For Medavie Blue Cross Group Advisors, Consultants, Employers and Plan Sponsors
Last updated: March 4, 2022 10:00 a.m. ADT
Given the unprecedented nature of this pandemic, the information on this page is subject to change without notice.
For Medavie Blue Cross Group Advisors, Consultants, Employers and Plan Sponsors
Last updated: March 4, 2022 10:00 a.m. ADT
Given the unprecedented nature of this pandemic, the information on this page is subject to change without notice.
Travel update: We have removed certain restrictions around travel coverage – there is no longer a requirement to be symptom-free and not have been in contact with anyone who has tested positive in the last 14 days. Standard “sudden and unexpected” limitations apply. See full details in Travel Coverage section below.
Please bookmark this page for the latest information on how this pandemic is impacting your plan and its members.
The content on this site will be updated on a regular basis – visiting here is the best way to ensure you are referencing the most up-to-date information possible.
Members can access the latest information about COVID-19 and their benefits at medaviebc.ca/covid19.
All content reflects standard group coverage. Some group policies may differ.
Will receiving the COVID-19 vaccine impact members' current or future benefits coverage?
Contrary to misinformation being shared online, receiving a COVID-19 vaccine will have no effect on the ability to obtain coverage or benefits from life insurance or supplementary health insurance.
These claims are incorrect and have no basis in fact whatsoever. Receiving the vaccine will not affect individual or workplace life or health insurance benefits, or ability to apply for future coverage. This information is available for members at medaviebc.ca/covid19
Will Medavie Blue Cross extend coverage to workers impacted by a temporary layoff during the COVID-19 pandemic?
Medavie Blue Cross recognizes the challenges many employers are facing in light of the COVID-19 pandemic. We will extend coverage for all benefits except disability benefits during a temporary layoff, per the temporary layoff provisions of the in force contract. This provision is typically for layoffs up to six (6) months. Employers should check their contract, as plans may vary.
Whether workers are paid or unpaid during their period of layoff, premiums must continue to be paid.
How does Ontario’s new infectious disease regulation under the Employment Standards Act impact worker coverage?
On May 29, 2020, the Government of Ontario added a new regulation under the Employment Standards Act, 2020 (ESA), called O. Reg. 228/20: Infectious Disease Emergency Leave.
This new regulation concerns non-unionized workers in Ontario who have had their hours of work eliminated or temporarily reduced during the “COVID-19 Period”, which started on March 1, 2020. Specifically, it adds new rules concerning the potential termination, severance and constructive dismissal of these employees.
The government has amended the Employment Standard Act to define the COVID-19 Period as ending on July 30, 2022.
For plan members considered to be on leave under IDEL, we will maintain their coverage for all lines of benefit, including STD and LTD, provided premiums are paid, until the IDEL regulation expires. Thereafter we will follow group policy provisions for coverage with respect to layoffs and employment termination.
Any plan sponsor putting temporary layoffs in place due to COVID-19 should consult their employment lawyer or human resources expert to ensure that their benefit coverage related to the employees conforms to this regulation.
Please keep Medavie Blue Cross informed of any layoffs or terminations, through your Account Associate.
Will Medavie Blue Cross extend coverage to workers impacted by a temporary reduction in work hours during the COVID-19 pandemic if they fall below the ‘minimum number of hours worked’ requirement?
In order to be eligible for continued group benefits, an employee is expected to be actively at work for the minimum number of hours required stipulated by the Group contract. Exceptions to this may be considered on a case-by-case basis. Please contact your Medavie Blue Cross representative to discuss if a request of this nature is required.
Plan sponsors must advise Medavie Blue Cross of salary reductions for newly affected employees so coverage (and premium) can be adjusted in the event of a claim during the period of reduced hours.
If a plan member hasn’t completed their waiting period and are temporarily laid-off, when would they become eligible for benefits?
The time spent while temporarily laid-off due to COVID-19 counts towards a plan member’s waiting period. The plan member would therefore be eligible for benefits on the later of: 1) their return to work date, or 2) the end of the waiting period.
