There are two ways to find your benefit ID: 

1. On your Canada Life pay direct drug card.
2. On the letter in your 3sHealth employee welcome package.

On your Canada Life pay direct drug card:

The numbers on your pay direct drug card are arranged like this: 

11 335663 0000 123456 01

Here is what the numbers mean:

11 335663 0000 123456 01 - is the code the pharmacist uses to identify Canada Life as the insurance carrier.

11 335663 0000 123456 01 - is your Canada Life group policy number.

11 335663 0000 123456 01 - is your unique benefit ID, also called your certificate number.

11 335663 0000 123456 01 - is the issue number. If your card is lost or stolen and you request a new card, the issue number will change to 02, etc.

If you want to update or change your home address, you use Gateway Online. Gateway Online can also be accessed from the home page on 3sHealth.ca.

If you want to update your marital status, add, remove, or change information about your spouse and dependent children, you use the Dependent Change Form found in the EBP Documents and Forms tab above.

If you are under age 65, your basic life insurance amount is calculated based on 2x your annual salary rounded up to the nearest $1,000 to a maximum of $1,000,000. This will be the amount or volume of your life insurance. In addition to your basic life insurance, you have accidental death and dismemberment insurance (AD&D). The amount of your AD&D insurance is equal to the amount of your basic life insurance.

If you are age 65 or older, your basic life insurance amount is calculated based on 1x your annual salary rounded up to the nearest $1,000 to a maximum of $250,000. This will be the amount or volume of your life insurance. In addition to your basic life insurance, you have accidental death and dismemberment insurance (AD&D). The amount of your AD&D insurance is equal to the amount of your basic life insurance.

The monthly premium rate for your basic life and accidental death & dismemberment (AD&D) insurance is $0.16 per $1,000 of coverage. To calculate your monthly premium amount: multiply the volume of your insurance by $0.16 and divide by $1,000. Example: $122,000 x $0.16 / $1,000 = $19.52 monthly premium amount. The cost of your monthly premium may be shared with your employer. Your monthly premium amount will be deducted from your paycheque on the first pay period in each month.

You may purchase additional coverage under the 3sHealth Group Life Insurance Plan including:

• Optional life insurance (employee only) is sold in units of $10,000 to a maximum of $500,000.
• Voluntary (AD&D) insurance (single or family) is sold in units of $10,000 to a maximum of $250,000.

If you purchase optional life insurance up to $150,000 and/or dependent life insurance in the first 90 days of plan membership, the coverage is guaranteed issue and you will not be required to complete a medical questionnaire.

The monthly premium rates for optional life insurance, dependent life insurance, and voluntary AD&D can be found in the overview of the Group Life Insurance Plan document.

You may name any person as your beneficiary such as your spouse, parent, etc. You may designate more than one beneficiary. You may also name a legal entity as your beneficiary such as your estate or a charitable organization. If you choose to name a charitable organization as a beneficiary, the full legal name and address of the charitable organization is required.

Yes, you may name your child as your beneficiary. If you name a minor child or children under the age of 18 as a primary or contingent beneficiary, you must appoint a trustee. Upon your death, the trustee will receive the policy proceeds and has a legal duty to use those proceeds for the benefit of the beneficiary. You will want to appoint someone who is capable of managing the policy proceeds wisely.

If you do not appoint a trustee, payment will go to the public trustee in the child’s province of residence or to a court-appointed property guardian.

When you designate your beneficiaries, you may indicate the portion (percentage) of the policy proceeds you would like to give to each of the named parties. If you do not detail a percentage of the benefit for each party, the policy proceeds will be divided equally among all of your named beneficiaries.

When you become eligible for the 3sHealth Group Life Insurance Plan, you must complete a Beneficiary Designation Form which includes a section to designate your beneficiary for your group life insurance. To change your beneficiary, contact 3sHealth Employee Benefits for the appropriate form. Once completed, return the original copy of the form to 3sHealth Employee Benefits. Please refer to the back of your Beneficiary Designation Form or the Designating a Beneficiary brochure in the EBP Documents and Forms tab above for more information on naming a beneficiary.

