SD42 -Exempt Staff
EXTENDED HEALTH CARE
Insurer: Pacific Blue Cross
Policy Number: 20042
Reimbursement
Choice 1- 20% until $1,000 paid, 100% thereafter;
Choice 2 – 80% until $1,000 paid, 100% thereafter;
Choice 3 – 100%
Annual deductible
N/A
Lifetime maximum
N/A
Termination Age
Coverage will terminate on June 30th following the date the Member attains age 75, or earlier retirement.
Medical referral travel benefit
N/A
Survivor extension
Yes, to a maximum of 24 months
Prescription Drugs
Drug formulary
Choice 1 – Pharmacare;
Choice 2 & 3 – Blue RX
Pay-direct drug card
Yes
Per prescription deductible
$0
Sexual dysfunction
Choice 1 – Not covered;
Choice 2& 3 – Covered
Oral Contraceptives
Covered
Fertility
Choice 1 & 2 – Not covered;
Choice 3 – $20,000 lifetime maximum
Smoking cessation
Not covered
Medical Services & Supplies
Medi-assist
Included
Emergency out-of-province reimbursement
100%
Emergency out-of-province maximum
N/A
Hospital
Choice 1 – Semi-Private;
Choices 2, 3 – Private or Semi-Private
Private duty nursing (including in-home)
Fees for a registered nurse for special duty nursing in an acute case when ordered by the attending physician, based on reasonable and customary charges.
Hearing aids
Choice 1 & 2 – $500/60 months (adult), $900/60 months (child); Choice 3 – $3,500 per 48 months
Other services and supplies (subject to reasonable and customary limits as defined by insurer)
Covered
Orthopedic shoes
Choice 1 – $300 per calendar year (combined with orthotics);
Choice 2 – $500 per calendar year (combined with orthotics);
Choice 3 – $600 per calendar year (combined with orthotics)
Orthotics
Included with Orthopedic shoes
Vision Care
Maximum
Choice 1 – Nil;
Choice 2 – $550 for vision care every 2 calendar year;
Choice 3 – $700 for vision care every 2 calendar year
Eye exams
Choice 1- Nil;
Choice 2 – $75 for eye exams every 2 calendar years;
Choice 3 -$100 for eye exams every 2 calendar years
Prescription sunglasses
Covered
Paramedical Services
Massage therapist
Choice 1 – $250 per person per calendar year;
Choice 2 – $900 per person per calendar year;
Choice 3 – $1,200 per person per calendar year
Physiotherapy
Choice 1 – $250 per person per calendar year;
Choice 2 – $900 per person per calendar year;
Choice 3 – $1,200 per person per calendar year
Chiropractor
Choice 1 – $250 per person per calendar year;
Choice 2 – $900 per person per calendar year;
Choice 3 – $1,200 per person per calendar year
Psychology
Choice 1 – $250 per person per calendar year;
Choice 2 – $900 per person per calendar year;
Choice 3 – $1,200 per person per calendar year
Naturopath
Choice 1 – $250 per person per calendar year;
Choice 2 – $900 per person per calendar year;
Choice 3 – $1,200 per person per calendar year
Podiatry
Choice 1 – $250 per person per calendar year;
Choice 2 – $900 per person per calendar year;
Choice 3 – $1,200 per person per calendar year
Acupuncture
Choice 1 – $250 per person per calendar year;
Choice 2 – $900 per person per calendar year;
Choice 3 – $1,200 per person per calendar year
Speech therapy
Choice 1 – $250 per person per calendar year;
Choice 2 – $900 per person per calendar year;
Choice 3 – $1,200 per person per calendar year
Osteopath
N/A
Christian Science
N/A
DENTAL CARE
Insurer: Pacific Blue Cross
Policy Number: 20042
Annual deductible
$0
Dental fee guide
PBC Schedule 2
Specialist fee guide
Specialist fees no longer capped at the General Fee Guide + 10%
Termination Age
Last day of the month in which Member’s employment terminates or member becomes ineligible for coverage, or August 31st coincident with or next following the date the plan member attains age 70, or the end of the month following the month in which the plan member retires, whichever is earlier.
Survivor extension
N/A
Basic Services
Reimbursement
Choice 1 – 80%;
Choice 2 & 3 – 100%
Maximum
Unlimited
Adult check-up
Choice 1 – Every 9 months;
Choice 2 & 3 – Every 6 months
Child check-up
Choice 1, 2 & 3 – Every 6 months
Endodontic/Periodontic Services
Reimbursement
Choice 1 – 80%;
Choices 2, & 3 – 100%
Maximum
Unlimited
Major Restorative Services
Reimbursement
Choice 1 – 50%;
Choice 2 – 60%;
Choice 3 – 80%
Maximum
Choice 1 – $1,000/calendar year;
Choice 2 – $3,000/calendar year;
Choice 3 – Unlimited
Orthodontic Services
Reimbursement
Choice 1 – Nil;
Choice 2 – 50%;
Choice 3 – 75%
Maximum
Choice 1 – Nil;
Choice 2 – $2,000/calendar year;
Choice 3 – $5,000/lifetime
Age limit
Covers adults and children
GROUP LIFE
Insurer: Pacific Blue Cross
Policy Number: 79520
Schedule
Choice 1 – 1 x annual earnings;
Choice 2 – 2 x annual earnings;
Choice 3 – 3 x annual earnings;
Choice 4 – 4 x annual earnings;
Choice 5 – 5 x annual earnings
Maximum
$600,000
Termination age
August 31st coincident with or next following the date you attain age 65 or the end of the month following the month in which you retire, whichever is earlier.
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
Choice 1 – 1 x annual earnings;
Choice 2 – 2 x annual earnings;
Choice 3 – 3 x annual earnings;
Choice 4 – 4 x annual earnings;
Choice 5 – 5 x annual earnings
Maximum
$500,000
Optional Accident
Available