Important Information
Here are a few things we recommend you do as a member.
Register your certificate/group number at your pharmacy and dental office for electronic submission of claims.
Read through your welcome package then remove the perforated section that contains your certificate/group number (on the front) and your travel emergency medical information (on the back) and put it in your wallet.
Not sure if something is covered? Call us to make sure.
Keep our contact info handy
1.855.934.2355.
Photocopy all your receipts.
Keep all your statements (Explanation of Benefits (EOB's), invoices etc.).
Hold on to your plan documents (Certificate of Insurance).
Claims must be submitted not more than 90 days following the close of each Benefit Year.
Remember your annual insurance renewal date; it's the start of each Benefit Year.
Simple.
We give you the coverage you need - minus the confusion
What's In The Writers' Coalition Program?
Reimbursement Percentage for each Insured Person 70%* of drug cost Annual Maximum for each Insured Person $400 AFBS Drug Formula The AFBS prescription drug formulary will be used to settle all drug claims Ingredient costs cover usual and customary costs. They do not include "dispensing fees"
*For those Members who reside in Québec the requirements of the Régie de l’assurance maladie du Québec (RAMQ) will take precedence.
Reimbursement Percentage for each Insured Person 70%* of drug cost Annual Maximum for each Insured Person Year 1: $1,000 Year 2: $2,000 Subsequent Years: $3,000 AFBS Drug Formula The AFBS prescription drug formulary will be used to settle all drug claims *We cover ingredient costs only. Ingredient costs cover usual and customary costs. They do not include "dispensing fees"
*For those Members who reside in Québec the requirements of the Régie de l’assurance maladie du Québec (RAMQ) will take precedence.
Reimbursement Percentage for each Insured Person 70% Annual Maximum for each Insured Person $5000* Annual Maximum for each Insured Person for Vision/Paramedical Care $350 *Maximum includes benefits paid for Vision/Paramedical Care
Reimbursement Percentage for each Insured Person Year One:70% Year Two:70% Subsequent Years:70% Annual Maximum for each Insured Person Year One:$7,500* Year Two:$7,500* Subsequent Years:$7,500* Annual Maximum for each Insured Person for Vision/Paramedical Care Year One:$500 Year Two:$500 Subsequent Years:$750 *Maximum includes benefits paid for Vision/Paramedical Care
Reimbursement Percentage for each Insured Person 50% Annual Maximum for each Insured Person $400 combined all services
Reimbursement Percentage for each Insured Person Year One:50% Year Two:50% Subsequent Years:%50 Annual Maximum for each Insured Person Year one:$800 Year Two:$800 Subsequent Years:$1,250 Basic Services Year one:$300 Year Two:$300 Subsequent Years:$500 Major Services (crowns, bridges, dentures) including Periodontal (gum disease) and Endodontic (root canal) Year one:$500 Year Two:$500 Subsequent Years:$750
Prescription Drug
| Standard | Comprehensive | |||||||
|---|---|---|---|---|---|---|---|---|
| All Years | Year One | Year Two | Subsequent Years | |||||
| Reimbursement Percentage for each Insured Person | 70%* of drug cost | 70%* of drug cost | 70%* of drug cost | 70%* of drug cost | ||||
| Annual Maximum for each Insured Person | $400 | $1,000 | $2,000 | $3,000 | ||||
| AFBS Drug Formulary | The AFBS prescription drug formulary will be used to settle all drug claims | The AFBS prescription drug formulary will be used to settle all drug claims | ||||||
*We cover ingredient costs only. Ingredient costs cover usual and customary costs. They do not include "dispensing fees".
For those Members who reside in Québec the requirements of the Régie de l’assurance maladie du Québec (RAMQ) will take precedence.
Extended Health Care (including Vision/Paramedical Care)
| Standard | Comprehensive | |||||||
|---|---|---|---|---|---|---|---|---|
| All Years | Year One | Year Two | Subsequent Years | |||||
| Reimbursement Percentage for each Insured Person | 70% | 70% | 70% | 70% | ||||
| Annual Maximum for each Insured Person | $5,000* | $7,500* | $7,500* | $7,500* | ||||
| Annual Maximum for each Insured Person for Vision/Paramedical Care | $350 | $500 | $500 | $750 | ||||
*Maximum includes benefits paid for Vision/Paramedical Care
Dental Care
| Standard | Comprehensive | |||||||
|---|---|---|---|---|---|---|---|---|
| All Years | Year One | Year Two | Subsequent Years | |||||
| Reimbursement Percentage for each Insured Person | 50% | 60% | 60% | 60% | ||||
| Annual Maximum for each Insured Person | $800 | $800 | $1,250 | |||||
| Basic Services | $400 combined all services | $300 | $300 | $500 | ||||
| Major Services (crowns, bridges, dentures) including Periodontal (gum disease) and Endodontic (root canal) | $500 | $500 | $750 | |||||
Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
Access to coverage and the amount of coverage is based on your age as indicated in the table below.