CUPE Disability Income Plan

• During the initial 119-day qualifying period following disability, bridge benefits equal to 66 and 2/3 % of your pre-disability regular gross weekly earnings.
• After the initial 119-day qualifying period, long term disability benefits equal to 60% of your pre-disability regular gross monthly earnings.
• Vocational rehabilitation services to help you to return to work.

SEIU-West Disability Income Plan

• During the initial 119-day qualifying period following disability, bridge benefits equal to 66 and 2/3 % of your pre-disability regular gross weekly earnings.
• After the initial 119-day qualifying period, long term disability benefits equal to 60% of your pre-disability regular gross monthly earnings.
• Vocational rehabilitation services to help you to return to work.

SUN Disability Income Plan 

• After the initial 119-day qualifying period, long term disability benefits equal to 75% of your pre-disability regular gross monthly earnings.
• Vocational rehabilitation services to help you to return to work.

General Disability Income Plan

• After the initial 119-day qualifying period, long term disability benefits equal to 75% of your pre-disability regular gross monthly earnings.
• Vocational rehabilitation services to help you to return to work.

In the event that you need to apply for disability income, please refer to the Disability Application at a Glance booklet. This document will provide you with the necessary information and the timeline for applying for disability income.

Please refer to your Disability Income Plan Commentary Booklet for information regarding your Disability Income Plan benefits.

Ambulance 

100% of licensed ambulance service when medically necessary.

Accidental dental 

Treatment of injuries or replacement of natural teeth.

Hearing aid 

$1,500 every five consecutive calendar years.

Prescription drugs 

Charges for drugs and serums listed on the Saskatchewan Drug Plan Formulary.

Deductible

• $9 per family per day for claims submitted online using My Canada Life at Work or using paper reimbursement.
• $10 per drug identification number (DIN) using the pay direct drug card.

Prescription smoking cessation drugs up to $500 lifetime maximum per insured person.

Diabetic supplies 

Unlimited insulin syringes, Novolin pens, test strips, bloodletting devices including platforms and lancets.

$10 per DIN deductible applies if purchased using the pay direct drug card.

Out-of-country medical emergency coverage 

Up to $1,000,000 in medical emergency coverage when travelling outside of Canada with a 60-day trip limitation.

Preferred hospital rooms 

Charges up to the cost of a semi private room.

Paramedical and professional services 

$400 per calendar year per insured person for a registered practitioner including: physiotherapist/occupational therapist, chiropractor, osteopath, podiatrist/chiropodist, naturopath, speech therapist, and acupuncture.

$500 per calendar year per insured person for massage therapist. 

$2,000 per calendar year per insured person for a clinical psychologist/social worker.

Therapeutic equipment 

Charges for eligible therapeutic equipment up to $2,000 per lifetime for any one like piece of equipment.

Survivor benefits 

Extended healthcare coverage for eligible spouse and dependent children for up to two years from the date of the employee’s death.

Vision 

• Eye exams - one eye exam for adults once every 24 months and one eye exam for children once every 12 months.
• Prescription eye wear - Up to $300 towards the purchase of prescription eye wear every 24 months for each insured person.
• Laser eye surgery - 2x the bi-annual vision maximum once in a lifetime.

Detailed information about the 3sHealth Employee Benefit Plans can be found in the Employee Benefit Plans section on 3sHealth.ca.

• Plan commentary booklets
• Claim forms
• Frequently asked questions

If you have questions about the Extended Healthcare Plan, please call Canada Life at 1.866.408.0213.

Eligible charges paid in accordance with the 3sHealth Maximum Reimbursement Schedule - Enhanced Dental Plan. A pre-authorization is required for any dental charges over $500.

Basic and routine services 

Coverage up to 100% of the Maximum Reimbursement Schedule amount for preventative, basic and routine services such as check-ups, cleanings, fillings, extractions, and root canals.

Major restorative services 

Coverage up to 75% of the Maximum Reimbursement Schedule amount for major services such as dentures, bridges, and crowns.

Orthodontic coverage 

Coverage up to 50% for orthodontic treatment to a lifetime maximum of $1,500 for each insured adult and $2,500 for each insured dependent child.

Detailed information about the 3sHealth Employee Benefit Plans can be found at in the EBP Documents and Forms tab above.

