Group Insurance Plan

FSSS (CSN) – RSGMF

You haven’t made your campaign selection in the Customer Center?

Please note that you will be granted coverage that is the closest equivalent to what you currently have on July 1, 2021.

If this does not suit you, contact our Customer Service department until June 30, 2021, at
1-888-636-9535 who has access to make your coverage selection on your behalf.

 
RSGMF

 

Important changes coming to your group insurance plan on July 1, 2021

Changes be made to health, short term disability, long term disability as well as basic and optional life insurance coverages on July 1, 2021.

Some of your coverages will automatically be replaced by new ones offering a similar level of protection to what you currently have. Be sure to check that they meet your needs.

If you are satisfied with the equivalent coverages granted to you, then NOTHING IS REQUIRED OF YOU.

Your dental care, spouse’s and dependent’s basic life as well as spouse's optional life insurance, when applicable, remain unchanged.

Go to the Documentation section for coverage information.

You have until May 28, 2021, to make your coverage selection.

The re-enrolment campaign will be held from May 3 to 28, 2021.

Please double-check the information below to make sure you are satisfied with the health coverage provided.

On May 3, you will be able to make your coverage selection in the Customer Centre.

If you aren’t already registered for the Customer Centre, you will need your certificate number and email address to create your account. Your certificate number appears in the top-right corner of your SSQ insurance card and insurance certificate.

What you need to know

Important change to Health Option 1

The list of prescription drugs that are covered in option 1 will match the RAMQ’s official list.

A $5 deductible per prescription drug will be added and the reimbursement percentage will be 65%.

You can check if your prescription drug appears on the RAMQ’s list by consulting the Régime de l’assurance maladie du Québec site.

If it doesn’t, ask your pharmacist or doctor for possible alternatives that are on the RAMQ list.

As a result of this change to Health Option 1, the premium will be reduced by more than 20%.

Other changes to the health insurance coverage

Below are reimbursement percentages applicable to most of the coverage:

  • Health 1: 65% + $5 deductible per prescription drug
  • Health 2: 75% + $5 deductible per prescription drug
  • Health 3: 80% + $5 deductible per prescription drug

The Healthcare Professionals component in Health Options 2 and 3 will be improved. The list of eligible healthcare professionals will be expanded and the maximums per care will be increased.

New health insurance coverage structure

On July 1, you will be granted coverage that is the closest equivalent to what you currently have. The table below shows the equivalences.

If you wish to do so, you have until May 28 to make any changes to the equivalent health insurance coverage that was automatically granted to you. Go to the Customer Centre!

If you currently have(1) On July 1, 2021, you will get(1)
Single Status Coverage option A
Health I for you
Health 1 Individual
Coverage option B
Health II for you
Health 2 Individual
Coverage option C
Health III for you
Health 3 Individual
Single-Parent Status Coverage option D
Health I for you
Health I for your dependant children
Health 1 Single-Parent
Coverage option E - ABOLISHED
Health II for you
Health I for your dependant children
Health 2 Single-Parent
Coverage option F
Health II for you
Health II for your dependant children
Coverage option G - ABOLISHED
Health III for you
Health I for your dependant children
Health 3 Single-Parent
Coverage option H - ABOLISHED
Health III for you
Health II for your dependant children
Coverage option I
Health III for you
Health III for your dependant children
Family Status Coverage option J
Health I for you
Health I for your spouse and your dependant children
Health 1 family
Coverage option K - ABOLISHED
Health II for you
Health I for your spouse and your dependant children
Health 2 family
Coverage option L
Health II for you
Health II for your spouse and your dependant children
Coverage option M - ABOLISHED
Health III for you
Health I for your spouse and your dependant children
Health 3 family
Coverage option N - ABOLISHED
Health III for you
Health II for your spouse and your dependant children
Coverage option O
Health III for you
Health III for your spouse and your dependant children

(1)If you were exempted from health coverage, the exemption will be automatically transferred on July 1, 2021.