What happens if an employer is unable to pay their premium on time because of the financial hardship they are experiencing during the COVID-19 pandemic?
Medavie Blue Cross understands that employers may still be struggling in light of the COVID-19 pandemic. Employers who have concerns about their ability to pay their premiums can contact their Medavie Blue Cross representative to discuss possible options.
Can a group temporarily discontinue/suspend all coverage and resume the same coverage when the COVID-19 pandemic is over?
We strongly recommend against this option, as it leaves your plan members exposed to possible financial hardship for their health costs. If deemed absolutely necessary, please contact your Medavie Blue Cross representative to discuss possible options.
If a plan sponsor chooses to pay all (or a portion) of the plan member share of disability premium, while their members are laid off work, how does this affect non-taxable disability benefits?
If an employer wishes to pay any portion of disability premiums on behalf of their employees, any disability benefit payments would be deemed taxable to the employee. If the disability benefit is currently non-taxable (i.e. 100% employee paid), a policy amendment is required. Professional tax advice is always recommended when considering changes to employee compensation or benefits.
How does the COVID-19 pandemic impact applications requiring medical underwriting (i.e. late applicants, coverage over non-evidence maximums)?
All applications will be underwritten according to our standard process. Paramedical service providers have resumed their services and are available when required.
Can members prescribed the antiviral medication Paxlovid (nirmatrelvir and ritonavir) submit claims for these drugs?
Currently, governments are controlling the purchasing & distribution of these drug and there is no expectation for private plan coverage.
We will be closely monitoring the issue and any eventual need for potential private purchase of these medications in the future.
You can find out more about these emerging treatments here.
Are COVID-19 tests covered by benefits plans?
COVID-19 tests, including travel-specific tests, are not covered by benefits plans.
For members with a Health Spending Account (HSA), a prescription from a medical practitioner is required for any COVID-19 tests to be eligible for reimbursement.
Expenses maybe eligible under your Personal Wellness Account if the benefit categories Safety and Security Items, Other Medical, General Lifestyle, Miscellaneous or Leisure Travel is included in coverage.
Can members still submit health and dental claims?
Of course! However, in light of the pandemic and potential impact to mail delivery, we encourage plan members to submit claims online via our website or mobile app. Click to learn more about how easy it is to submit claims online.
Can members be reimbursed for claims from health practitioners who offer their services virtually?
Yes. We have conducted a review of the scopes of practice for covered health practitioners to facilitate access to, and continuity of, needed care by virtual means. Currently we will accept receipts for virtual appointments from the health practitioners listed below. Members should consult their own provider(s) to determine if their specific care can be provided remotely. The list below is subject to change as we continue to assess scopes of practice. As always, providers must be registered with Medavie Blue Cross and all claims are adjudicated based on the member’s plan design and our reasonable and customary limits.
Audiologists
Chiropodists
Chiropractors
Counselling Therapists
Registered Dietitians
Naturopaths
Occupational Therapists
Optometrists
Physiotherapists
Podiatrists
Psychoeducators
Psychologists
Psychotherapists
Social Workers
Speech Therapists
Dentists
Guidelines around the types of services allowed, as well as specific protocols in providing virtual therapy, vary by the governing body of each provider type listed above. Again, members should speak with their health care provider to confirm what specific services they can deliver online and rely on them to follow the appropriate protocols.
Have you closed your Quick Pay locations?
Yes. As a precaution we have temporarily closed our Quick Pay locations across Atlantic Canada. We do not have a re-open date for our other locations currently, however, drop boxes for member claims are available at our Moncton, NB, Dartmouth, NS and St. John's locations.
Our location in Halifax has reopened as Medavie Benefits+, a new all-inclusive health benefits and wellness centre with agents available to recommend a plan or help members optimize use of an existing plan and smart kiosks to assist with digital adoption and self-service through our mobile app. Full social distancing protocols are in place.
Are charges for Personal Protective Equipment (PPE) charged by dental care professionals eligible for reimbursement under a dental plan?
Some dental care professionals have begun charging for PPE usage during the pandemic. Plan members are strongly encouraged to discuss any extra charges that may be requested by their provider, prior to their visit.