• Plan commentary booklets
• Claim forms
• Frequently asked questions
• Maximum Reimbursement Schedule - Enhanced Dental Plan

If you have questions about the Dental Plan, please call Canada Life at 1.866.408.0213.

Claims can be submitted online via Canada Life's My Canada Life at Work. You can sign up for My Canada Life at Work by clicking on the My Canada Life at Work tab above. You will require your plan #335663, and your benefit ID.

Claims can also be submitted using a paper claim form. Paper claim forms can be found in the EBP Documents and Forms or the My Canada Life at Work tab above. Complete the claim form, attach your original receipts, and mail it to Canada Life at Regina Benefit Payments, PO Box 4408, Regina SK S4P 3W7.

Electronic submission of claims is also accepted from providers such as your dentist, optical dispensary, massage therapist, physiotherapist, etc. Please ask your service provider if they are registered with Canada Life Provider eClaims.

You should receive your pay direct drug card within three to four weeks following your benefit eligibility date. If your spouse has coverage through an employer-sponsored benefit plan, you must contact Canada Life and provide them with your spouse’s benefit plan information before you begin using your pay direct drug card.

The Extended Health Care Plan is unique in the way it provides two options to plan members making prescription drug claims. One option is to pay with the “pay direct drug card.” The second is paying out of pocket and submitting a claim.

Your prescription needs and your payment preferences determine which option is right for you. You have the flexibility to change your payment preference each time you visit the pharmacy.

The pay direct drug card

The plan offers a convenient pay direct drug card that provides instant payment at the pharmacy, less a $10 per prescription deductible. 

When plan members use the pay direct drug card, it helps to avoid out-of-pocket costs and there are no claim forms to complete.  The claim process is complete when you leave the pharmacy.

Paying out-of-pocket and submitting a claim

The plan also offers a reimbursement option. You may pay the full amount of your prescription at the pharmacy, submit your claims for reimbursement, and pay a $9 per family per day prescription deductible. Claims can be submitted online via Canada Life's My Canada Life at Work. You can sign up for My Canada Life at Work by clicking on the My Canada Life at Work tab above. You will require your plan #335663, and your benefit ID. 

For plan members using the manual reimbursement method, you receive a higher level of reimbursement when you purchase all of your and your family’s prescriptions on the same day. 

Example

A plan member purchases five different prescriptions on the same day. 

Using the pay direct drug card, they would pay a $50 deductible ($10 per medication) and pay for any medication costs that the plan does not cover. 

If that same plan member submits a paper or electronic claim, they would pay the full cost of the five prescriptions at the time of purchase. They would then submit a claim form with receipt(s) to Canada Life. The plan member would then be reimbursed the full amount covered by the plan less the $9 deductible per family per day.

Claims must be submitted within 120 days of the date you terminate employment, or the end of the calendar year in which the expense was incurred or the services were performed. The claims submission deadline is April 30 each year.

For dental claims, you are encouraged to submit a pre-treatment estimate where the cost of the proposed services is expected to exceed $500.

Some medical services and supplies do require pre-authorization. Please refer to the Extended Healthcare and Enhanced Dental Plan Commentary Booklet in the EBP Documents and Forms tab above.

You can sign up for direct deposit through Canada Life by clicking on the My Canada Life at Work tab above.

Online services are available through Canada Life’s My Canada Life at Work. Through My Canada Life at Work, you can view information about your extended healthcare and dental coverage, submit claims, and view up to 24 months of claims history. In addition, My Canada Life at Work provides you with some useful health tools such as a health information library and a personal health risk assessment. Canada Life also provides a free GroupNet app for your mobile device. A NEW My Canada Life at Work app will soon be available from your chosen App Store. 

To access Canada Life's My Canada Life at Work, click on the My Canada Life at Work tab above. You will need your group #335663 and your benefit ID # located on your pay direct drug card.

You can view your recent claims and 24 months of history, recent payments, and coverage balances through Canada Life’s My Canada Life at Work.

Yes, once you have registered for My Canada Life at Work, you may install the free Canada Life GroupNet Mobile app on your device. A NEW My Canada Life at Work app will soon be available from your chosen App Store.