This benefit is only for the member – dependants are not covered for this benefit.
| Standard | Comprehensive | ||||
|---|---|---|---|---|---|
| Group Term Life | AD&D | Group Term Life | AD&D | ||
| Age at Annual Renewal | |||||
| 16 - 64 | $10,000 | $10,000 | $10,000 | $20,000 | |
| 65 - 69 | $5,000 | $5,000 | $5,000 | $10,000 | |
| 70 - 75 | $5,000 | Not covered | $5,000 | Not covered | |
If you have an accident or become ill outside your province of residence, your provincial health care program may not cover all your medical bills, even when travel is within Canada.
The Travel Emergency Medical benefit has been designed to cover many of the types of expenses that can occur when a medical emergency occurs while away from home.
This benefit is made available through iA Financial Group who is the provider of this benefit. Additional details are available below.
*The policy is null and void if you schedule or extend a trip beyond a 60 day duration, regardless of whether the extended period is insured by other parties.
**The policy is null and void if you schedule or extend a trip beyond a 30 day duration, regardless of whether the extended period is insured by other parties.
The Member and Family Assistance Program (MFAP) benefit reflects AFBS’ continuing commitment to the physical and emotional well-being of our membership. Through the Member and Family Assistance Program, offered by Telus Health, confidential help is available to members and their families to assist with resolving the personal problems that can interfere with their lives and work, including:
Counselling Services, provided on a voluntary, confidential and short-term basis either in person, online or by telephone; and
Work/Life Services which can include telephone and/or text-based resources either online or printed material in a wide-ranging number of areas including:
Coverage Amount Access to coverage and the amount of coverage is based on your age as indicated in the table below This benefit is only for the member – dependants are not covered for this benefit. Age at Renewal Under age 65: Group Term Life: $10,000 AD&D: $10,000 Under age 65 to 69: Group Term Life: $5,000 AD&D: $5,000 Under age 70 to 75: Group Term Life: $5,000 AD&D: Not covered
Coverage Amount Access to coverage and the amount of coverage is based on your age as indicated in the table below This benefit is only for the member – dependants are not covered for this benefit. Age at Renewal Under age 65: Group Term Life: $10,000 AD&D: $20,000 Under age 65 to 69: Group Term Life: $5,000 AD&D: $10,000 Under age 70 to 75: Group Term Life: $5,000 AD&D: Not covered
If you have an accident or become ill outside your province of residence, your provincial health care program may not cover all your medical bills, even when travel is within Canada.
The Travel Emergency Medical benefit has been designed to cover many of the types of expenses that can occur when a medical emergency occurs while away from home.
This benefit is made available through iA Financial Group who is the provider of this benefit. Additional details are available below.
*The policy is null and void if you schedule or extend a trip beyond a 60 day duration, regardless of whether the extended period is insured by other parties.
**The policy is null and void if you schedule or extend a trip beyond a 30 day duration, regardless of whether the extended period is insured by other parties.
The Member and Family Assistance Program (MFAP) benefit reflects AFBS’ continuing commitment to the physical and emotional well-being of our membership. Through the Member and Family Assistance Program, offered by Lifeworks, confidential help is available to members and their families to assist with resolving the personal problems that can interfere with their lives and work, including: Counseling Services (Family Support), Work/Life Services (Financial, Legal), and Health Coaching (Nutritional and Naturopathic Services). Coaching (Nutritional and Naturopathic Services).
Community.
We are truly a case of Artists helping Artists.
How Do You Make A Claim?
Server setup is near instant as soon as we receive your payment, our automated system takes care of everything so there is no lengthy waiting times.
Server setup is near instant as soon as we receive your payment, our automated system takes care of everything so there is no lengthy waiting times.
Server setup is near instant as soon as we receive your payment, our automated system takes care of everything so there is no lengthy waiting times.
Prescription Drug Benefit
In most cases, your pharmacist will file claims electronically at the pharmacy. AFBS works with ClaimSecure to provide Members and their covered dependants with pay-direct claims payments for Prescription Drug Benefit coverage. Since these claims are processed through the ClaimSecure network, the pharmacist requires your certificate and group number to process your claim.
