Your “Savvy Retiree” Newsletter for February 2025
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In 2025, there was a significant increase in insurance premiums.
In response to this situation, the retiree representatives, who have been involved in the renewal process for several years, have intensified their efforts to find solutions to minimize these increases. It is important to note that they are supported by an actuarial advisor who is well-versed in our contract, analyzes various alternatives in light of these increases, and provides recommendations.
As an example, we removed the pooling mechanism, which reduced the proposed increases from the insurer by 1.2%. We also removed weight control medications, as the insurer had requested an adjustment factor of 5%. However, we protected the insured individuals benefiting from reimbursements for a one-year period. Additionally, we were able to secure a slight reduction in the administrative fees charged by the insurer.
As mentioned in the December newsletter, the contract generated a deficit of more than $5,000,000 for the first time. Thanks to the stabilization fund, which amounted to $6,883,006, we were able to absorb the deficit. The increase in medication costs (due to inflation), the rise in claims, and the return to normal for travel insurance costs largely explain this deficit.
Always seeking solutions, we established a committee to work on improving the plan. It should be noted that the last major consultation took place in 2014. Our efforts were interrupted because the sustainability of the plan was questioned by active employee associations. Last November, the government decided to maintain the status quo. As a result, we will be able to present a proposal to the plan holder (Conseil du trésor - SCT) this spring. If the proposal is accepted quickly, we can proceed to the next step, which is to consult with you. Coverage for healthcare professional fees will be one of the topics, and of course, travel protection. Currently, our plan covers up to 180 days of travel. Many plans have reduced this coverage because claims history and payments have shown a significant rise in claim costs.
Billing Error in January
The insurer, Beneva, informed us that a human error led to an incorrect billing for the January premiums. The premium holiday was applied twice. After a meeting with the insurer's representative and the SCT representative, it was decided that the amounts owed would not be recovered. We ensured that the loss of $92,000 would not be charged to the group's experience during the upcoming October negotiations. The insurer has stated that they will implement a measure to prevent such an error in the future.
In conclusion, we understand your concerns about the impact of the premium increase on your income. However, it is important to emphasize that the Committee for Retirees (ACR) plays an advisory role, and the final decisions on pricing are made by the government through the Secrétariat du Conseil du trésor (SCT). It is the SCT that is responsible for awarding the contract to Beneva and validated the recommendation based on actuarial data and the financial needs of the plan. The government has no choice but to manage the collective plan properly, as it must comply with the law. Furthermore, it is important to clarify that the insurer, Beneva, strictly follows the clauses outlined in the contract. The premium holiday granted to all members for 2025 was recommended by the ACR.
Daniel Dubé
It is important to note that reimbursement requests must be submitted directly by the insured person to Beneva. Most claims can be made online through the Client Center or using the mobile app, available on your smartphone.
To be eligible for reimbursement, all invoices, including medication costs,
must be submitted within 12 months from the date they were incurred.
Remember that efficient management of your claims, including medications, helps expedite processing and ensures reimbursement within the required timeframe. You will also find practical tips to ensure your requests are processed quickly and correctly.
Before booking or embarking on a trip,
it is essential for a person with a known medical condition
to ensure that their health is stable and under control.
To guarantee adequate coverage during the trip, it is crucial that the condition shows no signs of worsening, relapse, or complications that could require medical attention during the journey outside their province of residence.
Contact the travel assistance company (CanAssistance) for any questions or concerns before your departure. Additionally, if you are traveling outside the United States and Western Europe, it is recommended to contact CanAssistance before your trip.
It is imperative to contact CanAssistance before consulting a doctor abroad or outside your province. The medical services number is located on the back of the collective insurance card provided by SSQ/Beneva. If you need to see a doctor but the situation is not urgent, call the toll-free number listed on the card (in Canada and the United States) or collect (other regions of the world). CanAssistance services are available 24/7.
In case of emergency, if you cannot immediately reach CanAssistance, go to the nearest clinic or hospital. Once emergency care has been provided, contact CanAssistance to open a claim file.
CanAssistance provides first-line agents available 24/7, 365 days a year.
Whenever possible, do not pay anything on-site
before speaking with your CanAssistance first-line agent, who will handle all billing.
In addition to monitoring the patient's health, CanAssistance considers all aspects of each situation: geographical location, cultural differences, quality of care, communication, costs, and insurance coverage.
It is strongly recommended to contact CanAssistance as soon as possible for several reasons:
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An agent will assess your needs, open a file, and guide you to the nearest clinic or hospital to receive appropriate care.
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The agent will confirm your eligibility and handle the billing to avoid, as much as possible, you paying on-site.
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They will stay in touch with you and your family during your hospital stay or until your health stabilizes during outpatient care.
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And more.
CanAssistance services include:
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Finding a nearby doctor or hospital.
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Assistance with your hospital admission.
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Confirmation of coverage with doctors and hospitals.
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Translation services.
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Coordination of your repatriation.
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And more.
Since June 2021, it is important to remind you that the travel insurance coverage does not apply to accommodation contracts where the property owner is not a business or a booking platform accredited or authorized by the relevant authorities to operate such a business or provide such services. This means that a private rental contract is not considered a "prepaid travel expense" eligible for trip cancellation insurance under your policy. Therefore, no reimbursement is provided under the policy in the event of cancellation of this private rental contract.
If you have any doubts, contact CanAssistance before booking your accommodation.