SD22 – Principals & VPs
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
Orthopedic 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
Psychological Counselling Services
$1500 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
equal to group term life insurance
Maximum
$310,000
Optional Accident
Available