There was a spirited
exchange on the university newsgroup Shoptalk recently about some glitches
in implementing the Clarica Assure Direct Pay and Emergency Travel Card
system, introduced in November.
The card, which is handled by BCE Emergis, is designed to bypass the paperwork
previously required to receive a reimbursement for most eligible drug
expenses, i.e. drugs listed on the RAMQ listing.
Through the card, you should also be able to find out right away what
proportion of your purchase is covered by the plan and how much you will
be reimbursed by the Concordia Health Insurance plan.
Heres how the new system
You give your card with your prescription to any participating pharmacist
in Canada. The pharmacist enters the data from your card and your prescription
into the computer system. Within seconds, this data is electronically
You pay the total cost of the claim to the pharmacist. He or she will
give you a receipt showing your portion of the cost and the plans
You have no claim form to complete. You will receive a reimbursement cheque
at a later date from BCE Emergis, on behalf of Clarica, in 90 days, or
as soon as your accumulated unpaid reimbursement amount reaches $150,
whichever comes first.
The card is valid for you and for any eligible dependents that you registered
during the first registration campaign last July.
A reminder to register eligible dependents was sent out in November and
employees were asked to fill out a Registration of Eligible Dependents
form to submit to Benefits Services. As mentioned in the documentation,
claims for dependents who are not properly registered will be rejected.
The Assure Card can be used only for drugs on the provinces RAMQ
list. The plan covers these drugs at 80 per cent of the first $2,000 of
eligible expenses per calendar year and 100 per cent thereafter, for the
balance of the year.
To obtain a reimbursement for drugs not on the RAMQ list, you must complete
and submit the regular Clarica form, available from Clarica. The plan
covers these drugs at 50 per cent. You will receive a reimbursement by
mail in the same way as you would for any non-drug claim.
Accurate information about claimants and their dependents will help to
ensure that claims are processed quickly and efficiently.
Dealing with growing pains
Robert Lacasse, Manager of Compensation and Benefits (Human Resources/Employee
Relations), explains how he has been dealing with the programs growing
In line with the orientation set out by the Concordia Employee Benefits
Committee and as part of the agreement with Clarica, the university took
on the responsibility for registering dependents eligible for the plan.
The university was also responsible for upgrading the computer systems
and electronic interface with Clarica to manage the card system.
There have been some problems on both levels. The employee response to
the solicitation drives was weak. Some employees did not respond at all
or responded very late, and many failed to provide complete information
and to register their dependents. Because the default for Clarica card
users is single, employees who failed to register their dependents
in the new system, but whose dependents had been previously covered under
the old one, found that their claims for dependents were denied.
Difficulties with rapidly interfacing the university and Clarica systems
slowed the processing of the refused claims, adding to the frustration
and anger of some employees. Benefits Service has been inundated with
phone calls at a time when major projects stemming from the part-time
faculty health plan and ACUMAE dental plan are also being introduced.
There have also been problems with updating lists of retirees and part-time
faculty eligible for benefits under the card program.
A review of the claim administration system and data reporting was done.
New staff were added to the Benefits Service; the non-pension benefits
team is now composed of four employees and is led by Senior Benefits Officer
Nicole Desrochers. As a result, service is expected to improve quickly.
We are also planning to improve the way we communicate benefits information.
We are doing all we can to ensure that claims are processed efficiently.
If you have any comments or questions, please feel free to contact me
at (514) 848 3675 or by e-mail: firstname.lastname@example.org,
or call Clarica: (514) 848-6003; outside Montreal: 1- 800 - 463-3572.
Benefit Services: Nicole Desrochers at 848-3661 or email@example.com.
Please forward your Clarica card system questions to Nicole Desrochers
by e-mail at: firstname.lastname@example.org.