To make a well-informed decision,refer to the Your Plan At A Glance document, in the Documentation section of the Customer Centre, for comprehensive information about Health Options 1, 2 and 3.

Minimum participation period for Health Options 2 and 3 is 36 months

If, during this re-enrolment campaign, you opt for Health Option 2 or 3, you will have to complete the 36-month participation period before being allowed to decrease your coverage level.

However, you can take advantage of this re-enrolment campaign, to decrease your coverage level even if you haven’t completed the 36-month participation period.

After the re-enrolment period, you will be able to decrease your coverage level without having completed the 36-month participation period as long as you make the request in the prescribed period following a family event like a marriage or the birth of a child.

Increasing coverage level is possible at any time. It will be granted on the first day of the premium period that coincides with or that follows the reception date of your request by your employer.

New short term and long term disability insurance coverage structure

On July 1, 2021, changes will be made to the short- and long term disability insurance coverages. You will no longer have to set your coverage based on the MPE’s(1) percentage. You will instead have four options:

For compulsory short term disability insurance:

  Option 1 Option 2 Option 3 Option 4
Compulsory Short Term
Disability period subject to benefits: 52 weeks
Weekly benefit
$300
Weekly benefit
$400
Weekly benefit
$500
Weekly benefit
$600

Your short term disability coverage option (Option 1, 2, 3 or 4) will determine the one for optional long term disability insurance coverage.

  Option 1 Option 2 Option 3 Option 4
Optional Long Term
End of Benefits: age 65
Monthly Benefit
$1,300
Monthly Benefit
$1,650
Monthly Benefit
$2,000
Monthly Benefit
$2,350

If you do not currently have optional long term disability insurance coverage, you can opt in during this re-re-enrolment campaign without having to provide proof of insurability.

Important! The disability period subject to benefits for compulsory short-term disability insurance coverage will decrease from 104 weeks to 52 weeks for all new disability claims as of July 1, 2021. The waiting period will also decrease from 14 days to 7 days.

Coverage most similar to what you currently have will be automatically granted. The table below shows the equivalences.

Your MPE Percentage(1) Short term disability insurance weekly benefit amount Long term disability insurance monthly benefit amount Equivalence
Between 38% and 48% of the MPE(1) Between $275 and $347 Between $1,087 and $1,373 Option 1
Obligatory short term: $300
Optional long term: $1,300
Between 50% and 62% of the MPE(1) Between $361 and $448 Between $1,430 and $1,773 Option 2
Obligatory short term: $400
Optional long term: $1,650
Between 64% and 76% of the MPE(1) Between $462 and $549 Between $1,830 and $2,173 Option 3
Obligatory short term: $500
Optional long term: $2,000
Between 78% and 80% of the MPE(1) Between $563 and $578 Between $2,230 and $2,287 Option 4
Obligatory short term: $600
Optional long term: $2,350

(1)The maximum pensionable earnings (MPE) are equal to the maximum employment income used to calculate a worker’s annual pension plan contributions. Although the MPE changes from year to year, your contract currently applies the MPE from 2015, which is $53,600.

New life insurance coverage structure

As of July 1, 2021, changes will be made to plan member’s basic life, accidental death and dismemberment (AD&D) and optional life insurance. You will no longer have to set your coverage based on the MPE’s percentage.(1).

For optional basic life and AD&D, you may choose one of the following options:

  Option 1 Option 2
Participant’s basic life and AD&D $25,000 $50,000

Coverage most similar to what you currently have will be automatically granted. The table below shows the equivalences.

Your MPE Percentage(1) Basic life and AD&D coverage amount Basic life and AD&D equivalences on July 1, 2021
Between 38% and 46% of the MPE(1) Between $20,368 and $24,656 Option 1 – $25,000
Between 48% and 80% of the MPE(1) Between $25,728 and $42,880 Option 2 – $50,000

As part of the re-enrolment campaign, you can accept the equivalent coverage that is granted to you, reduce your coverage amount and switch up from Option 1 to Option 2. However, if you do not currently have this coverage, you cannot opt in as part of the re-enrolment campaign. If you would like to add this coverage, you can submit a request directly with SSQ. Proof of insurability will be required. If you would like to add this coverage, you can submit a request directly with SSQ. Go to the Contact section for the contact information. Proof of insurability will be required.

