Fab Biagini,
Advisor, ZLC Employee Benefits Solutions

It may not feel like it, but spring travel season is right around the corner, and we wanted to remind everyone to remind their employees about emergency medical travel coverage they likely have available through your group benefits program when traveling outside their province of residence and Canada.

It cannot be overstated that each policy differs, and each traveler’s situation may differ. As such, we strongly recommend that anyone traveling outside of Canada review and understand their coverage thoroughly, paying close attention to the details noted in their plan booklet (including the exclusions section) or other insurer resources. If they require further clarification of their particular situation, they should contact the insurance company or the insurer’s travel assistance provider/partner (often noted on the back of the ID card) BEFORE they leave, to verify coverage.

The following provides some general principles of emergency medical travel coverage commonly included in most group Extended Health Care plans:

• Travelers (eligible employees, spouses, and their dependents) must be correctly enrolled under the Extended Health Care benefit plan. Employees can verify who is covered online through the insurer’s member portal or mobile app.
• Provincial government medical must be maintained for all travelers for the emergency travel benefit to be in effect.
• Emergency medical coverage is to alleviate a “medical emergency”. This is commonly defined as a sudden, unexpected injury or acute episode of disease demanding immediate medical attention that, prior to departing, could not have been reasonably anticipated based on the insured’s prior medical condition.
• In most cases, emergency medical travel coverage applies the same for all medical emergencies, and therefore includes coverage for a diagnosis of COVID-19 while traveling.
• Exclusions – As with all insurance contracts, there are limitations and exclusions that must be understood before departure. A few things to keep in mind:
  • Contracts do not provide coverage for regular or ongoing treatments of a pre-existing medical condition.  If you have a pre-existing medical condition, but believe your condition is stable, there may be limitations of coverage related to a stability period, whereby a pre-existing condition must be considered ‘stable’ for a stated period of time prior to travel, anywhere from 90 to 180 days.
  • Some insurance companies may also include limitations related to travel destinations and whether it is safe to travel to these locations as outlined on the Government of Canada Travel Advisory list.  For example, Travel Advisories of Level 3 (Avoid Non-Essential Travel) or Level 4 (Avoid all Travel) for a particular location may exclude all coverage regardless of the emergency.
  • Regarding COVID-19, while most employer-sponsored emergency travel insurance benefits will provide coverage when seeking medical treatment if you contract COVID-19 while traveling, it likely does not provide reimbursement for:
    • COVID-19 tests required to travel (before or after).
    • Accommodation costs due to the need or requirement to quarantine.
    • Costs associated to adjust travel plans (i.e., flight change fee, cancellation fee re-booked flight cost) – members should consider purchasing trip cancellation insurance if this is a concern.
    • Provincial/federal regulated quarantine accommodations upon return to one’s home province/country.
    • While medical expenses resulting from a COVID-19 diagnosis may be covered, it is prudent to consider the availability and accessibility of medical care at the member’s destination as the insurer is not responsible for ensuring appropriate access to care is available.

KNOW BEFORE YOU GO!

All travelers (employees, spouses, and their dependents) that are uncertain about their coverage, should contact the insurance company directly for coverage verification prior to leaving their province of residence. When contacting the insurance company, they should provide the call center with their specific Policy and ID numbers and ensure that the response is specific to the traveler’s policy through the employee benefits program versus general questions and comments, because insurance companies offer many types of policies which include travel insurance, and each can differ significantly. Travelers should always seriously consider their travel plans with the stated travel advisories as set out by the Government of Canada. Covid was not the first, nor will it be the last, issue impacting travel around the world, and understanding the coverage details and limitations will help protect travelers from any surprises.

BEFORE YOU DEPART: 

All travelers should carry their emergency travel medical card and ID card (if separate) with them at all times (if spouses or dependents travel separately, ensure they are provided this same information). They should also inform travel companions about their coverage details (in particular, contact information) in the event they are unable to call. Employees can order cards for themselves and their families directly from the insurance company and, in many cases, print them or download them on to a mobile phone from the insurer’s website.

IF YOU HAVE A MEDICAL EMERGENCY:  

In the event of a medical emergency while traveling, the employee, travel companion, or traveling family member should contact the emergency assistance number (as indicated on their benefit card) immediately prior to seeking treatment or as soon as possible after they have sought treatment. If they are unable to make contact on their own, they should have someone they are traveling with do so on their behalf. The travel assistance provider will be able to guide them through any concerns they may have, find the best facility to gain treatment, and confirm with hospitals or other medical professionals the coverage available to avoid any delays in treatment. If they are admitted to a hospital, the travel assistance provider will discuss treatment options and arrange for payment with the hospital directly. In some instances, and under certain circumstances, the travel assistance provider may also recommend transfer to a different medical facility or arrange for travel home.

Each organization’s needs are unique and warrant a customized solution. We would be pleased to discuss your specific situation with you to identify the best strategy with respect to your employee benefits program. Should you have any questions on the above, please don’t hesitate to contact me or a member of our team.

At ZLC Employee Benefits Solutions, we are one of the fastest-growing employee benefits advisors in Western Canada and we are fortunate to have the best people, resources, and clients. We provide value by leveraging one of the most skilled benefits teams – collectively over 400 years of experience within our team of 20 employee benefits specialists. We have been working with businesses ranging from 3 to over 75,000 plan members for over 35 years.