1. PLAN MEMBER INFORMATION SESSION
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Thompson Emergency Freight

2. YOUR MEETING TODAY Nichole del Sol, Client Service Representative, GSC
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3. AGENDA Benefits at a Glance – Plan Coverage Overview
Employee Experience
Customer Service
Being an Educated Consumer
Plan Member Online Services
Health Promotion
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Please ask questions at any time – but all personal claim inquiries should be directed to our CALL CENTRE (we will discuss this later in the presentation)

4. Health – Benefits at a Glance
Drug
Nil Coinsurance
Nil Deductible
Mandatory generic drug substitution applies
> age 65 -Ontario Drug Benefit co-pay/deductible is a benefit
Drugs covered include: legally requiring a prescription
Benefits do not include smoking cessation products and medication for the treatment of erectile dysfunction
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5. Health – Benefits at a Glance
EXTENDED HEALTH SERVICES
Coinsurance 100%
Deductible $25 single or $50 family per calendar year
Audio – covered at $300 every 5 years
Professional Services – up to $500 maximum per calendar year * Chiro - allows for $375 per covered person per calendar year
Vision - maximum of $125 every 24 months (12 months for dependents children 17 years and under)
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6. Eyewear Discount
We are pleased to announce that we’re expanding the Preferred Provider Network for Vision Care with the addition of Hakim Optical and ContactsExpress.ca.
Here is a full breakdown of the Vision PPN:
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7. Travel –Benefits at a Glance
For the first 60 days per trip
Emergency Maximum $1,000,000/ covered person/calendar year
Referral maximum $50,000/ covered person/calendar year
No Deductible/ No co-payments
Must contact GSC Travel Assistance within 48 hours of commencement of treatment.
Emergency means a sudden, unexpected injury, illness or acute episode of disease that requires immediate medical attention and could not have been reasonably anticipated based upon the patient’s prior medical condition.
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8. DENTAL BENEFITS
Deductible is $25 Single or $50 Family per calendar year
Coinsurance Basic Services/Comprehensive 100%, Major Services Restorative 50%
Your maximum for Basic services and Comprehensive basic services is $2,500 every 12 months based on date of first paid claim
Your maximum for Major services is $1,000 per calendar year
Basic services cover recalls once every 9 months, other exams and full mouth X-rays every 3 years
Comprehensive basic services cover denture relines once every 3 years
Major services cover standard dentures, crowns and bridges once every 5 years
Your eligible claims are reimbursed at the level stated above and in accordance with:
the current minus one year Provincial Dental Association Fee Guide for General Practitioners in the province where services are rendered
for independent Dental Hygienists, the lesser of, the current minus one year Provincial Dental Hygienists’ Association Fee Guide and Provincial Dental Association Fee Guide for General Practitioners in the province where services are rendered
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9. EMPLOYEE EXPERIENCE 1.888.711.1119 ONE CALL RESOLUTION
PLAN MEMBERS…SERVICE YOUR WAY
Call Centre
Monday to Friday, Eastern Time :30 a.m. to 8:30 p.m.
Low staff turnover < 3%
Simulated claims
Online services
Provider calls
Multilingual us
ONE CALL RESOLUTION
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10. EMPLOYEE EXPERIENCE ONE CARD DOES IT ALL! Very high card recognition
Claims processed in real time
Claims managed at point of service
Preferred Provider Vision Network
Extended Health Service providers can submit claims online!
JOHN SMITH
ABC Company
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Use this card when you visit a health service provider (pharmacist, dentist, extended health service provider)
Easy for member – only required to have UNIQUE ID. Don’t need to know policy number, Billing division, Class, Certificate number etc….
The back of the ID card will also contain the Travel Information (Unique 4-digit Travel Number and the Telephone Numbers for Green Shield Canada Travel Assistance). Patients must contact Green Shield Canada Travel Assistance within 48 hours of commencement of treatment.
ONE CARD DOES IT ALL!