For the optional additional life insurance amount, it will now be possible to select 1 to 20 units of $10,000. If you would like to add this coverage, you can submit a request directly with SSQ. Go to the Contact section for the contact information. Proof of insurability will be required.

(1)The maximum pensionable earnings (MPE) are equal to the maximum employment income used to calculate a worker’s annual pension plan contributions. Although the MPE changes from year to year, your contract currently applies the MPE from 2015, which is $53,600.

What do I do if I’m not satisfied with one of the equivalent coverages that was granted to me?

To make changes one of the equivalent coverages that was automatically granted to you, you must register for the Customer Centre (if you haven’t already done so) and then you have until May 28, 2021, to make your changes by clicking the Confirm my coverage button.

Once submitted, a confirmation will be displayed along with a reference number. You will also be sent a confirmation email. Please keep this confirmation number in your files.

If you are unable to make your changes this way, you must make them directly through SSQ. Your coverage selection will take effect on July 1 and your new premium will be billed on the first day of the premium period on or immediately following July 1, 2021.

Frequently Asked Questions

Is my insurance card still valid?

The policy and certificate numbers appearing on your SSQ card remain valid, despite making a change of coverage. You may continue to present it at your pharmacy and to your dentist.

I’m satisfied with the equivalent health, disability and life insurance coverages that will be granted to me on July 1, 2021. Is anything expected of me?

If you are satisfied with the equivalent coverage, then NOTHING IS REQUIRED OF YOU. All these coverages in your Customer Centre account will automatically take effect on July 1, 2021, and the new premium will be billed on the first day of the premium period on or immediately following July 1, 2021.

What are the prescription drug purchase best practices?

Did you know that you can save money by having prescriptions filled for three-month periods or by opting for a generic equivalent?

However, your pharmacist is also bound by a code of ethics and your prescription drug may not be appropriate for such a supply.

For more information, refer to the following document: Best practices for prescription drug purchases.

Can I terminate my dental care coverage?

If, when the plan was restructured on May 31, 2019, you maintained this coverage, you have not yet completed the minimum participation period of 36 months. The current re-enrolment campaign cannot be used as an opportunity to terminate coverage.

Termination will only be possible once the minimum participation period has elapsed.

However, you can terminate your coverage before the 36-month participation deadline if you can prove to SSQ that you became eligible for another group insurance plan that has dental care coverage.

I’m currently exempted. Must I inform you if I want to maintain this exemption?

No. If you don’t make any changes to your coverage, you will continue to be exempted on July 1, 2021.

I’m currently exempted. Can I revoke my exemption during this re-enrolment campaign?

Yes. You can terminate your exemption simply by selecting one of the coverage statuses available: individual, single-parent or family.

This will automatically revoke your exemption.

I want to opt out of my health insurance coverage. How can I?

It is not possible to opt out in the Customer Centre. Please contact us to submit the request. Our contact information is in the Contact section.

I began a disability leave on July , 2021.
Will I be automatically granted equivalent coverage?

Yes, if you are on disability leave on July 1, 2021, you will be granted equivalent health coverage just like other participants, according to the equivalency table and effective waiver of premiums criteria will be applied.

If you want to decrease your coverage, you can do so in the Customer Centre.

If you want to increase your coverage, you will have to wait until your return-to-work date, which will qualify you for a new disability period, before submitting the request to your employer.

If you want to increase your coverage, you will have to wait until your return-to-work date, which will qualify you for a new disability period, before submitting the request to SSQ.

I’m on temporary leave without treatment on July 1, 2021.
Will I be automatically granted equivalent coverage?