If your pharmacist cannot file claims electronically at the time of service,* you will be able to submit your claims via the ClaimSecure eProfile™ app or on their website once it becomes available to you. This online claim submission service will be rolled out to Members on a month-to-month basis (starting September 1, 2023) and you will be eligible on your annual coverage renewal date. You will be notified once this becomes available to you. You will need to submit any paper claims by mail to AFBS until you are able to submit via the ClaimSecure eProfile™ app or website.
Members who are new to the Program effective September 1, 2023, can use the ClaimSecure eProfile™ app or website immediately to submit claims.
When submitting a claim online, you can either upload a photo of the Prescription Drug Claim Form (PhotoClaim) or input the relevant information when prompted (eClaim).
To submit a claim by mail:
AFBS
1000 Yonge Street
Toronto, ON M4W 2K2
If AFBS is the second payor, please include the receipt of claim settlement information, often called an Explanation of Benefits (EOB), from the other insurance company along with copies of your official receipts from the pharmacy with a completed Prescription Drug Claim Form when sending by mail.
*Electronic submission by your pharmacist is not possible for all prescription drug claims, for example certain compounds or coordination of benefits scenarios. These must be submitted by mail with a completed Prescription Drug Claim Form. Special authorization drugs follow a certain protocol, for more information click here.Extended Health Care
For health care expenses like medical, paramedical (acupuncture, massage etc...) and vision care claims, you will be able to submit your claims via the ClaimSecure eProfile™ app or on their website once it becomes available to you. This online claim submission service will be rolled out to Members on a month-to-month basis (starting September 1, 2023) and you will be eligible on your annual renewal date. You will be notified once this becomes available to you. You will need to submit any paper claims by mail to AFBS until you are able to submit via the ClaimSecure eProfile™ app or website.
Members who are new to the Program effective September 1, 2023, can use the ClaimSecure eProfile™ app or website immediately to submit claims.
EHC claims incurred prior to your annual renewal date or before September 1, 2023, must be submitted by mail.
When submitting a PhotoClaim online please include a completed and signed Extended Health Care Claim Form and all supporting documentation.
To submit a claim by mail:
AFBS
1000 Yonge Street
Toronto, ON M4W 2K2
Dental Care
In most cases, your dental office will file claims electronically at the dental office. AFBS works with ClaimSecure to provide Members and their covered dependants with pay-direct claims payments for Dental Care coverage. Since these claims are processed through the ClaimSecure network, the dental office requires your certificate and group number to process your claim.
If your dental office cannot file claims electronically at the time of service,* you will be able to submit your claims via the ClaimSecure eProfile™ app or on their website once it becomes available to you. This online claim submission service will be rolled out to Members on a month-to-month basis (starting September 1, 2023) and you will be eligible on your annual renewal date. You will be notified once this becomes available to you. You will need to submit any paper claims by mail to AFBS until you are able to submit via the ClaimSecure eProfile™ app or website.
Members who are new to the Program effective September 1, 2023, can use the ClaimSecure eProfile™ app or website immediately to submit claims.
When submitting a dental claim online, you can either upload a photo of the standard dental claim form (PhotoClaim) or input the relevant information when prompted (eClaim).
To submit a claim by mail:
AFBS
1000 Yonge Street
Toronto, ON M4W 2K2
If AFBS is the second payor, please include the receipt of claim settlement information, often called an Explanation of Benefits (EOB), from the other insurance company along with all relevant documentation and standard dental claim form from the dental office when sending by mail.
*Electronic submission by your dental office is not possible for all dental claims, including the submission of certain x-rays and major restorative work. You can submit these claims online using the ClaimSecure eProfile™ app or on their website (once it becomes available to you) or by mail. Be sure to include all supporting documentation.Group Term Life and AD&D Insurance
In the event of your death, notification of a claim for the Group Life benefit must be made to AFBS. AD&D benefits may also be payable if death is a result of an accident. The necessary forms and instructions will be sent to your beneficiary, executor or lawyer.
If you suffer a covered loss of use or dismemberment, as a result of an accident, your AD&D claim must be submitted to AFBS within 90 days of the accident.
AFBS
1000 Yonge Street
Toronto, ON M4W 2K2
Travel Emergency Medical
To submit a claim for expenses incurred while travelling out of your province of residence, you must send your original invoices and/or receipts with the required form.
INDUSTRIAL ALLIANCE INSURANCE AND FINANCIAL SERVICES INC.