11. BE AN EDUCATED CONSUMER…
PROTECT YOUR PLAN!
Call Customer Service before large expenditures
Check your invoice before provider submission
Explore provider discounts – enhance your benefit dollars
Protect your benefit plan, help keep it safe!
Sometimes we require additional claim information
Provider Profiling
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- Large expenditures over $300
- Shop around…try to be a smart consumer….Check out the different dispensing fees by pharmacy. Is it worth it to go to Costco vs a 24 hr Shoppers Drug Mart….Plan ahead.
- Explore Provider Discounts – We offer VISION PROVIDER DISCOUNTS (previously mentioned)
COP – traceable – bank statements, cc receipts etc.
We track and make sure all providers have their credentials including licenses and registrations.

12. PLAN MEMBER ONLINE SERVICES
PLAN MEMBERS…SERVICE YOUR WAY
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MY PROFILE – Allows PM’s to change their address, user name, password or challenge question if password is forgotten.
MY BENEFITS:
View My Benefit Coverage – allows you to submit a “mock” claim to see your benefits coverage, how much will be paid and any limited or conditions on your plan.
View Benefit Booklet – allows you to pull up a PDF copy of your GSC Benefits Booklet specific to your plan
My GSC ID Card – allows you to print a temporary paper copy of your GSC ID card
MY CLAIMS:
Submit a Claim - Physiotherapy, Massage Therapy, Chiropractor, Speech Therapy, Emergency Ambulance, Vision Care, Various Medical Items, Orthodontic Dental, Counselling Services (Psychologist, Social Worker), Podiatrist/Chiropodist, Naturopath, Osteopath, Health Care Spending Account
Personalized Claim Forms – allows your to pull up a paper claim form with your personal information already pre-populated (name, ID number, address, etc).
My Claim Statements – allows you to pull up PDF copies of your Explanation of Benefit (EOB) Claim Statements or Dental Pre-Determination Statements. This can be used when Coordinating a claim under a spouse’s plan. Statements are posted by date.
Search My Claims History – allows you to pull up claims history, up to the last 12 months, for any participant under your plan and for any specific benefit (shows amounts submitted and paid).
MY SPENDING ACCOUNTS:
PLAN MEMBER SUMMARY – contains personal information, coverage status and Coordination of Benefit details.
DIRECT DEPOSIT – enter your transit number, bank number and account number to set-up direct deposit of funds for claim reimbursements. You can also select to be notified by once the funds have been deposited.
CONTACT US – Allows you to send questions about a claim, eligibility or coverage directly to our Customer Service Department. All questions are answered within 2 business days.
GLOSSARY – provides definitions for commonly used insurance terms (i.e., Coordination of Benefits, DIN, etc.)

13. EMPLOYEE EXPERIENCE (LOG IN)
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**Note: Hit “space” on keyboard again to view LARGER image of this screen shot**
If you haven’t already registered, just click on “Register” (left hand side of screen), fill out the necessary information and an Access Code will be ed to you to activate your new PMOL account.
Plan Member Online Services access is only for Plan Members and not available for family members or dependents.

14. EMPLOYEE EXPERIENCE (MENU)
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This is the HOME PAGE for Plan Member Online Services.
As you can see, the website itself is very easy to navigate and extremely user friendly.
NOTE – You will see the “FIND A PROVIDER” and “IS MY DRUG COVERED?” search tools on the home page of the website.
I will now walk you through each of the features available in PMOL by expanding on each of the menu options on the left hand side of the screen.

15. Plan Member Online Services – Introducing the Drug Coverage Search Tool
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When searching a specific Drug name or DIN, you will get information specific to your own coverage:
Whether the drug is covered
The reimbursement level
Information on whether the drug requires prior authorization. If your drug requires authorization, you’ll be able to download the authorization form directly, print it and bring it to your physician.

16. Plan Member Online Services – Introducing the Provider Search Tool
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Our new “Find a Provider” feature will help you search for eligible dental, paramedical practitioner and vision care providers who are registered and in good standing with our provider registry.
Please note that we will only display those providers who are set-up with direct billing to GSC – we want to make things convenient for you by identifying those providers who can bill GSC directly so that you do not have to submit a claim form to us!

17. We’ve got an App! GSC on the Go
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New Application for Apple, Android and Windows phone is now available

18. Helping You Achieve Better Health
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19. Thank you
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