or a dependent is covered under your group insurance plan and under a spouse's program. In this case, the two plans may combine to pay up to 100% of the claim expenses . 

When both spouses have coverage, claims should go to the patient's plan first. Any expenses not covered by the patient's plan should then be submitted to the spouse's plan along with the Explanation of Benefits from the initial claim. 

For dependent's benefits, the claim goes through the plan of the parent whose birthday falls earlier in the calendar year, then to the spouse's plan along with the Explanation of Benefits. 

When parents are separated or divorced, dependent's claims should be submitted in this order:

  • The plan of the parent with custody
  • The spouse of the parent with custody 
  • The parent who does not have custody 
  • The spouse of the parent who does not have custody

Remember to make photocopies of all documents before you send them to each plan. By coordinating benefits, you can ensure your employees are making the most of their benefit plans.

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. 

 


Be Prepared For Your Vacation

One of the most important steps in preparing for your holiday is to review your insurance plan to make sure you have Emergency Medical Travel coverage. 

The Chamber Plan's Voyage Assistance program covers expenses that you may be charged outside of your province of residence in a medical emergency. The Chambers Plan will pay eligible expenses over the amount covered by your provincial health insurance including: 

  • A semi-private hospital room 
  • Medical services and supplies in a hospital 
  • Physicians' services 
  • Prescription drugs 

Voyage assistance confirms your eligibility for coverage and can help you during a medical emergency. it can direct you to a local physician or medical facility, cover payments required by treatment facilities, and cover changes to  your travel plans to ensure you return home. 

The Chambers Plan covers insured employees and their dependents as long as they're also covered by their provincial health care program. Completely disabled employees who qualify for the Waver of Premium under the life insurance benefit are not covered for emergency medical travel.