SD5 – Exempt Staff
EXTENDED HEALTH CARE
Insurer: Pacific Blue Cross
Policy Number: 20005
Reimbursement
100%
Annual deductible
$50 per person or family each calendar year
Lifetime maximum
Unlimited
Termination Age
Last day of the month in which the member’s employment terminates or the member retires
Medical referral travel benefit
N/A
Survivor extension
N/A
Prescription Drugs
Drug formulary
Prescription required
Pay-direct drug card
No
Per prescription deductible
N/A
Sexual dysfunction
Not Covered
Oral Contraceptives
Not Covered
Fertility
Not Covered
Smoking cessation
Not Covered
Medical Services & Supplies
Medi-assist
Included
Emergency out-of-province reimbursement
100%
Emergency out-of-province maximum
$1,000,000 per lifetime
Hospital
Private or Semi-Private
Private duty nursing (including in-home)
$20,000 per calendar year
Hearing aids
$3,500 every 48 months
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
$800 every 2 calendar years
Eye exams
Included in maximum
Prescription sunglasses
Covered
Paramedical Services
Massage therapist
Max 40 visits per calendar year
Physiotherapy
Max 40 visits per calendar year
Chiropractor
$1,000 per calendar year
Psychological Counselling Services
$100 per calendar year
Naturopath
$1,000 per calendar year
Podiatry
$800 per calendar year
Acupuncture
$1,000 per calendar year
Speech therapy
$800 per calendar year
Osteopath
N/A
Christian Science
N/A
DENTAL CARE
Insurer: Pacific Blue Cross
Policy Number: 20005
Annual deductible
None
Dental fee guide
PBC Schedule 3
Specialist fee guide
Fee Guide +10%
Termination Age
Last day of the month in which the member’s employment terminates or the member retires.
Survivor extension
N/A
Basic Services
Reimbursement
100%
Maximum
N/A
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
50%
Maximum
$2,500/Lifetime
Age limit
N/A
GROUP LIFE
Insurer: Pacific Blue Cross
Policy Number: 79520
Schedule
3 x annual earnings (min. $200,000)
Maximum
$500,000
Non-Evidence Maximum
$400,000
Termination age
Age 70 or earlier 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
Matches Basic Life
Maximum
$500,000
Optional Accident
Available