SD43 – Teachers
EXTENDED HEALTH CARE
Insurer: Pacific Blue Cross
Policy Number: 20043
Reimbursement
100%
Annual deductible
$25
Lifetime maximum
N/A
Termination Age
Retirement
Medical referral travel benefit
N/A
Survivor extension
Yes, to a maximum of 100 days after the date of the Member’s death.
Prescription Drugs
Drug formulary
Prescription Required
Pay-direct drug card
No
Per prescription deductible
$0
Sexual dysfunction
N/A
Oral Contraceptives
Covered
Fertility
$3,000 per lifetime
Smoking cessation
Not covered
Medical Services & Supplies
Medi-assist
Included
Emergency out-of-province reimbursement
Emergency Eligible Expenses: 100%
Non-emergence eligible expenses: 100% of the reasonable and customary charge as if the expense was incurred in the person’s province of residence subject to the deductible, in-province reimbursement percentage and maximums
Emergency out-of-province maximum
N/A
Hospital
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
Hearing aids
$500/5 year period for Adults and Children
Other services and supplies (subject to reasonable and customary limits as defined by insurer)
Covered
Orthopedic shoes
One pair of Orthopedic shoes or orthotics per person on prescription by a physician/podiatrist. Replacements due to normal wear and tear only as necessary and pre-approved by PBC.
Orthotics
Yes. See Orthopedic shoes coverage details.
Vision Care
Maximum
$300 / every 2 calendar years
Eye exams
N/A
Prescription sunglasses
Covered
Paramedical Services
Massage therapist
Reasonable and Customary charges
Physiotherapy
Reasonable and Customary charges
Chiropractor
$200 per calendar year
Psychology
$100 per calendar year
Naturopath
$200 per calendar year
Podiatry
$200 per calendar year
Acupuncture
$100 per calendar year
Speech therapy
$100 per calendar year
Osteopath
N/A
Christian Science
N/A
DENTAL CARE
Insurer: Pacific Blue Cross
Policy Number: 20043
Annual deductible
N/A
Dental fee guide
PBC Schedule 2
Specialist fee guide
Fee Guide +10%
Termination Age
Retirement
Survivor extension
Yes, to a maximum of 100 days after the date of the Member’s death.
Basic Services
Reimbursement
100%
Maximum
N/A
Adult check-up
2 per year
Child check-up
2 per year
Endodontic/Periodontic Services
Reimbursement
100%
Maximum
N/A
Major Restorative Services
Reimbursement
100%
Maximum
N/A
Orthodontic Services
Reimbursement
100%
Maximum
N/A
Age limit
Covers adults and children
GROUP LIFE
Insurer: Pacific Blue Cross
Policy Number: 79543
Schedule
Teaching Staff without Dependents: $9,000, or if Employee elects 2.5 times Category 5 minimum salary stated in the Teacher’s salary scale; Teaching Staff with Dependents:
1) Basic Amount of Insurance – 2.5 times Category 5 minimum salary stated in the Teacher’s salary scale; Or if the employee elects
2) Optional Amount of Insurance – the percentage of the Employee’s annual basic earnings, shown below, the result subject to a maximum benefit of 600% of the Category 5 minimum salary stated in the Teacher’s salary scale.
Under age 35: 400% of annual earnings;
Age 35-40: 375% of annual earnings;
Age 41-45: 350% of annual earnings;
Age 46-50: 325% of annual earnings;
Age 51-55: 300% of annual earnings;
Age 56-60: 250% of annual earnings;
Age 61-65: 200% of annual earnings
Maximum
600% of the Category 5 minimum salary stated in the Teacher’s salary scale
Termination age
Earlier of age 65 or retirement.
Age reduction
Optional amount reduces as per above table
Waiver of premium definition
Matches LTD
Optional life
N/A
GROUP ACCIDENT
Insurer: N/A
Policy Number: N/A
Principal sum
N/A
Maximum
N/A
Optional Accident
N/A