By Fab Biagini and Nancy Periera

As we enter the summer months, with pandemic restrictions easing after over 2 years, travel appears be back in full force (even though not all airports or airlines appear to be ready for it). 

Now is a great time to remind employees about emergency medical travel coverage they have through your group benefits program when travelling outside their province of residence and Canada. 

Of course, each policy differs, and each traveler’s situation may differ. Subsequently, we strongly recommend that anyone travelling outside of Canada review and understand their coverage thoroughly, paying close attention to the details noted in their plan booklet or other insurer resources. If they require further clarification of their particular situation, they should contact their 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. 

It is important that employees understand the overriding principles of the emergency medical travel coverage commonly included in most group Extended Health Care plans: 

• Eligible employees and their dependents will generally be provided with this coverage as long as they are insured under the Extended Health Care benefit. 
• Coverage under the provincial government’s medical plan must be maintained for the emergency travel benefit to be in effect. 
• Coverage is to alleviate an “emergency” which 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 travelling. 
• As with all insurance contracts however, 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. Contact the insurer if unsure. 
  • Some insurance companies may also include limitations related to travels 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 many employer-sponsored emergency travel insurance benefits will provide coverage when seeking medical treatment if you contract COVID-19 while travelling, 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.

We reiterate and emphasize that if an employee is uncertain about their coverage, they should contact their insurance company directly for coverage verification prior to leaving their province of residence. When contacting the insurance company, they should provide the call centre 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. Insurance companies offer many types of policies which include travel insurance, and each can differ significantly. At times like these, travelers should continue to seriously consider their travel plans with the stated travel advisories as set out by the Government of Canada. This is 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: 

Travelers (employees, spouses or dependents) should carry their emergency travel medical card and ID card (if separate) with them at all times and 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 carrier and, in many cases, print 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 travelling, the employee, travel companion or travelling 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 travelling 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 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 to you by leveraging one of the most skilled benefits teams – collectively almost 400 years of experience within our team of 19 employee benefits specialists.  We have been working with businesses ranging from 3 to over 70,000 plan members for over 35 years.