RTO/ERO Group Benefits Program Régime collectif d’avantages sociaux d’ERO/RTO ADMINISTERED BY / ADMINISTRÉ PAR 2017/2018 going places Proof of Departure Inside In the event of a claim, Allianz Global Assistance will require proof of departure. This proof must confirm when you were last in your province of residence, not when you Allianz Global arrived at your destination. This proof is necessary so Allianz knows how long you have 2 Assistance – Making been outside your province of residence. the Grade in Service to You Each insured person must have their own proof of departure. Balance Billing The proof must: Reminders • Identify you • Indicate that the transaction took place in your province of residence before the trip Mr. John Doe Travel Plan Questions and Answers • Specify the date Toronto, Canada 3 Some examples of acceptable proof are: Rome, Italy Travelling Out-of- • Duty free receipt Province within Canada • Airline boarding pass YYZ • Credit card receipt (and copy of credit card statement if receipt is not signed) Supplemental Travel • Signed and dated bank/financial institution 4 Plan – annual rates documents (for example, if you went to the bank to change currency) Contact information • Receipt for professional services performed (for example, massage therapy, dental treatment, eye examination) Allianz Global Assistance – Balance Making the Grade in Service Billing to You In a medical emergency, Allianz Global Assistance will locate Allianz Global Assistance thanks you • Whether a member is being appropriate medical care and for giving them top marks in the most treated in hospital for a medical coordinate eligible payments to recent RTO/ERO survey. They value emergency or as an outpatient hospitals and physicians on your your feedback as it enables them to with a complex case, they will behalf. Allianz works with health learn about where they’re doing well. have a direct and dedicated point care providers worldwide and can What you have to say also lets them of contact from Allianz’s Case validate that your claims are based know where they can improve. Management team coordinating on charges that are reasonable and the details of their care. customary for the region. As well, Forty-five per cent of members who they negotiate discounted prices were sent the survey took the time As they look to build on these and other efforts, Allianz Global with selected providers and make to share their thoughts. It feels great Assistance will continue to seek out, payments on your behalf. to know that of that group, 89% listen to and act on your feedback to On occasion, after a bill has been rated Allianz Global Assistance an ensure they keep on making the grade 8 or higher on their willingness to paid by Allianz, health care providers in your books and remain at the top have attempted to bill the patient the recommend them. Additionally, 86% of the class in service to you. would recommend Allianz Global difference between the lower price Assistance to friends and colleagues. For more information, contact negotiated by Allianz and the higher Johnson Inc. Plan Benefits Service. pre-negotiated rates. This is called At the same time, one thing that came balance billing. Do not pay these bills. through loud and clear is that excellent The RTO/ERO group travel insurance plan is If you should receive a billing notice service continues to be important to underwritten by Sun Life Financial and CUMIS you. Allianz hears you and they feel the from a hospital, collection agency, General Insurance Company, administered by etc., after Allianz has paid your bill, same – it’s what you deserve. With that Johnson Inc., with travel emergency assistance and please contact Allianz immediately at in mind, below are just some examples claims administration services provided by Allianz the number located on your Allianz of what Allianz Global Assistance has Global Assistance. Allianz Global Assistance is a registered business name of AZGA Service Explanation of Benefits. They will take done and are doing to help make a the appropriate steps to resolve the positive difference in your experience Canada Inc. and AZGA Insurance Agency Canada Ltd. issue on your behalf. with them. Member communication • Members can now obtain additional details when their case is opened. This includes Reminders information on required documents and how to obtain • The maximum allowable supply for prescription medications help with completing claim forms. is 100 days. If you plan on taking an extended vacation, • Member call backs are now being a further 100 day supply can be obtained by having your streamlined to help ensure members pharmacist contact Johnson Inc. Plan Benefits Claims. Please are contacted in a timely manner. remember that the total cost of the prescription will count towards the calendar year maximum in the year in which the • Members can expect enhanced prescription is filled. service by way of ongoing training for claims representatives, which • The out-of-province/Canada travel benefit is designed to helps ensure that key information protect you in the event of a sudden and unforeseen medical is clearly and effectively shared. emergency. Travel should take place when you are healthy. Medical conditions should be investigated and the appropriate Claims process treatment received before you travel. Once your condition • For claims in excess of $10,000, an is stable, according to the stability clause, your trip can be improved Explanation of Benefits booked, payments made, and you can travel knowing you are letter now provides members with protected by the RTO/ERO out-of-province/Canada travel more details so they have a clearer benefit for eligible expenses. understanding of the claim decision. 2 going places Travel Plan Questions and Answers I’m an Ontario resident. are sent to you at the time your case is would however, have coverage for any I booked hotel opened. These include an authorization medical emergency that was unrelated Q accommodation in for release of medical records from to your kidney surgery. If you chose to Niagara Falls. Due to a death in my your physician, authorization to submit cancel this trip, your eligible expenses immediate family, I had to cancel my claims on your behalf to your provincial would be reimbursed to a maximum hotel. The hotel would not refund health care plan as well as coordinating of $6,000 per person, under the Trip the cost of the room. Why was this with other insurance coverage(s) Cancellation benefit, so long as your not an eligible claim under the out- where applicable. The receipt of condition was stable in the 90 days of-province/Canada travel benefit? these completed forms is required for prior to the date the trip was booked. The trip cancellation/ Allianz Global Assistance to start the interruption benefit covers adjudication of your claim. If you have My physician has confirmed pre-paid, non-refundable travel any questions regarding your travel claim that I am okay to travel A even with my current arrangements outside your province of forms, please feel free to call Allianz at Q residence. Travel arrangements within the number on your ID card. medical condition. Will the out-of- province/Canada travel benefit cover your province of residence are not I booked my trip in me if I have a medical emergency eligible under the out-of-province/ August 2017 for travel while travelling as a result of my Canada travel benefit. Q in December 2017. In current medical condition? October 2017, I was admitted to How long does it take to hospital for emergency kidney Your physician’s authorization Q pay a travel claim? surgery. Would I have coverage does not override the for any problems relating to my RTO/ERO policy. If, Travel claims are more complex A surgery while on my trip? Would I than extended health care or according to the policy, your condition need to cancel my trip? A dental claims and, as a result, would not be considered stable, a can take longer to process. They involve While travelling, you would medical emergency related to this coordination with your provincial health not have coverage for any condition would not be covered. Please care plan and often involve language A medical emergency relating to refer to the inside cover of your Out- translations and interpretation of other your surgery as it took place within 90 of-Province/Canada Travel Booklet, countries’ billing practices. Most forms days prior to your departure date. You specifically the medical stability clause. Travelling Out-of-Province Within Canada Most people are aware of the need for Province/Canada Travel Plan and are Family/companion to accompany travel health insurance when travelling not covered by your provincial GHIP: surviving spouse – In the event of outside of Canada. However, many are death of a spouse while the couple not aware of the importance of travel Ground and air ambulance is travelling together, the plan will insurance when travelling outside their Vehicle return – A maximum of allow for one economy round- province of residence, within Canada. $2,000 for the return of one vehicle trip fare to a maximum of $1,500 to your place of residence if you are for one extended family member Provincial Government Health unable to operate the vehicle due to or companion to accompany the Insurance Plans (GHIP) provide sickness, injury or death. surviving spouse home to his/her some out-of-province coverage province of residence. through provincial reciprocal Additional hotel and meal agreements. Typically, these cover expenses – Incurred by you and/ Trip interruption/delay – Covers up medically necessary eligible physician or your travelling companion due to $6,000 per insured person. and hospital services only.