Navigating Travel Benefits: Answers to Your Top 5 Questions

By Human Resources Communications on April 20, 2018

Summer is right around the corner and if you plan to travel, it’s best to understand your travel benefits coverage prior to your trip. Visit our Travel Benefits webpage for full details, but if your bags are packed and you’re ready to go, review our top five frequently asked questions before you leave.

1. Am I covered while travelling outside BC or Canada?

Yes, and coverage depends on the expense. See the table below for a summary of coverage.

Remember, if you experience a medical emergency while travelling, it’s important to contact Allianz Global Assistance, Sun Life’s travel assistance provider, as soon as possible.

Expense Coverage Outside BC or Canada Amount Covered
Physician Services
(emergency only)		 Yes 100%, up to your overall lifetime max. of $2 million per person
Hospital Services
(emergency only)		 Yes 100%, up to your overall lifetime max. of $2 million per person
Ambulance Services – air or ground
(emergency only)		 Yes 100%, up to your overall lifetime max. of $2 million per person
Prescription Drugs
(emergency and non-emergency)		 Yes Same level of reimbursement as if the expense had been incurred in BC, up to your overall lifetime max. of $2 million per person
Other Services & Supplies – normally covered by UBC’s Extended Health Plan

(emergency and non-emergency)

 Yes Same level of reimbursement as if the expense had been incurred in BC, up to your overall lifetime max. of $2 million per person

In order to have coverage, you must be enrolled in the BC Medical Services Plan (either through UBC, your spouse/partner’s employer’s plan or with Health Insurance BC directly) and the UBC Extended Health Plan while temporarily outside of BC. You are covered for 365 days from the date you leave BC or your home province.

Your dependents are also covered if they meet the definition of eligible dependent and they are enrolled in the BC Medical Services Plan (either through UBC, your spouse/partner’s employer’s plan or with Health Insurance BC directly) and listed as your dependent under your Extended Health plan.

2. Should I purchase additional travel insurance?

How you answer this question will depend on your situation. And while we can’t make this decision for you, we can provide you with information on what your insurance covers (and what it does not cover). We suggest reading our previous Benefits FYI article where we answer this very question.

3. I have a pre-existing condition. Am I covered if I need medical attention related to my condition while travelling?

Yes, if the pre-existing medical condition is stable and controlled at the time of departure from BC/Canada and if your doctor has cleared you for travel. It’s strongly recommended that you obtain a letter from your doctor clearing you for travel or ask that a note be added to your medical file.

4. I am travelling to a country that has a travel advisory warning. Am I covered if I need medical attention while in that country?

Yes, travelling to a country that has a travel advisory warning does not mean you lose your coverage. We recommend calling Allianz Global Assistance, Sun Life’s travel assistance provider, in advance of your travels to confirm whether you will be able to access their medical emergency travel assistance services in your destination area. It is your responsibility to review your benefits coverage, including exclusions and limitations, prior to travel.

If you are experiencing a medical emergency while outside BC or Canada, contact Allianz Global Assistance as soon as possible. Allianz Global Assistance will try to connect you with medical services to the best of its ability; however, services may be delayed or unavailable depending on the situation.

5. Am I covered for trip cancellation, trip delay or lost luggage?

No. However, you can purchase such an insurance policy with the airline or travel company you have purchased your flight(s) or vacation package from.

For more information:

Understanding Your Travel Benefits (Vancouver campus)
Date: Monday, April 30, 2018
Time: 12:00 p.m. to 1:00 p.m.
Location: Michael Smith Labs, 2185 East Mall, Room 102
Cost: Free but RSVP required

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FACET Prior Authorization Drug Program

By Human Resources Communications on April 20, 2018

The UBC Extended Health Plan provides you and your eligible dependents with comprehensive coverage for medical services, supplies and prescription drugs.

Effective May 6, 2018, specialty drugs that are used to treat specific health conditions and that cost more than $5,000 per person, per calendar year will require pre-approval (“Prior Authorization”). This means that if your physician prescribes such a specialty drug for you or your covered dependents, you and your physician must submit evidence that supports the need for the drug in order to obtain coverage for it under the extended health benefit plan.