COVID-19 related surcharges for PPE are NOT eligible benefits under existing dental plans. Dental claims will continue to be paid in accordance with the benefit provisions outlined in the group insurance contract, which does not include reimbursement for these items. Any additional surcharges for added time requirements (i.e. pre-screening, donning and removing PPE and any down time for sanitizing, etc.) are also NOT eligible expenses.
Upon request, plans of any size can add coverage for these surcharges under ‘Basic Care’, subject to the plan’s rules.
Please contact your Medavie Blue Cross representative should you wish to add this coverage to your dental plan and/or to determine the impact on your dental premium.
What about PPE surcharges from other types of health care professionals?
PPE surcharges from eligible, non-dental health care professionals are managed within the reasonable and customary limits that are set per practitioner per visit, based on a monitoring of claims activity.
If a health care professional adds the cost of these items to their invoice, our system controls ensure the total reimbursement for the service will not exceed this limit.
Are PPE expenses eligible under HSA?
Yes. PPE surcharges from both health and dental care professionals are considered eligible under Health Spending Account (HSA) or Personal Spending Account (PSA) plans.
Are COVID-19 tests from private providers covered?
COVID-19 tests are available through government agencies, so they are not covered by benefits plans. A prescription from a medical practitioner is required for any COVID-19 tests to be eligible for reimbursement through a Health Spending Account (HSA).
Will benefit maximums/coverage be extended for people: a) who had health or dental appointments delayed or cancelled and their policy year ended (i.e. annual maximums were reset); or b) whose coverage is no longer in effect (i.e. over-age dependants)?
We will continue to administer our group benefits plan according to the terms of each contract, which means claims incurred during the current policy year and/or before someone’s coverage has come to an end will be paid according to the plan rules and benefit maximums for that policy year.
Have the terms of a Health Spending Account (HSA) and/or Personal Spending Account (PSA) changed?
HSA and PSA terms remain the same and these plans will continue to be managed in accordance with the contractual provisions. Members can check their benefit and grace periods in their benefits booklet and learn more about the many expenses they can claim against their HSA and/or PSA balances by checking their booklet or our online Help Centre.
Our HSA admin system is designed to protect plans against actions typically not permitted by the Canada Revenue Agency. Temporarily extending the period for unused HSA credits can be entertained but system testing is required for quality assurance purposes. An allocation equal to the balance of expiring credits can more easily be added to the credit allocation for the next policy year.
Does group life insurance cover a death resulting from COVID-19?
Yes. If a covered plan member or eligible dependant were to die as a result of contracting COVID-19 then the life insurance claim would be payable, assuming all other terms of the group life policy are satisfied.
How are you helping plan members access their medication through mail order services?
Helping your members access the products and services they need has always been a priority for us. As the COVID-19 pandemic has changed so much of peoples’ lives, we have been working to address changing expectations of how plan members access health care benefits. This includes options for accessing their prescribed drugs.
To support plan members’ access to the convenience and comfort of home delivery for their daily maintenance medications, we have established our My Home Rx offering. Available to all Medavie Blue Cross plan members, except in the province of Quebec*, My Home Rx leverages our relationships with two leading home delivery pharmacy service providers, Sobeys Pharmacy by Mail and Alliance Pharmacy, to make it easy for members to access the drugs they need, the way they want.
Simple, convenient and safe
Online purchases and home delivery of many goods and services have become a standard part of daily life. The COVID-19 experience is changing expectations and comfort-level of Canadians in how they access health care products and services as well, including greater interest in obtaining prescriptions by mail.
My Home Rx helps Medavie Blue Cross plan members to access their prescriptions for maintenance drugs through our home delivery pharmacy partners - with added convenience and the comfort of physical distancing - without any changes required to your plan design.
Lower cost for plans and members
My Home Rx offers the benefits of free home delivery and low dispensing fees versus many traditional pharmacy options. This provides an opportunity for savings, both for the member and their drug plan.
If your plan currently offers our Pharmacy Partners preferred pharmacy network (PPN), which includes Sobeys and Alliance, your members can also take advantage of the convenience and savings of the home delivery services offered by these pharmacies through My Home Rx as well.
