Transitioning to Great-West Life – Things You Need to know

Please see the information below regarding the transition of insurance provider to Great West Life. We are posting this for your information.

NOTE: We cannot answer questions about the plan. Questions should be directed to your Plan Administrator (for your workplace).

They have also launched a welcome site that is very informative at:

The Provincial Government is currently in the process of transitioning from the current insurance provider, Desjardins Financial Security, to Great West Life, who will be the new group insurance provider for the public service starting September 1, 2015. Below is important information for all employees and some key dates to note before the transition takes place.

• Group Insurance Benefits
o Your benefits will remain the same. This includes your current benefit maximums and coinsurances.
o After the transition to Great-West Life on September 1, 2015, you will see a minor reduction in some premium costs. The premium guarantees offered by Great-West Life are noted below for the following benefits:
A. Basic Life and Dependent Life insurance – minor reduction in premium and rates will remain the same for 43 months once the transfer is complete.
B. No increase to your Extended Health and Basic Accidental Death & Dismemberment premium and rates will remain the same for 19 months once the transfer is complete.
o For some services, (e.g., Massage Therapist, Chiropractor, Physiotherapist, Medical Equipment & Supplies), you will see some minor changes in claim payment amounts as all insurance carriers have different claim adjudication rules for these types of services.

• Benefit Cards
o Benefit cards will begin to be mailed August 1, 2015.
o If you have not received your benefit card by September 15, 2015, contact your plan administrator.

• Address Verification
o Ensure your address is current as benefit cards are being mailed to the address on file. You can verify your address by reviewing your most recent pay statement. If incorrect, you can contact your plan administrator.

• Great-West Life Office Locations
o The St. John’s claims office is located on the second floor, 15 Hebron Way, St. John’s.
o The Corner Brook claims office is located at Suite 204, 10 Main Street, Corner Brook.

• Claims History
o The claims history will be transferred from Desjardins to Great-West Life. Benefits involving maximums (e.g. for dental, eye care etc.) will not be reset to $0 when we transition.
o The benefit maximums are based on the calendar year (January 1 to December 31) and any claims you have made against the maximum will be carried forward to the new carrier.

• Special Authorization Drugs
o Desjardins will accept Special Authorization requests up to Friday, August 14, 2015. Desjardins cannot process special authorization requests after this date because of the 10 business day processing time. Desjardins will forward all requests received after August 14, 2015 to Great-West Life for processing effective September 1st, 2015.
o Desjardins has confirmed they will look at urgent requests on a case-by-case basis.
o Beginning September 1, 2015, all Special Authorization drug requests must be submitted to Great-West Life.

• New Enrolments and Changes
o Desjardins will continue to manage new enrolments and changes as they impact claim payment. However, drug cards will no longer be produced and sent after August 1, 2015.
o You can obtain a temporary card from the Desjardins Plan Member website as all you require for a dental office or pharmacy is your group and certificate number. This can be obtained from your Plan Administrator or the Desjardins Call Centre (1-877-838-7763) up to and including August 31, 2015.

• Claims
o To minimize possible delays in processing please ensure you send all claims for any benefit under the program into Desjardins as they are incurred. This includes medical, dental, long-term disability, Life, Critical illness, etc.
o As a reminder, if the service received was before September 1, 2015, it will covered by Desjardins provided the claim is submitted to Desjardins on or before August 31, 2015.

• Medical and Dental Estimates
o Any estimates received for approval after August 1, 2015 will be sent to Great-West Life for processing. However, Desjardins will handle the requests for nursing and home care if the service is urgently required.
o For any claims that will be incurred prior to September 1, 2015, please remember to keep a copy of the Desjardins estimate and submit to Great-West Life with the claim if the procedure is not completed by September 1, 2015.

• Banking Information
o Beginning September 1, 2015, you will need to go to Great-West Life’s plan member website to sign up for plan member access, electronic Explanation of Benefits and provide your banking information.

• Claim Drop-Boxes located in Confederation Bldg. and Health Sciences Centre
o They will be removed and the last pick up for these boxes will be Thursday, August 13, 2015.
o Electronic claims submission tools have significantly reduced the requirement for this service.

• Medical Claims Report for Income Tax Purposes
o You can download a medical claims report of how much you received in group insurance benefits from your Desjardins plan member secure site up to August 31, 2015 for the 2015 tax year. This will provide you with claim information from January 1, 2015 onward. Please note that the report is not an official document for income tax purposes. To download your report, log onto the Desjardins plan member site with your UserID and password and follow these instructions:

1. Click on Consult My Claims File on the home page of the secure site.
2. Click on View my Medical claims report for income tax purposes.
3. In the Request a report section, choose the tax year from the dropdown menu and click on Request this report.
4. The report will appear in the Consult my reports section.
o If you’ve requested a previous year’s report and would like to consult it again, follow the instructions in step 3 to update the information in the report.

Please click (English) and (French) to find out additional information about some of the tools and services being offered by Great-West Life beginning September 1, 2015. Once you click either link, all you need to do is enter GNL (either upper or lowercase) as the welcome code.

This is a site created by Great-West Life designed for plan members and contains information (in English or French) regarding your benefits card, the eWelcome package, your benefits summary and information you should provide to your current pharmacist and other medical care providers.

If you have any further questions about this change in benefits carrier, please contact your plan administrator.