As the end of the year approaches, health and dental pre-authorization requests will be held until mid-January before they are assessed and approved. Canada Life will begin processing pre-authorizations in mid-January in the order they were received and will work diligently to be caught up by January 31, 2025. 

Pre-authorization occurs when plan members submit estimates for health and dental services before receiving those services. Canada Life then assesses and approves the pre-authorization requests based on plan rules and percent of coverage.  Pre-authorization requests are typically made by plan members or their providers, for services that cost over $500, to ensure coverage is in place. 

This hold on assessing pre-authorization requests is due to the annual measure. During annual measure, 3sHealth assesses the hours worked of all other-than-full-time employees over the previous calendar year (2024), to determine their eligibility for benefits for the upcoming year (2025).The plan member must work 780 hours in the previous calendar year (January 1 to December 31) to qualify for benefits. Depending on the number of hours worked, plan members may gain, lose, or maintain their coverage and benefit levels. 

For anyone who is in an other-than-full-time position your 2025 health and dental claims may be reassessed once the annual measure is complete to ensure the reimbursement amount aligns with your 2025 health and dental coverage level.

All plan members have until April 30, 2025, to submit their claims from the 2024 calendar year (January 1 to December 31).

If you have questions about the annual measure or about claims processing during the month of January 2025, please send an email to EBP@3sHealth.ca. You may also contact a 3sHealth Benefit Services Officer by telephone at 1-866-278-2301, option 4.