If you or your covered dependents were reimbursed for a specialty drug under UBC’s extended health plan in the 12 months prior to the effective date of the program (May 6, 2018), you will be automatically grand-parented and will not be required to apply for prior authorization for that drug. Visit the Prior Authorization webpage for more details.

Specific Health Conditions that Require Pre-approval/Prior Authorization

Certain drugs that are used to treat the following health conditions, and that cost over $5,000 per calendar year, per person, require prior authorization:

  • Asthma
  • Cancer
  • Crohn’s Disease/Ulcerative Colitis
  • Hepatitis C
  • Hypercholesterolemia
  • Multiple Sclerosis
  • Psoriasis
  • Psoriatic Arthritis
  • Rheumatoid Arthritis

About Prior Authorization

Prior authorization is used in many organizations’ extended health and dental benefit plans for high-cost medical services, supplies, procedures and prescription drugs. This approach ensures that specialty drugs are reimbursed when most needed so that extended health benefit plans remain stable and sustainable.

At UBC, our new prior authorization drug program is referred to as FACET and is administered by an independent, third-party organization called Cubic Health. FACET offers the following:

  • Prescription drug experts (licensed pharmacists) who make evidence-based decisions
  • Provides expert support in navigating related issues and collaborates with you and your physician to ensure appropriate drug and dose regiments for effective treatment
  • Coordination of coverage with the BC Fair PharmaCare Plan and other provincial drug plans, while continuing to provide choices in prescription drug treatment

Additional information about the new prior authorization drug program, including a list of frequently asked questions are available on our FACET Prior Authorization webpage.

Process for Obtaining Pre-approval for Coverage of a Specific Drug

1. Starting May 6, 2018, you can find out which prescription drugs require prior authorization by logging in to Sun Life’s website at www.mysunlife.ca (currently not available on Sun Life’s mobile app).

Once logged in, go to coverage information; medical – drug coverage; drug look up and search by drug name or DIN (drug identification number).

If your prescription drug requires prior authorization, you will receive a message indicating “to be considered for coverage for this drug, have your doctor complete the appropriate form”. You will be directed to the FACET Prior Authorization Drug Program webpage to complete the form (go to Step 2).

If you do not receive this message, prior authorization is not required at this time and no further action is required by you.

2. Go to the FACET webpage to find the Prior Authorization Request Form that matches your health condition.

3. Ensure that you and your physician complete the form – this can be completed through the “fillable” form.

4. Submit the form and supporting clinical information to Cubic Health via one of the following ways:

Note: Medical information is submitted directly to Cubic Health, and is not shared with UBC.

5. Allow three business days for review once all necessary information has been received by Cubic Health.

6. If your drug is approved, Cubic Health will notify Sun Life to cover the drug for a one-year period.

7. If the drug you were prescribed cannot be approved, your physician will be contacted by Cubic Health directly to discuss alternatives.

8. Cubic Health will send both you and your physician the decision in writing.

For more information, please visit:

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What to Expect When Calling EFAP

By Human Resources Communications on April 20, 2018

Looking for confidential, solution-focused counselling support for personal, work, health or life issues? UBC’s Employee and Family Assistance Program (EFAP) can help. Through our EFAP provider, Morneau Shepell, you can access a wide range of services 24/7 and choose the counselling format that works best for you. Whether you’ve used Morneau Shepell before or are using them for the first time, here’s an overview of what to expect when you access EFAP services.

About EFAP services:

  • Available to all eligible UBC staff and faculty and their dependent family members
  • Free (no cost other than your monthly premiums)
  • Voluntary and confidential (UBC is not informed of the identity of those who use EFAP services)
  • Available 24 hours, seven days a week, 365 days a year
  • Multiple languages available
  • Short-term counselling with community referrals available for longer-term or ongoing support
  • Professional counsellors have master’s level training and five to 10 years of EFAP-specific training

Seven ways to access services:

  • Telephone counselling (Care Access Centre at 1-800-387-4765)
  • In person counselling (various locations)
  • Instant chat (First Chat)
  • Mobile in-app counselling
  • Web and e-counselling
  • Video counselling
  • Online group counselling

What to expect when you contact Morneau Shepell’s Care Access Centre (CAC):

1. When you call 1-800-387-4765, after the language prompt, choose from three selections:

  • Press 1 for immediate telephone counselling. You will be transferred to a counsellor immediately. If you would like to arrange for in-person counselling during this call, an appointment will be set up within 24 hours.
  • Press 2 to schedule an EFAP service or if you need to cancel or reschedule an appointment. (If you press 2 and you are experiencing trauma or at risk of harming yourself or others, you will be transferred to a counsellor immediately.)
  • Press 3 for critical incident debriefing (for onsite crises). This service is available to Human Resources professionals who are requesting services for their department/faculty.