Lost or stolen pay direct drug cards should be reported immediately to 3sHealth Employee Benefits at 1.866.278.2301 or Canada Life at 1.866.408.0213. A new pay direct drug card will be issued to you. Your old pay direct drug card will be suspended until you receive your new pay direct drug card.

Live Chat

You can live chat with a 3sHealth Benefit Services Officer from the 3sHealth website. Simply click the Live Chat box to ask your question. Live Chat is supported Monday to Friday 8 a.m. to 4:30 p.m. After hours, your question will automatically be forwarded to ebp@3sHealth.ca.

Email us 

Inquiries and requests for assistance for all benefit eligibility, claims and coverage, retirement, and life insurance can be made by emailing us at  ebp@3sHealth.ca.

Call our toll-free number 

If you can’t find the information you need online, 3sHealth provides a dedicated toll-free number (1.866.278.2301) that is staffed between 8 a.m. and 4:30 p.m., Monday to Friday.

Who can complete the “Attending Physician’s Initial Statement Form” for me?

The licensed physician or a nurse practitioner who is involved in your care and treatment must fully complete and sign this statement.

Chiropractors, and registered psychologists can complete the statement for up to eight weeks from your disability start date.

If your time on disability extends longer than eight weeks, a licensed physician or a nurse practitioner must complete any further medical forms to support your disability claim.

What will happen to my health and dental benefits while I am on a leave of absence?

Your coverage will continue for up to 18 months. There will be no cost to you. All extended health care and dental insurance will terminate at the end of 18 months. If your disability claim is approved, your coverage will remain in effect for up to two years and 119 days from your date of disability. There will be no cost to you. After two years and 119 days, you will have the option to join the retiree health and dental plan on a premium paying basis.

If I am on a leave of absence, what happens to my Group Life insurance?

Your coverage for Basic Life insurance must continue for up to 18 months as a condition of your employment. You are responsible for paying the monthly premium. You can elect to continue Optional Life insurance for up to 18 months. You are responsible for paying the monthly premium. All life insurance will terminate at the end of 18 months.

You must elect to continue your Optional Life Insurance within the first 30 days of your leave of absence. If you do not elect to continue Optional Life insurance then upon your return to work, you must submit medical evidence of insurability as your application for coverage.

If 3sHealth approves your disability claim, your group life insurance coverage remains in effect for the approved disability period. There is no cost to you. Coverage includes Basic Life, Accidental Death and Dismemberment (AD&D), Dependent Life, Optional Life, and Voluntary Accidental Death and Dismemberment insurance.

How long does it take to adjudicate my application for disability benefits?

An adjudicator will review your application to determine your eligibility for benefits within eight business days of receiving your complete application. The adjudicator may request additional medical information. If deemed necessary, the request for additional information may delay the adjudication process. We will advise you if additional medical is required.

How soon will I receive my disability benefit payment after 3sHealth approves my claim?

3sHealth pays bridge benefits weekly for the prior week. Benefit payment deposits occur weekly on Friday.

Example: Your adjudicator calls you on Friday, Jan. 31, 2020 and approves your claim from Feb. 3, 2020 to Feb. 28, 2020. On Friday, Feb. 14, 2020, you will receive the first deposit of your weekly bridge benefit payment for the period of Feb. 3 to Feb. 9, 2020.

3sHealth pays long-term disability benefits monthly for the current calendar month. Benefit payment deposits occur monthly on the last banking Friday.

Example: Your adjudicator calls you on Friday, Jan. 31, 2020 and approves your claim from Feb. 3, 2020 to March 31, 2020. On Friday, Feb. 28, 2020, you will receive your first deposit of your monthly long-term disability benefit payment for the period of Feb. 3 to Feb. 29, 2020. On Friday, March 27, 2020, you will receive your next deposit of your monthly long-term disability benefit payment for the period of March 1 to March 31, 2020.

Why do I need to provide my banking information to 3sHeath?

3sHealth will directly deposit disability benefit payments into your bank account.

Do I have to apply for Canada Pension Plan (CPP) benefits?

3sHealth may require you to apply for CPP disability benefits at some point during your disability claim. Your 3sHealth adjudicator will advise you if and when you should apply.

