Publications

Trustees Newsletter – December 2019

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I'm Brain Health Conscious!

The NBTF Group Insurance Trustees care about your health!

Your brain is one of the most vital and probably the most complex organ in your body. In order to maintain its health, improve its cognitive behaviour and prevent aging, you must eat properly (for example, the brain loves avocado, dark chocolate and berries), get active, sleep well, socialize and face new challenges regularly.    

In Canada:

  • 16,000 people under the age of 65 living with dementia
  • 25,000 new cases of dementia are diagnosed every year
  • 63% of those diagnosed with dementia over the age of 65 are women
  • 1.1 million people are affected directly or indirectly by the disease
  • 45% greater risk of developing dementia if you smoke

Here are some activities that could help maintain your brain health:

  • Play. Find a game involving memory, thinking, attention or logic. Play it once a week.
  • Socialize. Visit friends, accept invitations, volunteer once a month.
  • Keep Positive. Smile often, do something that makes you laugh, stay positive, think young. 


Participate for a chance to win a box of board and logic games! (valued at $150)

This challenge is intended for all teachers, active and retirees. 
*All activities may be completed individually or in small groups, but only one prize will be awarded among all participants.

The winner of My Healthy Routine challenge is Nathalie Paquet.
She will receive a 3-month membership to the gym of her choice.
Congratulations!

Your Group Benefits: Critical Illness

Basic Critical Illness Insurance – Active Members Only

If, while you are insured for this benefit, you are diagnosed with one of the covered Critical Illness conditions shown in the Covered Critical Illness Conditions Pamphlet available from the benefit administration department, you can submit a claim for your Basic Critical Illness benefit. You must have survived your illness for 30 days or more past the date you were first diagnosed. Your claim will be evaluated using the Entitlement Criteria.

The Benefit Benefit Type – Comprehensive

Benefit Amount – $10,000

Termination Age – your benefit terminates at the earlier of age 75, your retirement or your Critical Illness benefit is paid out in each of the 4 Multiple Event Coverage Groups

Member Optional Critical Illness Insurance

If, while you are insured for this benefit, you are diagnosed with one of the covered Critical Illness conditions shown in the Covered Critical Illness Conditions Appendix, you can submit a claim for your Member Optional Critical Illness benefit. You must have survived your illness for 30 days or more past the date you were first diagnosed. Your claim will be evaluated using the Entitlement Criteria.

The Benefit Benefit Type – Comprehensive

Benefit Amount – increments of $10,000, to a maximum of $300,000 (minimum benefit of $10,000)

Non-Evidence Limit – All amounts are subject to Evidence of Insurability. However, for Active Members, evidence of insurability will be waived for an amount which is $50,000 or less. For Retired Members, evidence of insurability will be waived for an amount which is $20,000 or less.

Termination Age – your benefit amount reduces by 50% at your age 65, to a maximum of $50,000 for Active Members, $20,000 for Retired Members (minimum benefit of $10,000), and terminates at the earlier of age 75, or your Critical Illness benefit is paid out in each of the 4 Multiple Event Coverage Groups. The reduced maximum cannot be increased at a later date.

Entitlement Criteria

Manulife Financial will apply the following criteria in determining your entitlement to Critical Illness Benefits: 

  • Manulife Financial receives medical evidence documenting your diagnosis of a covered Critical Illness condition; 
  • the diagnosis of any Critical Illness is made by a Physician, practicing medicine in Canada in a specialty relating to the applicable Critical Illness. At any time, Manulife Financial may require you to submit to a medical examination or evaluation by an examiner selected by Manulife Financial.

 

Critical Illness Covered Conditions

Further detail on these conditions are available here.

Submitting a Claim

To submit a Critical Illness Insurance claim, the person must have survived their illness for 30 days or more past the date they were first diagnosed.

For all Critical Illness coverage, Manulife Financial needs to receive your completed claim form within 90 days of date of diagnosis of the Critical Illness. You can obtain a claim form from the benefit administration team. The form shows all of the necessary documents you need to submit to support your claim.

For more information on the basic or optional critical illness insurance plans, please read the pamphlet by clicking here or contact Johnson Inc. at 1-888-851-5500.

How to Fill a Benefit Entitlement Review Form? (Appeal Form)

Have you ever submitted a claim to Johnson and had it denied?  You do have the option of filing an appeal called the Benefit Entitlement Review.
 
STEP 1:
In order to appeal a denied claim, you must first call Johnson and request to speak to a Claim Specialist. Explain everything to this person.
 
STEP 2:
If your claim is still denied and you would like to pursue the matter further, there is an appeal process. Be advised that you will need to have a paper trail and detailed notes about what you submitted, the paper response, details of your conversation or emails with the Johnson representative, and finally a completed form. You can either request a form from Johnson or access it on the NBTF website or use this link: https://nbtffenb.ca/benefit-entitlement-review
 
It would be a good idea to read this form before you call Johnson, so you will know exactly what details you should record. Also, Johnson’s Claim Specialist may offer to send you the form.
 
STEP 3:
Complete the BENEFIT ENTITLEMENT REVIEW form (which you can photocopy and mail OR complete online and submit – make sure you save a completed copy for yourself) and send it either to the Co-Chairs of the NBTF Group Insurance Plan at the mailing address provided on the form, or directly to Johnson Inc. Acknowledgment of receipt of the appeal will be sent to you. The trustees meet to four times a year, and your appeal will be reviewed at the next Group Insurance Trustees meeting following receipt of your appeal. 
 
NOTE: If you think there might be a problem before you submit your initial claim, keep a photocopy of your initial receipt(s) and claim form. If you receive notice that your claim has been denied, add a copy of that letter to your records. Keep notes about any and all contact (dates and names) with Johnson, whether it is by email or by phone. Document everything; it all will become part of your submission as you thoroughly complete the Benefit Entitlement Review form. Continue to keep a copy of everything that you submit. Once your appeal has been reviewed by the Group Insurance Trustees, you will receive a written notification of the Trustees’ decision from the Co-Chairs of the NBTF Group Insurance Trustees.

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