We provide plan advisors, plan sponsors and plan members with important information on what’s happening in the industry.
ACUPUNCTURE IN ONTARIO NOW REGULATED
On April 1, 2013, acupuncturists and traditional Chinese medicine (TCM) practitioners became a regulated health profession in Ontario. This means that any practitioners providing acupuncture or TCM must be registered with the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario (the College).
Accordingly, GSC will no longer be allowed to reimburse claims for services provided by acupuncturists who are not registered with the College. As it will take some time for all Ontario practitioners to go through the registration process, we will continue to pay acupuncture claims as usual for a three-month transition period. Effective July 1, 2013, claims from unregistered acupuncturists will not be eligible for reimbursement; plan members who had their acupuncture claims paid in the past may have their claims declined.
To find a registered practitioner or confirm a practitioner’s registration status, please check the College’s website at www.ctcmpao.on.ca.
|
|
TRAVELLING TO CUBA? HERE'S A REMINDER OF WHAT YOU NEED TO BRING (AND WE DON'T MEAN YOUR BATHING SUIT)
Effective May 1st, 2010, the Republic of Cuba required all travellers, foreigners and Cuban overseas residents to possess a travel insurance policy (covering medical expenses) that had been issued by an insurance entity recognized in Cuba.
Please note: travel insurance requirements for Canadian visitors to Cuba have been updated. Going forward, we understand that the Cuban government will accept a valid Provincial Health Insurance Plan card as proof of sufficient travel insurance coverage from Canadian travellers entering Cuba. In addition, it is strongly recommended that Canadians also take proof of additional travel insurance.
|
|
MORE SERVICES ADDED FOR PLAN MEMBER ONLINE CLAIMS SUBMISSION
GSC is always looking to enhance the plan member experience. So now we are expanding our online claim submission capabilities.
If you have registered for full access to Plan Member Online Services, as of mid-December, you will have access to submit your own claims online for the following:
-
Foot care services (podiatrist and chiropodist)
-
Acupuncture services
-
Speech therapy services
-
Counselling services (psychiatrist, psychologist, social worker)
-
Naturopath services
In addition to:
-
Physiotherapy
-
Chiropractic
-
Vision care
-
Massage therapy
-
A wide range of medical items
-
Orthodontics
Online claim submission is a self-serve option that puts quick and easy claims processing at your fingertips. You can submit claims whenever you want, wherever you are. And you can benefit from real-time claim adjudication, so you’ll know immediately how much your plan covers.
|
|
IMPORTANT INFORMATION FOR PLAN MEMBERS…CHANGES TO GREEN SHIELD CANADA (GSC) DRUG REIMBURSEMENT PRACTICES
At GSC, we are focused on making sure that group and individual health plans are properly managed today so they are sustainable in the future. To do so, we must ensure that the right person is being treated with the right drug at the right time…and in the right packaging.
How?
Well, we need to make sure that your benefit plan is always protected against unnecessary health care costs. So starting November 1, 2012, changes are being implemented by GSC that may impact how your drugs are dispensed to you at a pharmacy.
|
|
INNOVATION IN DRUG PLAN MANAGEMENT CONTINUES…
As GSC is an industry-leader in pharmacy benefit management, it was time once again to focus our attentions on innovative cost containment strategies and sound drug claims management. That means striving to eliminate things such as excessive dispensing fees due to unnecessary compliance packaging and waste due to unused high cost medications.
The new strategies revealed…
Effective November 1, 2012, important changes are being implemented by GSC on two fronts:
1) Compliance Package Management – Compliance packaging (sometimes referred to as “blister packs”) for a seven day supply will only be reimbursed for GSC plan members using five or more “maintenance” drugs (with some specific exceptions related to diagnosis, i.e., mental health conditions). A recent review of our claims data suggests a sharp increase in dispensing fees related to compliance packaging – without clear evidence of its therapeutic need in many instances.
2) 30 Day Supply Limit for High Cost Drugs – “High Cost Drugs”, defined by GSC as ones with a daily cost of approximately $40 or more, will be capped at a maximum 30 day supply. While this will increase the volume of dispensing fees, we foresee less waste and overall lower costs in the system, due to unused medication.
Like our initiatives over the past few years – biologics management policy, narcotic management policy, pharmacist opinion “refusal to fill” policy – these changes are meant to ensure we partner with pharmacy to ensure the highest value for the dollars spent by GSC plan sponsors.
|
|
BECOMING ONE OF CANADA’S BEST EMPLOYERS…GSC TELLS ALL
Toronto, October 18, 2012: Green Shield Canada (GSC), Canada’s only national not-for-profit health and dental benefits specialist, has earned a seventh place ranking on the Aon Hewitt 2013 Best Employers list.
Each year, the Aon Hewitt study determines which employers provide Canada’s 50 best places to work. The foundation of the Best Employers list is high employee engagement so the list is determined, in large part, by surveying employees.
“What earned us such high marks? That’s easy…” explains Steve Bradie, GSC president and CEO. “Our employees have said GSC is a great place to work. They are proud of our company, and they know it is their efforts that are driving the company’s success”.
|
|
NEW GREEN SHIELD CANADA WEBSITE ELIMINATES THE DIGITAL DIVIDE FOR PEOPLE WITH DISABILITIES
December 1, 2011- Toronto, ON: Today Green Shield Canada unveils their new website that—unique to the industry—offers free online accessibility technology.
“We developed our new website as part of a whole new look because we want people to know that we’re not a typical health and dental benefits carrier. We’re different… we’re a compelling alternative, so we’ve updated our look to more accurately represent what we’re all about,” explains Steve Bradie, president and CEO. “And although our look has changed, as Canada’s only national not-for-profit health and dental benefits specialist, we’re still focused on the same driving force since 1957…we’re focused on the greater good and a perfect example is the free online accessibility technology available on our new website.”
|
|