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FLEXible Benefits Plan FAQ's

The Student FLEXible Benefits Plan allows you to choose coverage to suit your needs. Below is a summary of the coverage options available. All eligible students are provided with a Balanced Coverage, and you can choose to stay in the balanced plan or “Flex” to a coverage package that better suits your individual situation. You have one opportunity each year during your enrolment period or the anniversary of you first enrolment period to Flex your benefits. To Flex you benefits you must complete the Opt-out/Enroll form and submit it prior to the applicable deadline. All eligible students are automatically enrolled in the Balanced Plan.

FLEXible Benefits Plan FAQs

What is a Benefits Flex Plan?
A Benefits Flex Plan provides plan members with insurance coverage while allowing individuals to choose a coverage that best suits a personal situation. In the case of a Student FLEXible Benefits Plan, the options are based on a base plan (called the Balanced Plan), and only the defined options are available.

Why a Benefits Flex Plan?
To provide students with supplemental health & dental insurance that can be customized to an individual’s situation or needs.

Who is eligible for the SAMU Student FLEXible Benefits Plan?
Any students who are eligible for the SAMU Student FLEXible Benefits Plan are able to choose a Flex option. All eligible students are automatically enrolled in the Balanced Plan.
How much does it cost to flex my benefits?
The Student FLEXible Benefits Plan has been created so that all coverage options are provided at the same cost. There is no additional fee to Flex your plan, the Student Fee you pay with your tuition covers the cost of your coverage.

How and when can choose a Flex option?
You can choose a Flex option in the semester you become eligible for the Plan or on at the beginning of the Benefit Year (September 1). There is an enrolment change deadline and all forms must be submitted prior to the deadline.

Can I change my Flex option?
If you choose a FLEXible Benefit option your selection will remain in force for a minimum of 2 plan years. Following 2 plan years you may elect to change to the Balanced plan. If you do not select the Balanced Plan at that time, you will remain enrolled in your FLEXible option.

If I add my Family, how does Flex impact their coverage?
If you enroll eligible family members into the Plan(s), the coverage provided to family members will be based on the same plan that the student is enrolled in. Any coverage maximums apply to each individual in the family.

On Campus Care

Your Benefits Plan Office, Student Service Coordinator is fully acquainted with the details of health and dental benefits and has been selected based on their understanding of the unique needs of students along with their personal service skills. The following is a partial list of services that are available from the SA MacEwan Student Benefits Plan Office:

• pick up your myBenefits Card
• pick up forms
• purchase coverage for your spouse and/or dependent(s)
• plan inquiries

Please feel free to contact the Student Service Coordinator on any matter in which you require personal attention.

SAMU Student Benefits Plan Office
6-108 City Centre Campus
10700 - 104 Avenue
Edmonton, Alberta T5J 2P2
Phone: 780-497-4675 ♦ Email: macewanplan@mystudentplan.ca
Fax: 780-497-5680

Insurance Carrier

Claims Mailing Address:
The Great-West Life Assurance Company
Group Claims Department
P.O. Box 4408
Regina, Saskatchewan S4P 3W7

Customer Service:
For claims status and benefit inquiries: 1-800-957-9777
You will require your plan number (59355) and Student ID when calling.

General Online Inquiries: greatwestlife.com
GroupNet Plan Member Services: gwl.greatwestlife.com

FAQ

Who do I contact for claims related issues?
Students must contact Great-West Life (Insurance Carrier button) customer service directly to inquire about payment status and claims history details. Your Benefit Plan Office does not have access to your claims details.

Who do I contact for eligibility and enrolment inquiries?
Students must contact the SA MacEwan Student Benefits Plan Office (On Campus Care button) for eligibility and/or enrollment status.

Why a health and dental plan?
Costs for dental and health services are at an all time high and show no sign of reprieve. Students on fixed incomes are especially susceptible to these increases, and the last thing they want to spend these fixed monies on is an unforeseen accident, dental or medical procedure. Putting even routine procedures off can have monumental effects for students, as missing classes or study time can have disastrous consequences. Considering these points, the SA MacEwan has worked to design and implement a reasonably priced health and dental insurance plan. This plan can aid students in maintaining a quality of health, which can ensure that avoidable medical emergencies do not endanger the pursuit of their studies.
 
Why is the plan mandatory?
With a mandatory plan, the insurance risk is spread over a larger number of students, thereby lowering the cost per student, making the fee in a range that is affordable to students. An individual health and dental plan can cost as much as 5 times the current student fee.
 
