faqs

Certainly. You may submit claim forms with supporting documentation and invoices to a dedicated e-mail address. 

Barbados - [email protected]

Yes, this benefit is accessible upon receipt of supporting referral documentation and approval by Sagicor.

The change form, along with a Group Health Statement will be required. The dependent spouse will need to be assessed by our underwriters and approval is not guaranteed.

The change form, a Group Health Statement, and a pediatrician’s report will be required. The dependent spouse will need to be assessed by our underwriters and approval is not guaranteed.

Types of documents and when they are required:

1. Marriage certificates are requested where the spouse carries a different surname to the employee.

2. Common law certificates are required as proof of co-inhabitation between employee and common law spouse. This is only applicable to those employees who have been cohabiting for a period of more than 2 years. (This applies for unmarried couples living together)

3. Spouse’s signature is required ONLY when there is a spouse to be added (on the Group Health Statement).

4. Birth certificates are required when dependent (child/children’s) surname differs from the employee or the insured spouse.

5. Student letters are required for dependents between the ages of 19-25 years and must be submitted on an annual basis for dependent’s coverage to be continued.

6. Company stamp is necessary on enrolment/change form.

7. Pediatrician’s report is required for dependent babies 2 years of age and under. This report must be done by a pediatrician, not a nurse or normal general practitioner. Hospital birth reports and immunization reports are not considered pediatrician reports and if such is submitted a pediatrician’s report will still be requested.

8. Group Health Statements are required for all small groups. For employees of large groups, they are needed if the submission of the application for the employee has crossed the 31 day grace period and therefore the employee would need to be underwritten.

There are a range of solutions that business clients can choose from.

TYPE1 - offers full administration of the client's health insurance portfolio

Option 1: CariCARE™ Advantage which provides cover for large groups

Option 2: CariCARE™ Enterprise which provides cover for small groups.

TYPE 2 - offers Administration Services Only (ASO)

Flex-Care is our Administrative Services Only (ASO) plan for Group Health clients who opt to self-fund their employee benefits plan but outsource specific administrative services for us to manage on their behalf."

Your benefit limit is the maximum amount as stated in your schedule of benefits, less any prior payments.  Our Sagicor Team is available to provide you with information on your current remaining benefit maximum.

The change form, along with a Group Health Statement will be required. The dependent spouse will need to be assessed by our underwriters and approval is not guaranteed.

Within 31 days of marriage, a dependent spouse can be added automatically, once Sagicor receives the documents to add within 31 days of the date of marriage.

Yes, this benefit is accessible upon receipt of supporting referral documentation and approval by Sagicor.

There are certain services associated with some benefits to which the deductible does not apply, and these are usually set out in the Plan's schedule of benefits. Three examples of these are: Preventative Care Benefit, Air ambulance and Airfare benefit.

The order of benefit determination tells us!

Most plans allow a maximum of 3 deductibles per family under the medical plan.

E.g. if the yearly deductible is $500.00 per insured and an insured has 4 dependents, (5 persons in the family) The maximum amount paid in deductible for that family in a calendar year is $1500.00. 

Note: It is the deductible amount and not number of persons so that $1500.00 can be accumulated over the whole family or $500.00 each by 3 persons.

Most plans allow a maximum of 3 deductibles per family under the medical plan.

E.g. if the yearly deductible is $500.00 per insured and an insured has 4 dependents, (5 persons in the family) The maximum amount paid in deductible for that family in a calendar year is $1500.00. 

Note: It is the deductible amount and not number of persons so that $1500.00 can be accumulated over the whole family or $500.00 each by 3 persons.

There is no 'Family deductible' under the dental and vision benefits. Each member will be responsible for the full amount of eligible expenses for which no benefits are payable in any one calendar year.

The deductible is the amount of eligible expenses for which no benefits are payable in any one calendar year. In other words, the amount of eligible expenses as stated in the Plan's schedule of benefits which is the member's responsibility. The medical plan does not reimburse on this amount.

Note it is the amount which is eligible and not necessarily what was spent.

E.g. $200.00 was charged for a visit, however the plan allows $150.00 as per the schedule, only $150.00 goes towards the deductible.

Reimbursements are made by the plan after the full deductible has been met.

These are eligible expenses incurred in the last 3 months of a calendar year (Oct-Dec), which would be applied towards the deductible for that year and is used to reduce the deductible for the following year, provided that no benefit was paid after the deductible was satisfied.

Example: If $100.00 was accumulated towards a service where the deductible was for example, valued at $300. in October 2020, the full deductible for 2020 was not satisfied and no further claims were submitted or paid, that $100.00 will go towards satisfying the deductible for 2021.

The minimum number of persons is five (5).

Small group sizes: BB 5-10 persons  TT: 5- 25  EC & BZ: 5-15

View the list of participating providers within your location on our Group web page: https://eservice.sagicorlife.com/groupwebsli/ProviderList.aspx