In This Issue…

In This Issue…

 

Hello RSB plan members! In this winter edition of Viewpoints, we bring you several important articles and reminders, including:

Changes to Group MSP Administration

As we mentioned in previous Viewpoints, the Feb. 2018 BC Budget announced that effective Jan. 1, 2020, all BC residents who meet the eligibility requirements will no longer have to pay monthly Medical Services Plan (MSP) premiums. Because of this, UBC will no longer need to administer a Group MSP plan effective Dec. 31, 2019. Once this occurs, Health Insurance BC will automatically enrol you and your eligible dependents under your own MSP account. No action is needed on your part.

Even though you don’t need to pay MSP premiums, you are responsible for making sure the information that MSP has on file is up-to-date. For example, you must notify MSP with any address or name changes.

Please refer to the MSP Information Bulletin that was enclosed with your Winter Viewpoints newsletter. If you have questions about your MSP account, please contact their office directly:

  • Lower Mainland: 604-683-7151
  • Elsewhere in BC (toll-free): 1-800 663-7100

We wish you all the best for the rest of 2019 and happy holidays!

2020 Sun Life Rates

Each year, the Sun Life Extended Health and Dental plans are reviewed with UBC’s benefits consultants to determine the appropriate premium rates to support claim costs expected for the upcoming year.

The following tables outline the required rate adjustments to the Extended Health and Dental plans, effective Jan. 1, 2020. The renewal rates are based on analyzing 12 months of past claims experience (Jul. 1, 2018 – Jun. 30, 2019) while incorporating ongoing inflation.

Dental Plan Current 2019 Monthly Rates New 2020 Monthly Rates
Effective Jan. 1, 2020
Adjustment        
Single $49.08 $47.61 – 3.00%
Couple $98.16 $95.22 – 3.00%
Family $145.80 $141.43 – 3.00%
Extended Health Plan Current 2019 Monthly Rates New 2020 Monthly Rates
Effective Jan. 1, 2020
Adjustment
Plan 1 (LTM* $15,000)
Single $51.16 $44.00 – 14.00%
Couple $102.32 $88.00 – 14.00%
Family $102.32 $88.00 – 14.00%
Plan 2 (LTM* $50,000)
Single $103.94 $103.94 No change
Couple $207.88 $207.88 No change
Family $207.88 $207.88 No change
Plan 3 (LTM* $200,000)
Single $65.66 $70.26 + 7.00%
Couple $131.32 $140.52 + 7.00%
Family $131.32 $140.52 + 7.00%

* LTM – Lifetime Maximum

Submit Your Extended Health Claims

Any extended health medical claims incurred in 2018 must be received by Sun Life by Dec. 31, 2019.

There are 3 ways to submit your claims to Sun Life:

  1. Online: mysunlife.ca
  2. Mobile app: sunlife.ca/mobile
  3. Mail a paper form by:
    • Downloading an RSB Extended Health Claim Form or contacting Julia Carandang at julia.carandang@ubc.ca or 604-822-4580 to have a form sent to you.
    • Attaching the relevant original receipts. Keep copies for your records.
    • Mailing your completed claim forms and original receipts to:

Sun Life
PO Box 2010 Stn Waterloo
Waterloo, ON N2J 0A6

2019 Tax Receipts

Every year, tax receipts are issued to retirees who pay their own extended health and/or dental premiums. The tax receipts will be mailed to you by Feb. 29, 2020.

Please contact Julia Carandang only if you do not receive the letter by Mar. 16, 2020.

In-depth: Claims Requiring Pre-approvals

In-depth: Claims Requiring Pre-approvals

In the summer 2019 issue of Viewpoints, we mentioned that we would expand on the topics of Prior Authorization (which refers to Extended Health coverage), and Predetermination (which refers to Dental coverage).