*For Plans and Members in Quebec: The My Home Rx offering is not available in Quebec. Members based in Quebec can take advantage of existing locally available mail order pharmacy services. Our member communication educates them on the benefits of mail order pharmacy and encourages them to ask their local pharmacy about home delivery options.
Please share the following message with your plan members through email, internal newsletters, or any other information channels you have available:
My Home Rx: Home Delivery of Prescription Drugs
Our benefits provider, Medavie Blue Cross, offers My Home Rx, a home delivery service for your prescription drugs. My Home Rx provides convenient options for free delivery of your prescriptions to your door, with online refill ordering and low dispensing fees to help save money, all without having to leave your home. Find out more at medaviebc.ca/members/programs/myhomerx.
The COVID-19 pandemic is evolving rapidly. New information emerges constantly and decision-making is required frequently. We will continue to provide updates, as necessary. We remain committed to supporting members when an injury or illness prevents them from doing their essential work tasks.
Medavie Blue Cross continues to manage and pay short-term disability claims according to our regular disability management guidelines. Given the current challenges around accessing COVID-19 test and physician visits, we have made temporary adjustments to our claims approval processes:
1. Employee is unable to work because they have been placed under quarantine or their place of work is closed and you cannot accommodate working from home, but not too ill to work otherwise: These employees may qualify for the Canada Recovery Sickness Benefit (CRSB). You can find out more about qualifying for CRSB here. They will not qualify for Short Term Disability coverage.
2. Employee has a positive COVID-19 test, and unable to work because of illness: Qualify for Short Term Disability once the waiting period is satisfied. Member should submit the standard Disability application forms along with one or more of the following reflecting their condition and inability to work:
These claims are not automatically accepted: a phone interview will be conducted with the employee to confirm illness and inability to work and outline requirements to access medical confirmation if possible.
If we approve only based on PCR Test or rapid test, we will allow a maximum benefit period for the COVID diagnosis of 10 days. Medical evidence should be provided if condition proves to be disabling beyond this period of time. If the claimant is experiencing restriction and limitations beyond the 10-day period, they will be expected to seek medical attention and provide medical evidence to support the claim beyond this period of time.
3. Employee is unable to access a COVID-19 test but is too ill to work due to flu-like symptoms: If a member is unable to work due to COVID-19 illness but are not able to submit any of the above medical evidence, they should complete and send us this form (Medavie Blue Cross Plan Member Confirmation of Illness).
These claims are not automatically accepted: a phone interview will be conducted with the employee to confirm illness and inability to work and outline requirements to access medical confirmation if possible.
If we approve only based on Confirmation of Illness form, we will allow a maximum benefit period for the COVID diagnosis of 10 days. Medical evidence should be provided if condition proves to be disabling beyond this period of time. If the claimant is experiencing restriction and limitations beyond the 10-day period, they will be expected to seek medical attention and provide medical evidence to support the claim beyond this period of time.
Standard waiting period applies.
Disability coverage varies by plan sponsor and it is best to check your specific disability coverage. Sick and vacation policies vary by employer and are outside the Medavie Blue Cross group benefit plan.
What mental health supports or resources are available to plan members?
We know that COVID-19 is taking a toll on the physical and mental wellbeing of many Canadians. For plan members that are experiencing stress or anxiety, and/or struggling to cope, please know that expert help is just a call or click away. Here are just some of the services and supports available to help our members get through this difficult time – from the security, privacy and comfort of your home.
How can I make my employees and plan members aware of the resources available to them?
Please feel free to adapt or share the following message with your members using email, internal newsletter or your other communications channels:
To our valued employees,
During the COVID-19 pandemic you may be concerned about your health and/or the health of your loved ones. We would like to assure you that our benefits partner, Medavie Blue Cross, has many tools in place to support your physical and mental health through this time.
This includes:
For more information on these and other tools that are available to support your mental health during this time, visit the Medavie Blue Cross COVID-19 Mental Health Resources web page.