You may elect to apply for a CPP disability benefit at any time. If you do, you must advise 3sHealth that you have applied. Make sure to forward your CPP denial or approval letter to your adjudicator at 3sHealth.

3sHealth may require you to appeal any denial of your CPP disability application.

Do I have to apply for Saskatchewan Workers’ Compensation Board (WCB) benefits?

Yes. 3sHealth requires you to apply to WCB if your illness or injury is the result of a workplace incident.

3sHealth may require you to appeal any denial of your WCB application.

Do I have to apply for SGI benefits?

Yes. 3sHealth requires you to apply to SGI if your illness or injury is the result of a motor vehicle accident.

3sHealth may require you to appeal any denial of your SGI application.

Does my Canada Pension Plan (CPP) benefit affect my claim?

Yes.

Both CPP retirement and CPP disability benefits are a direct offset to your claim. This means that 3sHealth subtracts what you receive from CPP from your disability benefit.

3sHealth may require you to apply for CPP disability benefits.

Do I have to report other sources of income?

Yes.

Employment, retirement, CPP, SGI, WCB, and private disability insurance earnings may reduce the amount of the disability benefit you are eligible for. Income received due to a disability from a 3sHealth-participating employer, government agency, or any retirement benefits may also reduce your disability benefit paid by 3sHealth.

In order for 3sHealth to determine if your earnings reduce your disability benefit, we require you to report them to us. Failure to report alternate income, including alternate employment income, can result in an overpayment. In the event of an overpayment, 3sHealth may reduce your future disability payments or may require you to repay the overpayment.

It is your responsibility to notify 3sHealth if you are employed or self-employed while on an approved disability claim, regardless of whether you are in receipt of earnings.

How can I check the current status of my claim?

You can check the status of your claim by phone at 1-866-278-2301 or by email at ebp@3sHealth.ca.

What medical forms does 3sHealth need to support my application for disability benefits? Can I just provide a note from my doctor?

A doctor’s note is not sufficient to support an application for disability benefits.

To qualify for benefits, you must provide medical evidence that clearly shows you are totally disabled from performing the duties of your own occupation throughout the 119 calendar day qualifying period and, potentially, for up to two years after the qualifying period. This is called the “own occupation” period of disability.

The plan requires you to be under appropriate medical supervision and treatment for your condition from the beginning of your absence from work.

Am I responsible for the cost of the “Attending Physician’s Initial Statement Form” needed for my initial application?

Yes.

Under the terms of the plan, it is your responsibility to provide medical information in support of your application. You are also responsible for the costs.

Does 3sHealth share my private medical information with my employer?

No.

3sHealth does not share your personal medical information with your employer. We are committed to protecting your privacy. We limit access to your personal information to 3sHealth employee benefits staff and to any third-party authorized by 3sHealth and by law in order to facilitate your disability benefits.

Your adjudicator may share information about your restriction and limitations with your employer in order to support your accommodation/return-to-work planning.

How can I submit my application to 3sHealth Employee Benefits?

You can mail, email, fax, and drop off applications at:

Email: ebp@3sHealth.ca
Mail: 700-2002 Victoria Avenue, Regina, SK. S4P 0R7
Fax: 306.347.5910
In person: 700-2002 Victoria Avenue, Regina

Submitting electronic forms is easy. Simply download the fillable PDF form found here, fill out the details, sign it, and scan and email it to ebp@3sHealth.ca.

How will I know when 3sHealth approves my claim for disability benefits?

As soon as your adjudicator makes a decision about your claim, your adjudicator will call you and inform you of the decision. Following the telephone call, your adjudicator will send you a letter to document the decision.

How soon will I receive my disability benefit payment after 3sHealth approves my claim?

3sHealth pays bridge benefits weekly for the prior week. Benefit payment deposits occur weekly on Friday.

Example: Your adjudicator calls you on Friday, Jan. 31, 2020 and approves your claim from Feb. 3, 2020 to Feb. 28, 2020. On Friday, Feb. 14, 2020, you will receive the first deposit of your weekly bridge benefit payment for the period of Feb. 3 to Feb. 9, 2020.

3sHealth pays long-term disability benefits monthly for the current calendar month. Benefit payment deposits occur monthly on the last banking Friday.