Yes, you will be granted equivalent coverage as per the aforementioned rules. However, this situation in no way changes the fact that the coverage you selected at the start of your temporary leave will be maintained.

If you opted to maintain all your coverage, your health insurance coverage will be granted to you just like to other participants who are actively at work and it will be possible for you to modify it in the Customer Centre.

If you opted to maintain Health Option 1, only this coverage will be granted as per the proposed equivalency. If you want to increase your coverage level, you can submit a request directly to SSQ in the 30 days following your return-to-work date.

If you chose to not maintain any of the coverage, equivalent coverage will be granted just like other participants, but it will take effect upon your return to work. It will then be possible for you to submit a request directly to SSQ in the 30 days following your return-to-work date.

How can I make changes to coverage that is not part of this re-enrolment campaign?

Please refer to SSQ as you would normally. Our contact information is in the Contact section.

I have been on disability leave since before July 1, 2021.
Will the coverage changes have an impact on my benefits?

Even though changes are being made to your disability insurance coverage on July 1, 2021, the long term disability insurance coverage that was in effect at the start of your leave will continue to apply.

The new terms and conditions taking effect on July 1, 2021, will only apply to a new disability leave.

Who can I ask for help with my coverage selection?

You may contact SSQ. Our contact information is in the Contact section.

If I’m unable to make my coverage selection prior to May 28, 2021, what other option will I have?

Beyond May 28, 2021, it will no longer be possible to make your coverage selection in your Customer Centre.

However, you will have until June 30, 2021, to ask SSQ, who has access to make your coverage selection for you. Our contact information is in the Contact section.

Can I get basic life insurance coverage without providing proof of insurability?

If you did not have life insurance coverage, you will be allowed to get basic and optional life insurance, but proof of insurability will be required. If you would like to add this coverage, you can submit a request by contacting SSQ.

If you already had basic life insurance, you will have the coverage amount options of $25,000 or $50,000, which don’t require proof of insurability if you apply by May 28, 2021.

When does disability insurance coverage end?

The weekly benefit period for short term disability insurance coverage starts after seven consecutive days of disability leave and ends at week 52.

The monthly benefit period for long term disability insurance coverage starts after short term disability benefits end and up to age 65 (up from 61 in the previous plan ending on June 30, 2021).

If I understand correctly, I no longer have to select an MPE(1) percentage to set my reference salary?

As of July 1, 2021, there will no longer be any coverage based on this factor and simplified options will be provided.

It is therefore important for you to take advantage of this re-enrolment campaign to make new coverage selections.

(1) Le maximum des gains admissibles (MGA) équivaut au maximum des revenus de travail pris en compte pour calculer la cotisation de retraite annuelle d’un travailleur. Le montant du MGA varie tous les ans, mais votre contrat utilise actuellement le MGA de l’année 2015 qui était de 53 600 $.

Sign up for the Customer Centre and you could win an iPad Air.

Over 45,000 FSSS (CSN) plan members already use our online services. You too can sign up for the Customer Centre in three easy steps!

  1. Go to ssq.ca/acces
  2. Click the Login button, then Insured, followed by Register.
  3. Enter the requested information!
 
 

All persons who are already signed up and those who will have signed up by May 28, 2021, will be entered in a draw to win an iPad Air (worth $780). See the contest rules.

In addition to obtaining a reimbursement within 48 hours1 when making an online claim, you can also consult all the information in your insurance file and make a number of changes online. We currently have a 95% satisfaction rate. What are you waiting for2?

1For most treatments, when you are registered for direct deposit.

2Surveys conducted between January 1 and November 30, 2018, with 19,588 SSQ Insurance customers.

Any questions?

If you haven’t found answers to your questions, if you encounter any problems or if you need assistance with your Customer Centre account activation, please contact our Customer Service department, Monday to Friday, 8 a.m. to 8 p.m.

By phone: 1-888-651-8181
By email: rsgmf@ssq.ca