Claims Department
400-988 West Broadway, PO Box 5900
Vancouver, BC V6B 5H6
1-800-266-5667 or outside North America collect to 1-604-737-3802
SpecialMarkets-claims@ia.ca
Coordination of Benefits (COB) with Other Insurance Programs
Step 1
If you or your spouse/partner have coverage with another insurance company, you should send the claims to that insurer for payment. However, if you are a dependant under your spouse/partner’s coverage, your claim must be sent to AFBS first. Usually, claims for insured dependant children must be submitted to the plan of the parent whose birth day and month falls first within the calendar year. When administering coordination of benefits AFBS follows the guidelines established by the Canadian Life and Health Insurance Association (CLHIA).
Step 2
After settling a claim with the primary insurer, any portion not paid by the other insurance company will be reported on the Explanation of Benefits (EOB) statement. Submit this explanation to AFBS along with a completed claim form and copies of your original receipts.
Step 3
AFBS will adjudicate the remaining amount that was not paid by the primary insurer. You will be reimbursed up to your benefit level or 100% of the eligible health or dental expenses unpaid by the other insurer.
When you are coordinating claims between insurance companies, you will be required to provide copies of your receipts to the second insurer in order to be reimbursed by them.
Deadlines for Claims Submission
Claims for a previous Benefit Year must be submitted within 90 days of the close of the Benefit Year indicated on your Certificate of Insurance to remain eligible for payment.
Server setup is near instant as soon as we receive your payment, our automated system takes care of everything so there is no lengthy waiting times.
Server setup is near instant as soon as we receive your payment, our automated system takes care of everything so there is no lengthy waiting times.
Server setup is near instant as soon as we receive your payment, our automated system takes care of everything so there is no lengthy waiting times.
Supportive.
We look for ways to make our services go farther.
Take Advantage of Other Member Advantages
Everything from home insurance to personal and commercial banking.
All these products and services are completely voluntary. Please contact the program provider directly for all payment and processing.
Is your home covered?
Our group discount on home insurance could mean better rates and better value for your general insurance needs. HUB International offers you a free, no-obligation review of your insurance portfolio. For additional information call HUB at 1-888-749-7800.
Members have been thrilled with the personal attention, high level of service and preferred rates that HUB provides.
AFBS Group Home & Auto Insurance Program Disclosure
Ride the best rates
Our group discount on auto insurance could mean better rates and better value for your general insurance needs. HUB International offers you a free, no-obligation review of your insurance portfolio. For additional information call HUB at 1-888-749-7800.
Members have been thrilled with the personal attention, high level of service and preferred rates that HUB provides.
AFBS Group Home & Auto Insurance Program Disclosure
A banking institution formed to meet the financial needs of creative professionals
Creative Arts Financial was originally conceived and built for the benefit of professionals in the entertainment industry. If you are a member of one of the many unions, guilds, associations or companies serving the entertainment industry, you can take advantage of a full-service, full-channel community banking institution designed exclusively for entrepreneurial professionals like you.
To learn more about Creative Arts Financial, visit their website at creativeartsfinancial.com.
Planning for your loved ones
iA Financial Group is pleased to provide additional Voluntary Term Life Insurance. Additional information about this benefit, as well as an application form, can be found at www.solutionsinsurance.com/en/associations/afbs. For general inquiries about this program, please contact AFBS at 1-800-387-8897. All administration, premium invoicing and claims adjudication is provided by iA Financial Group.
Accidents happen. Be prepared if they do
iA Financial Group is pleased to provide additional Voluntary AD&D Insurance. Additional information about this benefit, as well as an application form, can be found at www.solutionsinsurance.com/en/associations/afbs. For general inquiries about this program, please contact AFBS at 1-800-387-8897. All administration, premium invoicing and claims adjudication is provided by iA Financial Group.
The money you need to focus on your recovery
iA Financial Group is pleased to provide additional Voluntary Critical Illness Insurance. Additional information about this benefit, as well as an application form, can be found at www.solutionsinsurance.com/en/associations/afbs. For general inquiries about this program, please contact AFBS at 1-800-387-8897. All administration, premium invoicing and claims adjudication is provided by iA Financial Group.
Accessible.
Find what you need, when you need it.
For Writers.
We give you the coverage you need - minus the confusion
Artists Helping Artists
The Writers' Coalition Program is offered by AFBS, a not-for-profit insurance provider owned by performers and writers. As an organization, we understand the unique needs of people who earn their living through their creativity and only insure those working in the writing community. We’re committed to the continued development of a program that works for the community.
How it all started
Canadian author, social activist and past chair of the Writers Union of Canada (TWUC), Susan Swan found herself musing on the fact that access to an affordable health care safety net – something enjoyed by salaried workers in the private and public business sector – was denied to too many people in the creative and artistic world.
