{"id":1933,"date":"2023-01-24T11:09:33","date_gmt":"2023-01-24T16:09:33","guid":{"rendered":"https:\/\/osstfbenefits.ca\/?p=1933"},"modified":"2023-01-24T11:09:33","modified_gmt":"2023-01-24T16:09:33","slug":"osstf-benefits-mise-a-jour-sur-la-coordination-des-prestations-cdp","status":"publish","type":"post","link":"https:\/\/www.osstfbenefits.ca\/fr\/osstf-benefits-mise-a-jour-sur-la-coordination-des-prestations-cdp\/","title":{"rendered":"OSSTF Benefits \u2013 Mise \u00e0 jour sur la coordination des prestations (CDP)"},"content":{"rendered":"

Les familles qui comptent deux adultes au travail ont fr\u00e9quemment plus d\u2019un r\u00e9gime d\u2019assurance maladie et dentaire. Les deux r\u00e9gimes peuvent avoir des niveaux de couverture l\u00e9g\u00e8rement diff\u00e9rents et offrir des options de service qui varient. Au titre de la coordination des prestations, les assureurs se partagent la responsabilit\u00e9 de payer les frais admissibles en mati\u00e8re de soins m\u00e9dicaux et dentaires en d\u00e9terminant lequel des r\u00e9gimes est le premier payeur et lequel est le payeur secondaire. Le premier payeur examine la demande de r\u00e8glement en premier et tout solde impay\u00e9 est examin\u00e9 par le payeur secondaire. Les prestations sont coordonn\u00e9es entre les deux r\u00e9gimes pour faire en sorte que vous obteniez le remboursement maximal pour vos frais admissibles, jusqu\u2019\u00e0 100\u00a0%.\u00a0<\/span><\/p>\n

Les d\u00e9tails de la disposition relative \u00e0 la coordination des prestations se trouvent dans votre <\/span>livret d\u2019assurance<\/span><\/a>, dans le site s\u00e9curis\u00e9 \u00e0 l\u2019intention des membres du RAEO.<\/span> Vous trouverez aussi d\u2019autres renseignements utiles sur la CDP, ainsi qu\u2019une FAQ, dans l\u2019article du RAEO sur la<\/b> coordination des prestations<\/b><\/a>.<\/span>\u00a0<\/b><\/p>\n

L\u2019ACCAP (Association canadienne des compagnies d\u2019assurances de personnes) a mis au point les lignes directrices en mati\u00e8re de CDP pour l\u2019industrie de l\u2019assurance, en vue d\u2019uniformiser la d\u00e9termination de la priorit\u00e9 de paiement et d\u2019\u00e9tablir le montant minimal \u00e0 payer par chaque r\u00e9gime d\u2019assurance collective dans les situations o\u00f9 une personne couverte peut pr\u00e9senter une demande de r\u00e8glement\u00a0\u00e0 plus d\u2019un r\u00e9gime. Ces lignes directrices d\u00e9crivent l\u2019ordre de paiement par les assureurs et la fa\u00e7on de coordonner les remboursements des r\u00e9gimes collectifs des personnes assur\u00e9es.<\/span>\u00a0<\/span><\/p>\n

Vous pouvez consulter les lignes directrices de l\u2019ACCAP <\/span>sur la coordination des prestations ici<\/span><\/a>.<\/span><\/p>\n

Qu\u2019est-ce que cela signifie pour le r\u00e9gime d\u2019assurance d\u2019OSSTF Benefits?<\/b><\/p>\n

Comme premier payeur, il n\u2019y a pas de changement pour le r\u00e9gime d\u2019assurance d\u2019OSSTF Benefits. <\/b>Cependant, si un membre ou une personne \u00e0 charge admissible a de la couverture au titre de la FSSBE de l\u2019OSSTF\/FEESO et d\u2019un autre r\u00e9gime, si la demande de r\u00e8glement va tout d\u2019abord \u00e0 l\u2019autre r\u00e9gime, comme payeur secondaire, le <\/span>r\u00e9gime de la FSSBE de l\u2019OSSTF\/FEESO remboursera les demandes de r\u00e8glement pour les m\u00e9dicaments admissibles en tenant compte des plafonds raisonnables et habituels du r\u00e9gime \u00e0 partir du 1<\/b>er<\/b> f\u00e9vrier 2023.<\/b> \u00a0<\/span><\/p>\n

La modification des r\u00e8gles de CDP entre les deux r\u00e9gimes fera en sorte que la FSSBE de l\u2019OSSTF\/FEESO ne rembourse pas plus qu\u2019il n\u2019est pr\u00e9vu selon les dispositions de son r\u00e9gime d\u2019assurance.<\/span><\/p>\n

Vous avez des questions?<\/b> Si vous avez des questions, veuillez communiquer avec Donna Morrison, directrice g\u00e9n\u00e9rale d\u2019OSSTF Benefits \u00e0 <\/span>donna.morrison@osstfbenefits.ca<\/span><\/a> ou avec les Services d\u2019assurance du RAEO au 1-866-783-6847.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Les familles qui comptent deux adultes au travail ont fr\u00e9quemment plus d\u2019un r\u00e9gime d\u2019assurance maladie et dentaire. Les deux r\u00e9gimes peuvent avoir des niveaux de couverture l\u00e9g\u00e8rement diff\u00e9rents et offrir des options de service qui varient. Au titre de la coordination des prestations, les assureurs se partagent la responsabilit\u00e9 de payer les frais admissibles en […]<\/p>\n

En lire plus ><\/span><\/a><\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[4],"tags":[],"class_list":["post-1933","post","type-post","status-publish","format-standard","hentry","category-non-classifiee"],"acf":[],"yoast_head":"\nOSSTF Benefits \u2013 Mise \u00e0 jour sur la coordination des prestations (CDP) - OSSTF Benefits<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osstfbenefits.ca\/fr\/osstf-benefits-mise-a-jour-sur-la-coordination-des-prestations-cdp\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"OSSTF Benefits \u2013 Mise \u00e0 jour sur la coordination des prestations (CDP) - OSSTF Benefits\" \/>\n<meta property=\"og:description\" content=\"Les familles qui comptent deux adultes au travail ont fr\u00e9quemment plus d\u2019un r\u00e9gime d\u2019assurance maladie et dentaire. 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