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Plan Text Documents and Contracts including Stand Alone Trip Cancellation/Interruption

This document details the eligibility, coverage, limitations and procedures under the Extended Health Care Plan.


This contract details the coverage, limitations, agreement, and length of term for ARTA’s Emergency Travel Insurance.


This document summarizes the Emergency Out-of-Country Medical Benefit coverage details.


This document details the eligibility, coverage, limitations and procedures under the Dental Care Plan.


This document details the coverage, limitations, exclusions and claim instructions.

Claim Forms


This form is used for health, prescription drugs, or vision claims. Please ensure to attach your receipts/invoices to this form.



Ce formulaire est utilisé pour les soins de santé et de vision revendications étendues. Se il vous plaît assurer de joindre vos reçus / factures à ce formulaire.



This form is used to submit all dental claims.



Ce formulaire est utilisé pour soumettre toutes les réclamations dentaires.



This form is to be used when requesting greater than a 100-day supply of medication when travelling outside Canada. It must be received by ASEBP, ARTA’s plan administrator, by fax or email, at least FIVE business days PRIOR to your date of departure. If approved by ASEBP, it will be sent to your pharmacist no earlier than seven days prior to your date of departure.



Complete this form if you, or one of your dependants, have had to prepay for medication(s) required in excess of the 100 day supply eligible under your ARTA Retiree Benefits Plan’s prescription drug benefit for the purpose of travel outside Canada.



This form is used for out-of-province and out-of-country emergency medical claims (effective November 1, 2016)



Ce formulaire est utilisé pour les demandes médicales d’urgence à l’extérieur de la province et à l’extérieur du pays (à compter du 1er novembre 2016)



This form is used for out-of-province and out-of-country trip cancellation, trip interruption and trip delay claims (effective November 1, 2016)



Ce formulaire est utilisé pour les demandes d’annulation de voyage, d’interruption de voyage et de retard de voyage à l’extérieur de la province et à l’extérieur du pays (à compter du 1er novembre 2016)


This form is for members who have purchased a separate Standalone Trip Cancelation Policy, underwritten by RSA Canada. Claim instructions are found on page 7-10 of this form. This coverage is purchased in addition to your ARTA retiree benefits. If your claim is for a trip covered by your Total Health or Ultimate Health plan, this is not the correct form; please complete the Allianz Global Assistance Cancellation/Interruption form provided on this page.


This form helps you report an emergency to Allianz Global Assistance. It outlines the steps to take and the information to provide to Allianz Global Assistance to ensure you get the assistance you need in a travel emergency. ARTA recommends you download and complete a copy of this form and keep it with your travel documents while you are away.

Plan Summary Forms and Documents

Education Sector

8 page overview of the Retiree Benefits Plan including premium rates


You will need to join ARTA to enroll in the Retiree Benefits Plan


Application to join the ARTA Retiree Benefits Program

Public/Private Sector

8 page overview of the Retiree Benefits Plan including premium rates.


ARTA Membership Application
There is no ARTA membership application for public service sector applicants as ARTA membership fees will be included in these applicants Health & Wellness Benefit Plan premium withdrawals.


Application to join the ARTA Retiree Benefits Program

ASET

8 page overview of the Retiree Benefits Plan including premium rates


ARTA Membership Application
There is no ARTA membership application for ASET applicants as ARTA membership fees will be included in these applicants premiums.


Application to join the ASET Retiree Benefits Program

Servus Credit Union

4 page overview of the Retiree Benefits Plan including premium rates


ARTA Membership Application
There is no ARTA membership application for Service Credit Union applicants as ARTA membership fees will be included in these applicants premiums.


Application to join the Servus Credit Union Retiree Benefits Program

AUMA/AMSC

4 page overview of the Retiree Benefits Plan including premium rates


ARTA Membership Application
There is no ARTA membership application for public service sector applicants as ARTA membership fees will be included in these applicants Health & Wellness Benefit Plan premiums


Application to join the ARTA Retiree Benefits Program

Enhanced Special Authorization Request Forms

On January 1, 2017, the ARTA Retiree Benefits Plan implemented a change to the benefit plan that impacts the way we manage drug special authorization requests for members being treated for chronic hepatitis C, Crohn’s disease and colitis, multiple sclerosis, psoriasis and rheumatoid arthritis.






If you require special authorization for a specialty drug used to treat a condition outside of the five covered by the enhanced special authorization process (e.g. ankylosing spondylitis, psoriatic arthritis, cancer, hemophilia, blepharospasms, etc.), your physician will manage this process for you. There are no ARTA Retiree Benefits Plan forms to be completed. Simply discuss your condition and treatment options with your physician and they will request approval for you. Your physician will have access to all of the necessary paperwork in order to submit this request.

 

Have Questions

View our information package below.

Change of Information Forms


This form is used to apply for monthly automatic withdrawals for benefit premiums from your bank account.



This form is used to make changes to your existing health, travel, and/or dental plans.



This form is used to terminate your benefits and/or select coverage.

ARTA Sponsored Programs & Articles

Sponsored Programs:

TW Insurance Brokers
TW Insurance is partnered with ARTA to bring its members a comprehensive suite of insurance products.


Home & Auto Insurance
As an ARTA member, you have access to exclusive rates provided by TW Insurance.


Life Insurance
TW offers short and long term solutions to protect you now and in the future.


Affinity Programs
As an ARTA member, you have access to discounts at a wide variety of organizations, businesses, and retailers across North America and Europe.

 

Articles:


This article details the drug plan changes in response to increasing pharmacy service costs.



This article summarizes key points pertaining to joining ARTA, making changes to your benefits, and options available.



This article describes the LCA provision and how it pertains to you.

For a complete directory of all the benefit related forms, documents, and articles, please select  from the following list:

To view our Plan Summary Forms and Documents, click here
For Claim Forms, click here
For Enhanced Special Authorization Request Forms, click here
To view the ARTA Sponsored Programs and Articles, click here
For Change of Information Forms, click here
For Plan Text Documents and Contracts including the Stand Alone Trip Cancellation/Interruption Plan, click here

Please Note...

All health care application and ARTA membership forms must be mailed to:
ARTA, 11835 149 Street, Edmonton AB  T5L 2J1.

All other forms must be mailed to:
ASEBP, Allendale Centre East, Suite 301, 6104-104 Street NW, Edmonton, AB, T6H 2K7