FIQ (Fédération Interprofessionnelle de la santé du Québec)

Group Insurance

The Social Security Sector is in charge of group insurance.


Change of insurer and plan on April 14, 2019

 

The FIQ will switch to a new insurer and plan on April 14, 2019. On the day of the switch, FIQ and FIQP members will become insured by La Capitale Insurance and Financial Services and will have a new and improved group insurance plan. It will include a modular health insurance plan and an optional dental care plan.


Changing your coverage

 

If you would like to make changes to your new group insurance plan with La Capitale, please go to La Capitale’s website: lacapitale.com/fiq


Do you have any questions about the new plan?

 

For more information, check out the Frequently Asked Questions below. You can also call La Capitale at 418-781-2830 or 1-855-781-2830 to ask questions regarding your new group insurance plan or your own situation.



What will happen between now and April 14, 2019?

 

All of your current insurance coverage and rates will remain effective with Desjardins Financial Security until the insurer change on April 14, 2019. The new plan and rates with La Capitale will become effective as of April 14, 2019.

Remember to submit your claims for any insured services received before April 14 to Desjardins as soon as possible, preferably within three months after changing insurers.

To submit a claim online or download the mobile app, go to Desjardins Assurances.

Should you have any questions about your current group insurance plan, feel free to discuss them with your union representative.



Frequently Asked Questions


Is participation in the FIQ’s group insurance plan mandatory?

Yes. The Act respecting prescription drug insurance in Québec requires all persons under age 65 who are eligible for a private group health insurance plan offering prescription drug coverage to enrol in the plan and cover their dependents (spouse and children) subject to the exemption privilege. The terms and conditions for participation in the other benefits offered under the plan are taken from the collective agreement.

Can I take advantage of the exemption privilege?

Yes. You may be exempted from participating in the health insurance plan if you provide your insurer with proof that you and your dependents, if any, are covered under a group insurance plan with similar benefits.

Who is required to make coverage selections?

All participants who are actively at work or who are on:

  • Leave with deferred pay
  • Protective reassignment
  • Maternity, paternity or parental leave
  • Leave without pay with insurance continuation

Participants who are currently on leave without pay and without insurance continuation will be able to make new selections when they return to work.

How do participants who are insured with more than one employer make their plan selections?

Participants will receive an insurance certificate from each of their employers. They will have to make their selection based on the employer with which it has health and Dental Care coverage. It is important to use the ID number appearing on the insurance certificate from that employer. The exemption will continue with other employers.

If I make new selections, can I still present the service card I received at the pharmacy?

Yes, because the ID number appearing on the card remains the same, regardless of your selections. A new insurance certificate confirming your new selections will be sent to you, however.

How did the insurer determine the participant status (individual, single-parent or family), which was applied to me by default for the health plan?

The participant status corresponds to the selection you had made for the basic prescription drug plan, even if you selected a different participant status for the Desjardins basic extended plan III (other medical care).

How did the insurer determine the participant status (individual, single-parent or family), which was applied to me by default for the Dental Care plan?

The participant status corresponds to the selection you had made with your previous insurer, based on the rules then in effect. The new plan now allows you to select a participant status (individual, single-parent or family) regardless of the category selected for the health insurance plan.

How come Vision Care, such as eyeglasses, is not included in the modules offered?

Based on the FIQ’s discussion of this matter with the actuary, in view of the high administration fees and taxes on the premiums for these services, it is more expensive to add these services to the insurance coverage than to individually cover the costs associated with them. The FIQ has therefore decided not to include that coverage in the options offered to you.

Why is a minimum participation period being introduced?

A When individual participants are able to make choices within a group plan, contracts generally provide a minimum participation period for the plan selected. The new maintenance period for health insurance will make it possible to ensure greater premium stability by limiting movements from one module to another as needs change, for the sole purpose of paying the lowest possible premium while maximizing reimbursements.

I currently have Dental Care coverage. Will amounts reimbursed to me before April 14, 2019 be taken into account?

No. All accumulators (other than those for orthodontic services, to which a lifetime maximum applies) will be reset to zero. Any reimbursement already received for orthodontic services will be taken into account for this lifetime maximum.

I currently have Dental Care coverage. Will amounts reimbursed to me before April 14, 2019 be taken into account?

No. All accumulators (other than those for orthodontic services, to which a lifetime maximum applies) will be reset to zero. Any reimbursement already received for orthodontic services will be taken into account for this lifetime maximum.

Will La Capitale take into account the amounts I have paid for prescription drugs since January 1, 2019?

Yes. In compliance with the Act respecting prescription drug insurance in Québec, when a change of insurer occurs during the course of a year, the amounts paid for prescription drugs between January 1 and the transfer date are taken into account by the new insurer for the purpose of reaching 100% reimbursement. Desjardins will provide La Capitale with the cumulative statement of the amounts paid out during that period for each participant.

Desjardins authorized reimbursement of a prior authorization drug for me or a family member. Will La Capitale reimburse those expenses?

Yes. La Capitale will continue to reimburse the prescription drug expenses during the period authorized by Desjardins. If appropriate, La Capitale will conduct its own analysis later on.

Will the amount reimbursed to me previously for participation in an addiction treatment program be taken into account?

No. The accumulators will be reset to zero.

Desjardins reimbursed the expenses I incurred for the purchase of a therapeutic device, which was prescribed for me. If I have to buy another one, will I need a prescription?

La Capitale may request a new prescription.

What do I need to do to receive more information regarding optional life insurance?

In the “Optional life insurance” section, simply check the box to indicate that you would like to receive the enrolment kit.

Is the information concerning my beneficiaries, for life insurance, in my file at La Capitale?

No. The information concerning your beneficiaries, for life insurance, has not been transferred to La Capitale. For that reason, it is important to designate your beneficiaries on the selection form; otherwise, your legal heirs will be designated by default.

When will La Capitale mail the documents to me?
  • Participant insured by November 30, 2018: mailed on March 1, 2019
  • Participant insured after November 30, 2018: mailed on April 1, 2019
I want to know what the coverage is under the current group insurance

First, you can consult your group insurance plan’s brochure.

For a more specific question on a clause in your plan, we suggest you contact Desjardins Assurances, Monday to Friday, from 8 a.m. to 5 p.m.:

  • By email : servicecollectif@dsf.ca
  • By telephone : 1 800 463-7843

Have your contract number, group name and certificate or identification number on hand when you contact the insurer.

I want to make a claim with my current group insurance plan

You can make your claims on the insurer’s secure site at: https://www.agea-gbim.dsf-dfs.com/AGEA-GBIM/default.aspx?cltr=fr-CA&Domd=3001&referer=dav

On the home page, click on Submit a claim, then click on Online.

I want to know if the FIQ members have better rates for auto/house insurance

Yes. The FIQ and The Personal have negotiated an agreement which gives you benefits and savings from a group insurance. For more information, go to this page: http://www.fiqsante.qc.ca/partenaires/#personnelle