Example: Your adjudicator calls you on Friday, Jan. 31, 2020 and approves your claim from Feb. 3, 2020 to March 31, 2020. On Friday, Feb. 28, 2020, you will receive your first deposit of your monthly long-term disability benefit payment for the period of Feb. 3 to Feb. 29, 2020. On Friday, March 27, 2020, you will receive your next deposit of your monthly long-term disability benefit payment for the period of March 1 to March 31, 2020.

What deductions will 3sHealth take from my disability benefit payment?

Disability benefit payments are taxable income. 3sHealth will reduce your gross benefit payment by the federal income tax deduction in accordance with the Canada Revenue Agency’s (CRA) basic tax table.

Other sources of income you are eligible to receive, such as employment, retirement, CPP, SGI, WCB, and private disability insurance earnings reduce the amount of the disability benefit you are eligible to receive from 3sHealth.

Will I receive a T4A for income tax purposes?

Yes. 3sHealth will prepare and send you a T4A for the current tax year before the end of February each year.

Do I have to pay for a physician or other health-care provider to provide requested medical information?

Once 3sHealth approves your long-term disability claim, 3sHealth will pay a standard fee to your physician or provider for the completion of medical forms, if requested. With your permission, we will contact your physician or provider directly and request the information we need to continue to assess your claim.

Will I have access to my extended health care and dental benefits when I am on an approved disability claim?

Yes. If you had extended health care and dental coverage on the date your disability claim started, then your benefits will continue for up to two years and 119 days during your approved disability claim.

What happens if 3sHealth does not approve my application for disability benefits or closes my claim?

3sHealth will inform you in writing of any decision to deny your application or close your claim. This written notification will include an explanation of why you do not qualify or no longer qualify for benefits under your plan.

As a Disability Income Plan member, you have the right to request a review if you believe that information was missing from your application or if you think 3sHealth has not correctly applied the terms of the plan to your claim.

How do I appeal?

To appeal a decision, you must send in a written request within 60 days of the later of: the date of the written decision to close your benefit claim or deny your application, or the date your benefit terminates.

What information should I include with my appeal?

You should submit any additional or new information that supports your reasons for requesting the review, including:

• More comprehensive information on your medical condition from your physician or a nurse practitioner. If you think 3sHealth’s assessment of your condition is inaccurate or incomplete, your physician or a nurse practitioner can submit a further report explaining medical investigations, treatment, and clinical observations.
• More accurate information from your employer. Sometimes 3sHealth disqualifies an application because the dates and other details that 3sHealth received from an employer do not match the employee’s physician’s, or a nurse practitioner’s submission. If you find an error, ask your employer to submit the correction to 3sHealth in writing.
• New or additional information that 3sHealth should consider in support of your claim. Include this information with your request for a review. You may also indicate clearly in your letter what information you intend to send. Please specify when 3sHealth can expect to receive it. Not submitting a clear indication of your intentions may delay the review.

Can someone help me with my appeal?

If you appoint another person to represent you, you must notify 3sHealth in writing. For example, some plan members appoint a union representative, family member, or lawyer to assist with the phone calls, letter writing, and other activities involved in the review process.

Who reviews my appeal?

Three 3sHealth team members will reassess your claim along with the new supporting information. The team will include an adjudicator or manager, and, if necessary, a rehabilitation or mental health advisor, medical consultant, or rehabilitation consultant. 3sHealth will phone you when the assessment is complete.

How long will it take for my appeal to be reviewed? 

Once your appeal and supporting information is received by 3sHealth, the review of your appeal will be complete within 30 business days.

What if my appeal is denied?

You are entitled to a second review. You must request a second review in writing within 60 days of the later of the termination of your benefit or of 3sHealth’s notification to you of the decision to maintain the closure of your claim or denial of your application.

Address your request for review to Claims Services Manager, Employee Benefits. If you have new or additional information that supports your claim, either include it with your request or indicate clearly in your letter what information you intend to send, and when 3sHealth can expect to receive it.

The Claims Services Manager will conduct a full review of all information and determine if further internal review is required. The Claims Services Manager may also seek advice from 3sHealth’s medical consultant. When the second review is complete, the Claims Services Manager will write to you to explain the results of the review.

The second internal review is complete and I don’t agree with the decision. What are my options?