Groups with our inConfidence Employee & Family Assistance Plan Only: You may also access our Employee and Family Assistance Program, inConfidence, for support.
If you or someone you know is in crisis, the Canadian Mental Health Association advises that you call 1-833-456-4566 toll free (In QC: 1-866-277-3553), 24/7 or visit www.crisisservicescanada.ca.
Finally, to learn more about the services available through Medavie Blue Cross and access your benefits, visit the plan member centre or download the Medavie Mobile App from the App Store or Google Play.
What else can members do to support their health?
On medaviebc.ca, we are encouraging everyone to download Canada’s COVID Alert app. COVID Alert is provided by the Government of Canada to help Canadians reduce the spread of COVID-19. The free and voluntary app helps notify users if they may have been exposed to someone who has tested positive for COVID-19 and is available to Canadians in most provinces and territories.
What is a Government of Canada travel advisory (i.e. warning)?
The Government of Canada (i.e. the federal government) issues travel advisories, available online, that show the overall risk level for a country or territory based on an assessment of the nationwide safety and security situation. Full details are available here.
It is strongly recommended that Medavie Blue Cross members with travel plans closely monitor travel warnings issued by the Government of Canada.
As you know, recent developments around COVID-19 have caused some questions about whether this will impact our provision of Group Travel coverage.
To confirm, we will continue coverage for plan members as per their contract, regardless of government restrictions. At this time, we do not intend to extend coverage to any quarantine-related expenses.
Details on what is, and is not, covered is available to members on our COVID-19 information page at medaviebc.ca/en/covid19
*Revised* Is a member who needs to travel outside Canada for business or personal reasons covered for COVID-19?
As countries re-open their borders, we recognize that members are looking to their travel coverage to provide protection and peace of mind and we feel strongly it should be there for them during the pandemic.
Consequently, we are pleased to advise that all standard Medavie Blue Cross travel plans will cover eligible emergency hospital and medical expenses related to COVID-19, subject to existing maximums and all other terms, conditions and limitations of the policy.
As with other health conditions, any illness must be considered “sudden and unexpected” in order to be eligible, meaning that if a member departs with a confirmed case of COVID-19 they will not be covered for any related costs.
Plan members who opt to travel internationally during this period are strongly recommended to carefully review the guidance available at travel.gc.ca around international travel and requirements around returning to Canada, and to regularly check the site for any new or updated information.
Is a member who is a student travelling to study outside Canada covered for COVID-19?
Emergency hospital and medical travel coverage for COVID-19 claims is extended to students studying abroad. In these cases, COVID-19 coverage will be extended to cover the full-school term if the trip limit in the travel contract permits it.
What are limitations on travel coverage?
Medavie Blue Cross travel insurance does not cover:
Please note: due to the impact of COVID-19 on health and travel resources in foreign countries, although we will endeavor to provide access to health resources in case of an emergency, we may be limited in the support that can be accessed.
If a member is required to receive a COVID-19 test to allow travel, is this covered by their plan?
Travel-specific COVID-19 tests are not covered by benefit plans.
What should a member do if they get sick while travelling?
If members are exhibiting symptoms of COVID-19, they should contact our medical assistance provider, CanAssistance. They can be reached by calling collect at 1-506-854-2222 (worldwide) or toll free at 1-800-563-4444 (Canada and the USA).
CanAssistance will assess the symptoms described and direct members as needed to a hospital or clinic for the appropriate care. Depending on the situation and needs, they may also:
During the consultation, members should inform the physician if they have visited any high-risk areas (crowded public areas etc.) or been in contact with any animals or persons who showed symptoms associated with COVID-19.
What if a member becomes ill after they return from a trip?
If symptoms develop and a member has travelled to a region with confirmed COVID-19 cases or have been in close contact with someone who has, they should:
If members develop fever, cough or difficulty breathing in the next 14 days, they should:
If members are ill and must visit a health care professional, they should:
If members feel sick during travel to Canada or upon arrival, they should:
Is a member covered if they need to cancel or interrupt a trip because of COVID-19?
