SD22 – Exempt Staff

EXTENDED HEALTH CARE

Insurer: Pacific Blue Cross

Policy Number: 37554

Reimbursement

100%

Annual deductible

N/A

Lifetime maximum

N/A

Termination Age

Earlier of age 70 or retirement

Medical referral travel benefit

N/A

Survivor extension

Yes, to a maximum of 24 months

Prescription Drugs

Drug formulary

Prescription required

Pay-direct drug card

No

Per prescription deductible

$0

Sexual dysfunction

Covered

Oral Contraceptives

Covered

Fertility

$20,000 per lifetime

Smoking cessation

Not covered

Medical Services & Supplies

Medi-assist

Included

Emergency out-of-province reimbursement

100%

Emergency out-of-province maximum

N/A

Hospital

Private or Semi-Private

Private duty nursing (including in-home)

Covered

Hearing aids

Adults: $3,500 every 4 years

Other services and supplies (subject to reasonable and customary limits as defined by insurer)

Covered

Othopedic shoes

$500 per calendar year

Orthotics

$500 per calendar year

Vision Care

Maximum

$650 per 2 calendar years

Eye exams

1 every 24 months (adults)
1 per 12 months (children)

Prescription sunglasses

Covered

Paramedical Services

Massage therapist

$1000 per calendar year

Physiotherapy

$1000 per calendar year

Chiropractor

$1000 per calendar year

Psychology

$1000 per calendar year

Naturopath

$1000 per calendar year

Podiatry

$1000 per calendar year

Acupuncture

$1000 per calendar year

Speech therapy

$1000 per calendar year

Osteopath

$1000 per calendar year

Christian Science

N/A

DENTAL CARE

Insurer: Pacific Blue Cross

Policy Number: 37554

Annual deductible

N/A

Dental fee guide

PBC Schedule 2

Specialist fee guide

Fee Guide +10%

Termination Age

Earlier of age 70 or retirement

Survivor extension

Yes, to a maximum of 24 months

Basic Services

Reimbursement

100%

Maximum

Unlimited

Adult check-up

2 per Calendar year

Child check-up

2 per Calendar year

Endodontic/Periodontic Services

Reimbursement

100%

Maximum

N/A

Major Restorative Services

Reimbursement

80%

Maximum

N/A

Orthodontic Services

Reimbursement

75%

Maximum

$5,000/Lifetime

Age limit

N/A

GROUP LIFE

Insurer: Pacific Blue Cross

Policy Number: 79520

Schedule

Under age 35: flat $10,000 + 3 x annual earnings;
Age 35 to 44: flat $10,000 +2.5 x annual earnings;
Age 45 to 54: flat $10,000+ 2 x annual earnings;
Age 55 and over: flat $10,000 + 1.5 x annual earnings

Maximum

$310,000

Termination age

Earlier of age 65 or retirement

Age reduction

N/A

Waiver of premium definition

Matches LTD

Optional life

Available

GROUP ACCIDENT

Insurer: AIG Insurance Company of Canada

Policy Number: Basic – 9428791 | Optional – 9428793

Principal sum

3 x annual earnings

Maximum

$400,000

Optional Accident

Available