There is an external, independent review process available. This process is available after 3sHealth’s two-stage internal review process is complete.

How does the external “Independent Review of Disability Decisions” work?

If you wish to appeal the decision that 3sHealth’s internal appeal process reached, there is an opportunity for an adjudicator who is external to, and independent of, 3sHealth to review your claim. You are entitled to a final adjudication of a disability plan appeal. 3sHealth must receive the request for review within 60 days of 3sHealth’s notification to you of their final internal review decision.

This process is “the final adjudication of a disability appeal.” The independent adjudicator will complete a review of your complete disability claim file.

3sHealth will inform you of your option for a final independent adjudication of your disability appeal.

Final adjudication of a disability appeal is available only on decisions that relate to medical matters and is not available on decisions relating to the administrative terms of the plans such as late applications or lack of plan membership.

In accordance with collective bargaining agreements, the decision of the independent adjudicator is final and binding.

Who should I notify when I am able to return to work?

You must contact both your employer and 3sHealth immediately when you are able to return to work. By notifying 3sHealth, you can prevent an overpayment of benefits from occurring. Benefit overpayments must be re-paid to 3sHealth.

Do I have the option to return to work gradually?

3sHealth, along with your employer, union, and physician or a nurse practitioner will work together to customize a suitable return-to-work program based on your functional abilities and restrictions.

If you experience difficulties while participating in your return-to-work program, contact your employer, your adjudicator, and your physician or a nurse practitioner. Any suspension in your return-to-work program requires medical information and support.

What is a Rehabilitative Employment Program?

A Rehabilitative Employment Program is a return to work on a part-time or gradual basis. Typically, you will work reduced hours compared to the hours you worked prior to your illness or injury.

3sHealth and your physician or a nurse practitioner must be approve the program before it begins.

What is a vocational rehabilitation consultant?

From time to time, 3sHealth may engage the services of a vocational rehabilitation consultant. The vocational rehabilitation consultant is provided to you to support your return to employment. Vocational rehabilitation services may include, but are not limited to, career exploration and counseling, vocational testing, resume production, job searching skills, etc.

For more information on gradual return-to-work programs, please contact ebp@3sHealth.ca or your employer.

What happens to my disability benefits when I receive earnings from my employer when I return to work?

If you return to work through a 3sHealth-approved rehabilitation program and you receive earnings from your employer, 3sHealth will adjust your disability benefits based on the amount of your rehabilitative earnings. However, your adjusted disability benefits plus your rehabilitative earnings may be greater than the disability benefits you received before your rehabilitative employment.

3sHealth requires your employer to report your gross weekly (for bridge) or gross monthly (for long-term disability) earnings to 3sHealth. Your disability benefit will be delayed by one to two weeks so 3sHealth can adjust the amount of your benefit by the amount of your employer paid earnings.

What happens to my benefits if I do not return to work and my disability claim closes?

If your disability claim closes and you do not return to work, your Group Life insurance can continue for up to 12 additional months from the date your claim closes.Your health and dental benefits continue for up to 18 months from the original date of your leave of absence. Your disability coverage will end effective the date your claim closes.

When you return to work, 3sHealth will reinstate your benefits.

Each January, 3sHealth Employee Benefits completes an annual measure for all other-than-full-time employees to determine eligibility for workplace benefits based on hours worked in the previous year. 

You must work a minimum of 780 hours in a calendar year to be eligible for workplace benefits.

The hours 3sHealth Employee Benefits uses to measure eligibility for workplace benefits are based on the hours your employer reports to 3sHealth Employee Benefits. 

If you contact us asking about a potential coverage discrepancy, 3sHealth Employee Benefits will check with your employer to confirm your hours worked to determine what the next steps would be regarding your coverage status.

If your benefit coverage expired, then it expired effective December 31 of the previous calendar year. The reason your coverage expired is that the hours reported from your employer were less than 780 hours from January 1 to December 31. The next annual measure will be in January of the next calendar year.

If you are on an approved leave of absence on December 31, you will not be measured until the December 31 following your return to work. 

Upon your active return to work, your pre-leave level of coverage is reinstated and remains in place until the next annual measure. 

