Dear Valued Member,
We understand that you may have questions about the recent adjustments to our Group Health Plan and changes in premium rates. However, we want to assure you that PCU’s Group Health Plan remains a competitive and quality option for comprehensive health care coverage, and we are committed to providing the best value to our members.
Under the enhanced plan, you will enjoy an additional benefit of the Medical Provider Network, available from Thursday 1st June 2023. The Medical Provider Network gives you access to over 360 quality healthcare providers nationwide with less out-of-pocket costs and less paperwork as members will now access services at the provider, pay their co-pay and deductible and sign the claim form. The provider will then submit the claim form for settlement by the insurer. This therefore removes the need for members to submit claim forms to PCU for settlement.
In addition, members 71 to 99 will enjoy a significant enhancement to the Major Medical benefit. Currently, these members have a Lifetime Major Medical benefit maximum of $500,000. Once this maximum is exhausted, members would cease having coverage. Under the enhanced plan, members 71 to 99 are now entitled to a six-year renewable benefit period.
We also now deposit reimbursements for claims directly to your PCU savings account and offer one-on-one meetings with our Genesis Insurance Brokers & Benefits Consultants Ltd. representative at PCU branches for faster resolution of queries.
The plan also includes a 90-day window for resubmission of claims (industry standard is 45 days), and a Medical Support Services team that directly consults with health care professionals, institutions, and members to ensure effective management of pre-certification and claims settlement.
At PCU, we are committed to being there for our members in the moments that matter. We are ready to help you manage anything relating to your health care coverage, from claims support to communication challenges. For information on the adjustments to the health plan, please see the FAQs below. If you or a family member need help to understand these changes, please contact us at 612-4728 ext. 1010 or email your questions to [email protected].
Thank you for choosing Police Credit Union as your financial services provider. We are dedicated to providing our members with the best value for money, extraordinary service, outstanding products, and competitive health care solutions.
FREQUENTLY ASKED QUESTIONS
1. When will the new premiums come into effect?
The new premiums will come into effect for PCU members at the end of May 2023 when the new premiums will be due.
2. What will be my new premium?
PCU will send communications to each policyholder advising of the new premiums, however, you can also view the premium due for each coverage group in the table below.
Rates for policyholders 0 to 70
|Coverage Type||Current Premiums||New Premiums||Difference Payable per. month|
|Major Medical Max.||$1,000,000||$1,000,000|
|Member & One||$394.50||$454.12||$59.62|
|Member & Family||$589.00||$678.82||$89.82|
Premiums for policyholders 71 to 99
|Coverage Type||Current Premiums||New Premiums||Difference Payable per month|
|Major Medical Max.||$500,000||$500,000|
|Member & One||$595.25||$686.96||$91.71|
3. When will I have to pay the new premium.
The new premium will be due from Members of PCU’s Group Health Plan at the end of May.
For members who service their insurance premiums via payroll allocation or standing order, we recommend:
- Immediately amending the allocation of your payroll if there are surplus funds going to your Deposit Savings Account or
- Increasing your payroll deduction or
- Visiting your bank to amend your standing order assigned to PCU or
- Visiting your branch to pay the additional funds at the teller
Amendments to payroll deductions can be delayed for up to 30 days, depending on the processing times at various organisations, so we strongly recommend visiting a branch to deposit the difference onto your Insurance Account, until the new amount is deducted from your salary or standing order.
4. Why is my premium changing?
The GENMed Group Health Plan, which PCU is a part of, is underwritten by Beacon Insurance Company Limited. Each year, as part of the annual renewal/underwriting exercise, Beacon reviews the plan’s performance to ensure it can meet members’ needs. Factors that can influence premium changes include the cost of claims, the number and type of claims received, the rising cost of health insurance claims, an increase in chronic health conditions, more complex and costly medical procedures, and inflation.
5. Why is my premium changing even though I have not made a claim or used my plan?
Unlike other types of insurance, Health Plan Premiums are reviewed every year to ensure they can cover the rising cost of healthcare and preventative care services.
6. Will these changes in the cost of premiums only impact members of PCU?
No. The increase in premiums applies to ALL Credit Unions who make up the GENMed pool.
7. How are new premiums calculated?
To determine suitable pricing for the plan, insurers use data on claims, service, administrative costs, and other existing costs, as well as forecasts of future costs, data on market trends, medical inflation etc.
8. What are some of the other adjustments to the Health Plan?
Some benefit adjustments were required to keep the plan competitive and affordable to all members. These changes are effective Monday 1st May 2023. The updated schedule of benefits is available at www.policecreditunion.com for a full listing of the adjustments implemented.
9. What is PCU doing to help members?
PCU is taking a proactive approach in looking for opportunities to reduce costs while increasing the value of coverage to members. We are collaborating with Genesis Insurance Brokers to coordinate and implement specially negotiated annual preventative care packages, offer Medical Concierge services to make emergency admittance to private medical institutions friction-free, provide members with access to a medical consultant, keep plan administration costs low while improving service to members, and utilize technology solutions such as the GENMed portal. Our priority is to provide members with a competitive and comprehensive health insurance product that offers exceptional value.
If you have additional questions, please email your query to [email protected] or call us at 612-4728 ext. 1010.