The COVID-19 pandemic is a known situation. The Government of Canada’s global travel warning to avoid all non-essential travel outside Canada, issued in March, remains in effect. Consequently, expenses related to cancelling a trip for a reason related to the COVID-19 pandemic are not covered, unless the trip was booked on or before March 15th, 2020. Furthermore, expenses related to interrupting a trip for a reason related to the pandemic are not covered unless the departure date was on or before March 15th, 2020.
Is a member covered if: A) the government of the destination country is advising travellers that they must be self- quarantined upon arrival; or B) their provincial government is advising travelling that they must be self-quarantined upon their return?
The actions and/or recommendations of a foreign or provincial government do not influence travel coverage. Members should contact their travel agent, airline carrier(s) and/or tour operator(s) regarding reimbursement. Members are not covered in scenario A or B.
Who should members contact first if they need to cancel their trip and want to be reimbursed?
Members should first seek reimbursements or credits through their airline carrier or travel agent. Medavie Blue Cross is the final payer on Trip Cancellation claims.
What is Medavie Blue Cross doing to ensure business continuity in the face of the COVID-19 pandemic?
Our role as a healthcare leader in our communities is always our number one priority. We understand the importance of our ability to serve our clients and plan members amidst this global health event. Rest assured, as we continue to adjust our business practices your needs are our priority focus. We have a detailed plan in place, are continuously monitoring the evolving global impact of COVID-19 and are in regular communication with federal and provincial health authorities.
We are prepared to minimize service disruptions related to COVID-19 outbreaks. We have enabled our work from home program and enacted additional social distancing, cleaning and disinfection measures to mitigate the risk of spreading COVID-19.
If it is not possible to obtain a ‘wet’ signature from a plan member or plan sponsor on a form, what other options are available?
Understandably, the past year has given us all new expectations on how technology can support our business and personal needs.
We accept e-signature submissions from plan sponsors and members for a wide number of requests or transactions, including plan contracts and amendments, beneficiary information, and life and disability claim information. We will also accept a signed photo or scanned copy of all documents.
For security and convenience, we recommend using one of the leading commercial e-signature platforms currently available in the industry: DocuSign, Adobe Sign, OneSpan and Paddock. You can also use other e-signature platforms, providing these documents are submitted with the certificate of completion or audit report/trail.
All tools must adhere to the CLHIA Process on Electronic Declarations.
We also encourage your members to use our digital platforms whenever possible, through our Medavie Blue Cross Mobile app and our Member Services Site. If a submitted document requires a signature, they can use an e-signature tool or provide a scanned image of the signed document.
What is Medavie Blue Cross doing to keep everyone informed?
For advisors and plan sponsors, Medavie Blue Cross continues to issue follow up communications and update this ‘COVID-19 Info Centre’ webpage.
For members, our contact centre is able to address member inquiries and there is an escalation process, when necessary. Our global travel assistance provider, CanAssistance, is also fully equipped to answer questions related to COVID-19 from members.
Medavie Blue Cross has also established a COVID-19 webpage in both English and French for relevant updates on COVID-19, which is featured prominently on our home page.
How is Medavie supporting the communities it serves during this pandemic?
The COVID-19 pandemic has forced us all to think differently and consider new ways to invest in improving the health and wellbeing of Canadians.
Medavie’s mission is to improve the wellbeing of Canadians – and we have never been more committed to that goal than now. That commitment to caring for Canadians extends to our communities, as well. The needs of our communities have been significant throughout this crisis, especially for our most vulnerable and at-risk community members.
That’s why, through the Medavie Health Foundation, we committed $5 million to improving access to food and mental health support. As of the end of 2020, more than half of the funds have been distributed to community-based charities addressing food insecurity and increasing access to mental health services for youth. Grant recipients include:
Downloads
Mental Health message template to share with your plan members – English | French
COVID-19 Digital Tools Member Flyer - English | French
Message from the CEO - English | French
Travel Insurance Claim Forms - English | French
As we support our clients and plan members through the pandemic, rest assured that all normal business needs are also being fully addressed. Please contact your Medavie Blue Cross representative if you have any questions about any of our products or services.