Effective January 1, 2022, eligible employees returning from an approved leave of absence can request a one-time annual measure following their return to work. Learn more about eligibility by reading this bulletin. 

You may request a one-time manual measure upon your return to work which will replace the pre-leave reinstated level of coverage. Please note that the results from a manual measure are binding and may either positively or negatively impact your coverage. Prior to requesting the one-time annual measure please confirm with your employer how many hours you worked in the previous calendar year. 

You must work a minimum of 780 hours in a calendar year to be eligible for workplace benefits. 

To request a one-time manual annual measure, call 1-866-278-2301 or send an email to ebp@3sHealth.ca.

If you lose your Group Life insurance coverage at the annual measure you do have an option to convert to an individual life insurance policy with Canada Life. You may convert an amount up to $250,000 in Basic Life Insurance and/or Optional Life Insurance to an individual policy.  

Application forms are available from your employer or from 3sHealth Employee Benefits. 

In order to convert any amount of your insurance coverage to an individual policy you must consult with a financial security advisor. You can reach out to an advisor at one of the Freedom 55 Financial Centres located across Canada on their website or by calling one of the offices directly:

· Regina 306-586-0905.

· Saskatoon 306-934-7060.

· Winnipeg 204-946-8109.

Each year, the conversion period to convert to an individual life policy with Canada Life is extended until the last day of February. This period is extended beyond the normal 30 days due to the timing of information going to employees regarding the results of the annual measure.

Each January, 3sHealth Employee Benefits completes an annual measure for all other-than-full-time employees to determine eligibility for workplace benefits based on hours worked in the previous year. 

You must work a minimum of 780 hours in a calendar year to be eligible for workplace benefits. 

During this annual measure process in January, plan members will experience a delay in claims processing.

Pre-authorizations submitted in mid-December will be held by Canada Life until 3sHealth Employee Benefits completes the annual measure. Any claims submitted for services that occurred in January will also be held by Canada Life until the annual measure is complete.

Canada Life will begin processing pre-authorizations and claims in mid-January in the order they were received and will work diligently to be caught up by mid-February. 

If your dentist submits claims electronically to Canada Life, your dentist will receive an electronic notice that the claim will be held for processing. Once claims processing commences, Canada Life will begin processing electronic claims in the order they were received.

3sHealth Employee Benefits encourages you to submit your drug claims using the paper method or online through the My Canada Life at Work website during the first three weeks in January. We ask you not to use your pay direct drug card during this period.

3sHealth Employee Benefits and Canada Life have worked together to extend Out-of-Country Medical Emergency coverage to January 31 of each year for health-care system employees during the annual measure period. 

For example: If you are an employee that had Extended Health Care Plan coverage in 2021 and you lost coverage on December 31, 2021, because you worked less than 780 hours, you will retain the Out-of-Country Medical Emergency portion of your coverage to January 31, 2022.

Claims related to COVID-19 during travel to a country with travel advisory warnings will be assessed like any other emergency claim. Coverage includes medical care to treat COVID-19 related symptoms if you present to a clinic because you are not feeling well or are hospitalized.  A positive COVID-19 test without acute symptoms or medical costs associated with your quarantine if you are asymptomatic are not covered. 

Plan members are encouraged to contact Travel Assist immediately if they are experiencing a medical emergency while travelling out of country.

Learn more about Out-of-Country travel coverage by reading this bulletin.

3sHealth Employee Benefits and Group Medical Services (GMS) are pleased to inform you about the GMS 3sHealth Retiree Benefits Plan for employees who previously had coverage under the 3sHealth Employee Benefit Plans. Health-care employees who lost coverage at the annual measure are eligible to enrol in the GMS plan. We encourage you to review the brochure located here. 

The GMS 3sHealth Retiree Benefits Plan offers an affordable solution for continued benefit coverage.  As detailed in the brochure, you may elect to enrol in “Health Only,” “Dental Only,” or “Health and Dental.”  If you apply by March 31, you will not be required to answer any medical questions or to complete a medical exam. Your enrolment is assured in the plan of your choice.

If you have any further questions about the annual measure or your eligibility for benefits, please send an email to ebp@3sHealth.ca or please phone a Benefit Services Officer by dialing 1-866-278-2301.