The results of her conversations and considerations ultimately led to a dialogue with AFBS, about underwriting a benefits program for the writing community. AFBS launched the first Canadian benefits insurance program specifically for uninsured writers and the writing industry in 2009. Two years later, the Arts & Entertainment Plan® was launched to serve the rest of the artistic community.
Who is AFBS?
FAQ.
100% Canadian. We are a national program, from coast to coast.
Application/Enrollment
The Standard program is available for new applicants age 70 and under and is renewable for those who have been insured prior to age 70.
The Comprehensive program is available for new applicants age 64 and under and is renewable for those who have been insured prior to age 64.
No, if you would like to apply offline simply print an Enrollment form and mail, scan or fax it in with your payment (be sure to sign and date it).
No, your coverage will start the first of the following month in which you apply (and only after you've been approved and premium has been collected). During the online enrollment process, your effective date of coverage will be noted and you will receive information on next steps.
No. When a plan is chosen, each family member must be covered by the same plan.
No, your provincial health care plan provides in-hospital care and doctor’s fees which are not covered through the Writers' Coalition Program. It is very important that you always keep your provincial health care benefits in place.
You would apply as a couple paying the lower rate.
As long as we know when your other benefits are terminating we’ll try to ensure that there is no lapse in coverage. Your benefits under the Writers' Coalition Program will commence on the 1st of the month following receipt and approval. We’ll need your completed application and premium payment in advance of your termination in order to avoid any lapse. Depending on when your other insurance terminates you might have some duplication of coverage for a short while. Contact us to discuss your particular scenario.
Yes. This is a guaranteed acceptance plan – no medical questionnaires need to be filled out.
If we receive your application and payment on or before the last of the month (and it has been approved), your benefits will be effective the first (1st) day of the following month.
If you’re a member of a company that provides group benefits and you leave that company, you may be able to join the Comprehensive program at Year 3 levels (Subsequent years). Call for more details.
Benefits
You may upgrade/downgrade between plan options however, you must satisfy the 12 month period in which your original contract was issued. Also, if your move is an upgrade to the Comprehensive program, you must satisfy the 2 year lock-in provision. This means once you make the move it is a 24 month commitment under your new plan option.
No, this is a group plan and increasing the duration or changing the benefits is not possible.
Claims
Many prescription drug and dental claims can be processed immediately at your pharmacy or dentist’s office. Be sure to provide your pharmacist and dental office with your group number and certificate number which can be found on your certificate of insurance included as part of your enrollment package.
If your pharmacist or dentist cannot file claims electronically at the time of service, you will be able to submit your claims via the ClaimSecure eProfile™ app or website, once it becomes available to you. For extended health care claims, if you are a new Member you can submit your claims via the ClaimSecure eProfile™ app or website. If you' not a new Member, this service will be rolled out to Members on a month-to-month basis (starting September 1, 2023) and you will be eligible on your annual renewal date. You will be notified once this becomes available to you. You will need to submit any paper claims by mail to AFBS until you are able to submit via the ClaimSecure eProfile™ app or website.
Once you submit a claim, whether it was handled electronically via the ClaimSecure eProfile™ app or website or by mail submission, you will receive an Explanation of Benefits (EOB) which details what was processed and the amount of any reimbursement. You will want to keep this document for income tax purposes or to coordinate benefits with another insurer. When you submit a claim by mail, in most cases the EOB will be accompanied with a cheque however, if there is no payment you will just receive the EOB. When you submit a claim electronically using the ClaimSecure eProfile™ app or website, you can view the EOB from your eProfile™.
Premiums
Terminology
Refers to the 12 month period from the date your benefits commence. For example, if your benefits start November 1st your benefit year would be November 1st to October 31st.
Natural children, stepchildren, common law children or legally adopted children.
The applicant and his/her married or common-law spouse/partner or a single parent with one child who qualifies as a dependant.
Spouse/partner and/or unmarried children (as defined above), under age 18. Note: Children between 18-26 may be covered as a dependent if they are in school or are disabled or handicapped.
The applicant and his/her spouse or common-law spouse/partner and any children who qualify as a dependant or a single parent with 2 or more children who qualify as dependants.
Products that contain medical ingredients identical to the original brand name drug in dosage form, safety, strength, administration, quality, performance and intended use. Generic drugs may be produced and marketed after the brand name drug’s patent has expired.
Any treatment, service or supply which is generally accepted by the medical profession as essential, effective and appropriate in the care and treatment of a medical condition, sickness or injury.