Is this plan the same as my provincial health care?
No. The Student Benefits Plan is an extended health and dental plan, which supplements your existing provincial health care. It DOES NOT replace your provincial health care. Student benefits are payable after any provincial health care benefits have been exhausted. This plan does not cover user fees.
 
How do I pay the fee?
The fees for the health and dental plans will be assessed automatically by the institution at registration if you meet the eligibility criteria previously listed.
 
What if I already have coverage?
Co-ordination of Benefits: Benefits under the two plans can be co-ordinated to increase your coverage up to a total of 100% of the actual expense(s) incurred. For example, following payment under this plan you can submit outstanding balances to the other plan for consideration.

Opting Out of the Student Benefits:  If you are an eligible student and have comparable health and/or dental coverage you may apply to opt-out of benefits. Each student is given an opportunity to opt-out of the benefits under the health and/or dental plan(s) each year. All Opt-Out Forms must be completed online or through the SA MacEwan Student Benefits Plan Office and must be received by the applicable deadline.

What if I miss the Opt-Out deadline?
You will not be able to opt-out of coverage at any other point during the school year. For example, if your program starts in September, you must opt-out prior to the end of the Fall deadline. The same rule applies for opting in (unless you lose your comparable coverage, see below for loss of coverage information). NO EXCEPTIONS will be made if the deadline is missed. It is the student's responsibility to pay the plan fees, should they miss the applicable opt-out deadline.
 
What if I or my family loses our comparable coverage?
If comparable coverage used to opt-out of the student plan(s) terminates, or coverage provided to cover your family terminates you have 30 days from loss of coverage to notify the SA MacEwan Student Benefits Plan Office in order to be covered under the health and/or dental plan(s). Confirmation of loss of coverage is also required on re-application for coverage. It is your responsibility to apply for benefits and provide payment of the family coverage fee prior to the 30-day deadline.

Downloads


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DIY & Video

Sign Up for GroupNet

When registering for GroupNet you will need to provide:
  • Plan Number: 59355
  • ID Number: Your Student ID
Watch a short video about how to register for GroupNet.


Visit gwl.greatwestlife.com for access to Member eClaims.

GroupNet for Plan Members

Students will appreciate the convenience of Member eClaims, which allows for submitting claims through a secured online service. Online claim submission is available for a variety of covered services, such as prescription drugs, dental care, vision care and paramedical services. To take advantage of Member eClaims, students must be registered on the insurer's member site (GroupNet), setup Direct Deposit of claim payments and complete the eDetails section. Students will then be notified by e-mail when a claim has been processed and that claim details are available for viewing online.

Watch a short video about how to go green with GroupNet.


Online Claim Submission

Watch a short video about online claim submission.


Personal Health Risk Assessment(PHRA)

The Personal Health Risk Assessment can be used to create a health profile, build an action plan to support your health and wellness needs and track progress.


Watch a short video about Personal Health Risk Assessment(PHRA).


Review Benefits and Claim History



Watch a short video about reviewing your benefits and claims history.


What Your Plan Covers



Watch a short video about your plan coverage.


Claims and Coverage Made Easy with GroupNet



Watch a short video on making claim and coverage easy with GroupNet

Enter the Drug Identification Number (DIN) or Drug Name of the prescription medication you are looking to confirm.

Should the prescription drug you are searching for not be covered by the plan, you may be eligible to complete a Drug Exception Request.

In the event that the drugs available on the Formulary are not effective in treating the condition, an exception process is in place. To be eligible for an exception, you must have tried one alternative drug that is eligible on the Formulary. An exception drug request form is available below or from your Benefits Plan Office and must be completed by your physician. Completed forms may be returned to your Benefits Plan Office, can be faxed directly to the insurance company, or sent via email to gwldrug.services@gwl.ca.

Request for Coverage of Exception Status Drug form

IMPORTANT! Your drug plan may have certain exclusions regardless if showing eligible under the prescription search tool. Please refer to the exclusions section for further details.



Drug Identification Numbers must be 8 digits. If you have a DIN less then 8 digits, pre-fill with zeros.

If you are enrolled in the student health & dental plan you can access your prescription drug benefits and dental benefits with the myBenefits Card. This means that for eligible benefits, you will only have to pay the co-pay portion of your claim at the time of service. No need to pay upfront and wait for reimbursement. 

The myBenefits Card also works at chiropractic, physiotherapy and vision care, providers but is dependent on each service provider's individual business billing practices.

For quick and easy access, choose the email option, to utilize your card from your mobile device.
 
Downloading the myBenefits Card does not confirm eligibility or benefits coverage. 
Please contact the SAMU Student Benefit Plan Office to confirm your enrolment in the plan.

 

Card Generator

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