Remember that:

1. For medical services and equipment in excess of $5,000, a preauthorization is required.

2. For certain drug therapies, Sun Life requires prior authorization.

3. For dental procedures that cost more than $500, we recommend that you receive a predetermination from Sun Life.

In these instances, having all the information beforehand can provide an estimate of your potential out-of-pocket expenses, and allow you to make an informed decision prior to using any of these costly services. In this article, we have provided detailed steps on how to send a preauthorization for medical services/equipment, prior authorization for prescription medication, as well as a predetermination for dental services to Sun Life.

Medical Services & Equipment Preauthorization

1. Complete the Extended Health Plan Claim Form, indicating “Preauthorization” on the form.

2. For medical equipment and supplies, make sure that the estimate includes the
following information:

  • Date of purchase
  • Claimant’s name
  • Item description, including make and model name if available
  • Quantity
  • Price
  • Physician’s name
  • Proof of the portion paid by the province in which the service or medical equipment was obtained (if applicable)
  • Receipts must be legible and each expense must be listed separately and clearly indicated.
  • Cash register receipts are acceptable if the name of the product is included, a
    physician’s referral is attached, and/or the name of the patient is indicated on a signed claim form.
  • If the receipt is for a brace, please indicate the body part (e.g. left knee brace)

3. Attach the recommendation from your physician (if required).

4. Make copies of all the above and mail to the nearest Sun Life Claim Centre as indicated on page 2 of the claim form, or submit the estimate using the “send documents” feature on the Sun Life Mobile app.

Prior Authorization Program for Prescription Medication (Extended Health Plan)

Prior authorization requires that coverage for certain drug therapies be pre-approved based on certain criteria. For full details, refer to page 14-15 of the Policy Booklet (2017 edition).

If the drug your doctor prescribes for you requires prior authorization, send Sun Life a completed prior authorization form before filling your prescription.

Visit mysunlife.ca/priorauthorization and enter your group Contract Number (020605) for a list of included drugs and forms.

Sun Life will review your request, usually within five business days, and let you know in writing if you are approved and the duration of your approval period.

Please contact Sun Life directly at 1-800-361-6212 if you have any questions.

Predetermination (Dental)

We recommend that you obtain a predetermination from Sun Life before you receive treatment for any dental procedure(s) that cost more than $500.

To receive predetermination for this work, ask your dentist to complete the RSB Dental Claim Form, detailing the dental procedure(s), and then have them send this form to Sun Life for you. Your dentist can also submit this form on your behalf.

Your dentist should include supporting information, such as X-rays or pictures of models or molds, to illustrate the services that are being recommended.

  • If your dentist does not provide this information with the form, your predetermination for services will be declined until this information has been received and reviewed by Sun Life.
  • Sun Life may also request further information from your dentist as part of its review process.

Once the review process is complete, Sun Life will send you a Claims Statement outlining what part of the cost is covered by the plan and what you will have to pay.

Please contact Sun Life directly at 1-800-361-6212 if you have any questions.

Please note that UBC does not have access to your medical and dental history, which includes preauthorizations, prior authorizations, and predeterminations. If you have questions regarding the status of your pre-approval requests, please contact Sun Life directly at 1-800-361-6212.

RSB FAQs

In this issue, we answer two of your frequently asked questions:

  • Where to find information about your emergency travel insurance
  • How to find out how much of your lifetime maximum (LTM) you have used.

Remember that both the emergency travel insurance and the LTM are relevant to plan members who are currently enrolled in the Extended Health plan.

I know that I have travel insurance specifically for medical emergencies. Where can I access information regarding my coverage?

Visit the RSB website to view an online summary of the travel insurance information, which is also available in your Policy Booklet (refer to p. 15 to 18). Click on “Sun Life RSB Policy Booklet” to find detailed coverage information for the Extended Health plan and Dental plan.

How do I find out how much of my LTM I’ve used under my Extended Health plan?

Please note that UBC does not have access to your personal claims history, which means that we do not know how much of your LTM you have used. Sun Life does not release this information to UBC.

For assistance, please contact Sun Life directly at 1-800-361-6212.