2. CAC intake specialist will:

  • Gather your contact information
  • Confirm your eligibility in the program
  • Ask you some preliminary questions about your issue so that they can let you know about the available services to help you resolve it

3. If you are scheduling an EFAP service:

  • You will be asked some preliminary questions about your issue.
  • You will be asked to complete an online pre-assessment form* prior to scheduling your appointment. This form will be emailed to you within 24 hours of your call. Once you submit the form, you can call the CAC back to schedule your appointment.
  • If you are scheduling an in-person counselling** appointment, the general wait time to see a counsellor in person is within five business days (non-emergency counselling). If you have specific preferences, you may have to wait longer. For example, if you request an in-person appointment with a female counsellor in Burnaby on a weekend, you may need to wait longer than five business days.

* Your pre-assessment form gives your counsellor background details in advance, allowing you to maximize the time spent with your counsellor during your appointment. If you’ve used Morneau Shepell’s services in the past, this form was previously completed at the beginning of your counselling appointment. For each new case or series of counselling sessions, a new form must be completed.

** In-person counselling through EFAP is available at many different locations. Morneau Shepell’s main offices are located in downtown Vancouver, Richmond, Burnaby, Coquitlam, Surrey, Kelowna and Kamloops. Other private offices in the Metro Vancouver and the Okanagan are also available.

For more information:

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MSP Premiums Eliminated Effective Jan. 1, 2020

By Human Resources Communications on April 20, 2018

In February’s 2018 BC Budget announcement, the Finance Minister announced the following changes to Medical Services Plan (MSP) premiums:

  • Beginning Jan. 1, 2020, all BC residents (and employers who pay MSP premiums on behalf of their employees) will no longer be required to pay monthly MSP premiums. For 2018 and 2019, MSP premiums will still apply.
  • Beginning Jan. 1, 2019, employers such as UBC will pay an Employer’s Health Tax (EHT) to allow for the full elimination of MSP premiums.

More information about these changes will be provided prior to their implementation date.

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Update on CAMMPUS: Project to Improve Heart Health for UBC Vancouver Faculty & Staff

By Human Resources Communications on April 20, 2018

CAMMPUS is a unique multi-year collaboration between the UBC Faculty of Pharmaceutical Sciences and UBC Human Resources. Known as the Cardiovascular Assessment and Medication Management by Pharmacists at the UBC Site, the CAMMPUS project focuses on improving the cardiovascular heart health of UBC Vancouver faculty and staff.

In the fall of 2017, CAMMPUS completed the data collection phase. Data analysis and evaluation is currently underway and results are anticipated later in 2018. They will be shared with the UBC community, as well as in professional human resources and pharmacy practice circles. It is expected that findings from CAMMPUS will inform future discussions and policy decisions around the role pharmacists have in preventive health care.

Thank You to CAMMPUS Participants

CAMMPUS would not have been possible without the support of UBC’s health-conscious community. Thank you to the UBC faculty and staff who participated and made time to prioritize their cardiovascular health, as well as the Faculty of Pharmaceutical Sciences and UBC Pharmacists Clinic for being long-time champions of UBC’s efforts to help build a sustainable, healthy workplace for UBC employees.

About CAMMPUS

The idea for CAMMPUS formed in 2014 when UBC HR’s Health, Wellbeing & Benefits unit partnered with the UBC Pharmacists Clinic to offer heart health assessments at the annual UBC Travelling Health Fair. Employees were eager to learn about their own health and, through this event, a proportion of employees were identified as having higher risk for future problems than expected or recommended.

