Surviving the First Month at Canadian WorkplaceLesson 8: Getting Paid (Employee Benefit Plans)

To prepare for Lesson 8, skim through the lesson below and read Task 1 & Task 2. What are the functions and forms you may use in the class? Post your answers here.
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Lesson 8 Homework: johnsonkunnel johnsonkunnel 0 2 Jun 16, 2015 by johnsonkunnel johnsonkunnel


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Pre-Task: In groups of four, discuss “Employee Benefit Plan.” Have you ever had one? What are the benefits to having a plan? Be prepared to share your ideas with the class.


Pre-Task 2: Listen to a recording about employee benefit plan. You will hear the following words being mentioned. Listen and guess what these words mean. Then discuss with your friend.

Disability, extended, incentives, group plan, vision plan, access, features, retiree, tailored

Task: Work with a partner. You are a human resource manager. Talk to a new employee about employee benefit plans in your company and help him / her to make the best decision. The new employee should ask questions if anything is not clear to you. Both of you may use the reading handout below.

Post-Task Analysis: The instructor role-plays the conversation with a competent student. Other students listen for the language of comparison and contrast.

Post-Task Practice: Which of the following did you use during your conversation? Role-play the conversation once again. This time try to use a few comparisons and contrasts.


Lesson 8: Task 2 (Reading and Writing)
Pre-Task: Read the information sheets below (the letter and the brochure from Happy Life Insurance Unlimited) and answer the questions that follow.
Group Benefits Happy Life Insurance Unlimited

My-LINC Centre


Group Policy No. 422432


Dear Mr. Kummel,


My-LINC Centre is happy to enclose your new prescription drug card.

With effective November 29, 2014 your healthcare plan has been changed to include a prescription drug card with mandatory generic substitution and a $12,000 calendar maximum per person. This means that the amount you can be reimbursed for your prescriptions is limited to the cost of the lowest-priced generic alternative. Please ask your doctor to prescribe the generic equivalent whenever possible. You can still request the brand name drug your doctor has prescribed, but you will have to pay the difference in cost between the lowest-priced generic drug and the brand name drug.

Paramedical practitioners will now be covered up to $400.00 per calendar year.
For any claims inquiries feel free to call Happy Life Insurance at 1-800-957-1234.

Your employee package includes:
  • Drug Cards for you, your spouse and any dependents over the age of 21.
  • If you require a drug card for a dependent under the age of 21, please let your Human Resource Department know and they will order one.

Benefit statement indicating the information that we have on our benefit payment system.

LTD volumes, health and dental coverage and dates of birth for you and your dependants
If any of this information is incorrect please contact Human Resource Department and they can update the Happy Life Insurance system. The enclosed brochure has detailed information about how to use your drug card “Fast-sure.”


Truly,


Manager


Happy Life Insurance

Happy Life Insurance Unlimited

Welcome to Fast-Sure Claims!

Paying for your prescriptions has never been so easy.
The Fast-Sure card is an electronic payment system that provides on-the-spot submission of prescription drug claims at almost any pharmacy in Canada.
It’s a convenient, easy-to-use alternative to submitting paper claim forms. Your personalized Fast-Sure card is provided to you as part of your Happy Life group coverage and is administered by our pharmacy benefits manager (PBM) experts.
Using your assure card:

When filling prescriptions, provide your Fast-Sure card to the pharmacist before the prescription is filled. The pharmacist will require the following information:
  • Name
  • Address and postal code
  • Telephone number
  • Date of birth
  • Relationship to the plan member
  • Plan sponsor name (e.g. your employer)
  • Plan number
  • Plan member ID number

Based on this information, the pharmacist is able to confirm your eligibility and drug coverage. Our PBM electronically pays the pharmacist the amount covered by your plan. You pay the pharmacist only the portion not covered by your plan, if any.
Always provide your card when filling a prescription
For security reasons, pharmacies generally don’t share computer systems, even if they are part of the same chain. If you forget your card, you can still get your prescription filled. However, you will have to pay the full amount of your prescription up front and submit a paper Fast-Sure Card Claim Form with the receipt for reimbursement.

Keep your information current: All of your dependents must be registered with your plan sponsor to be covered through your Fast-Sure card. Only you can register dependants or update information. Be sure to advise your plan administrator of any changes to your address or your marital status if you adopt or have a baby, or if any of your children are attending university. Inform the pharmacist of any changes to your benefits, or if you have been issued a new Fast-Sure card.

Enabling Task1: While reading the letter and the brochure, you took the following notes. Double check if the notes you took is accurate by writing True or False in the boxes next to the statements.

Statement (your notes)
True / False
1
Health care plan covers $1200 per year per person.

2
I can buy only the lowest-cost prescription at the pharmacy.

3
If I call an ambulance, the plan will cover $400 a year.

4
Changes to the plan must be made through my workplace.

5
I cannot use the new card outside my province.


Enabling Task 2: While reading the letter and the brochure, you also wrote some questions to help you understand them better. Now go back to the letter and the brochure and answer the following questions by writing short answers (1 to 4 words or numbers).

Questions
Answers
1
How can the doctor help?

2
What should the member do to get more information about the plan?

3
Can any dependent get a card?

4
What’s the purpose of the brochure?

5
Can a member get reimbursement if s(he) is forgets the card?


Task: Fill out extended healthcare and vision care claim form below. Click **HERE** to access the form.

Task Reporting: Instructor invites 3-4 learners to present their in-class writing to the class. Learners put their writing on document sharing camera ( ELMO), the class read the work silently and then the presenter shares his/her reflections.

Post-Task Analysis: Compare your form with your partner’s form. Do you both have the same information? Is your form legible?

Post-Task Practice: Based on the reading, the role-plays you have watched and the feedback from your instructor what changes will you make to your first role-play? Do the role-play once again.

Optional writing Task Practice:
Step 1: Add / invite your classmates to your friends circle on Facebook.
Step 2: Accept the invitation from Alex Koh. Alex is an insurance broker.
Step 3: Ask for suggestions about an insurance plan you would like to purchase. Keep your instructor in the loop.
Important: You will get feedback about your online communication in the class next week.
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End of Lesson 8 >> Go to Lesson Module 1 - Lesson 09 (Getting on Time)