The project was launched in 2015. Service costs were 100% covered by UBC’s extended health benefits plan and available at no cost to the employee. Over 500 employees volunteered for a confidential, 30-minute cardiovascular risk assessment administered by a registered pharmacist (or registered pharmacy student under pharmacist supervision). Of the employees initially assessed, over 200 with elevated risk volunteered to receive up to 12 months of standardized service designed to reduce heart health risk and guide improved health through customized care plans. More than 86% completed the study, which is considered an excellent retention rate.

For more information:

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Demystifying Dental Fees and Claims

By Human Resources Communications on February 20, 2018

Understanding dental charges and claims doesn’t have to be like learning a foreign language. In this article, we demystify dentist fees and dental claims – all to help you become more informed.

What is the Dental Fee Guide?

The British Columbia Dental Association (BCDA) produces an annual fee guide¹ for BC dentists, outlining over 1,400 dental codes, code descriptors and suggested fees that relate to specific elements of dental treatment. The document serves as a guide only: dentists are not required to follow the guide or any fee schedule.

Many dental plan providers base their coverage on the fees and codes within this guide. Sun Life, UBC’s Dental Plan provider, reimburses for dental services based on the current year’s BCDA fee guide for general practitioners.

How do dentists determine their fees?

The cost of delivering high-quality dental care is based on the complexity of treatment for each patient, as well as the cost of the following factors²:

  • Specialized equipment
  • Approved materials
  • Sterilization and safety protocols
  • Trained and licensed professional staff
  • External laboratory fees
  • Location of dental practice

What about fees for dental specialists?

Dental specialists receive additional training in a particular field of dentistry. When a high level of expertise is required, general practice dentists will refer patients to a specialist.

Treatment provided within speciality fields is often highly technical and complex. It can involve the use of special equipment, specific materials for treatment, additional staffing and ongoing education. All these factors are considered by specialists when determining treatment costs.

How can I be more informed?

1. Talk to your dentist.

Discuss all of your treatment options and the associated costs with your dentist before proceeding with treatment. Read on to learn what you need to do for recommended dental care procedures in excess of $500.

2. Ask if your dental office follows the BCDA fee guide.

A dental office may bill some, or all, codes based on the suggested fee guide.

UBC’s Dental Plan reimburses based on the current year’s BCDA fee guide for general practitioners. If your dental office charges more than the guide, you will be responsible for the additional cost.

If you receive dental services from a dental specialist, Sun Life reimburses based on the BCDA fee guide for general practitioners, plus 10%. You are responsible for any amounts not covered by the UBC Dental Plan.

3. Get a preauthorization for recommended dental work prior to receiving treatment.

For dental care procedure(s) in excess of $500 and all orthodontic work, you must receive a preauthorization from Sun Life before you obtain treatment.³

To begin the process:

  • Ask your dentist to complete the Dental Claim form, detailing the dental procedure(s) or orthodontic treatment plan. Your dentist can send this form to Sun Life for you, either by mail or electronically.
  • Your dentist should include supporting information (e.g. x-rays or pictures of models or molds) to illustrate the services that are being recommended. If your dentist doesn’t provide this information, your preauthorization 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.

How do I make a dental claim?

Many dental offices will submit claims for your dental procedure(s) directly to Sun Life. You’ll need to provide your dentist with your UBC Group Number (025205) and your Member ID (seven-digit UBC employee number).

For more information about dental reimbursements when your dentist submits a claim on your behalf, click here.

If your dentist does not submit claims on your behalf, you can submit a claim yourself.

References:

¹ The BCDA does not produce an electronic version of the fee guide for the public or its members. Instead, you can find a print copy at BC public libraries – the same version sent to all dentists in BC. If patients have questions about a specific code, they can ask their dentist directly, or contact the BCDA at 604-736-7202.

² Dentists are governed by the Health Professions Act of BC. Like medical clinics, dental clinics must adhere to strict regulatory standards to ensure a high level of patient safety and care.

³ It is your responsibility to request a preauthorization before receiving dental treatment in order to know what the dental plan will cover and how much you will be expected to pay out of pocket. If you obtain dental services without a preauthorization, you are responsible for what the plan does not cover. In the case of major dental work or services provided by a dental specialist, this could be a significant and unexpected amount.

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