SD52 – Principals & VPs

EXTENDED HEALTH CARE

Insurer: Pacific Blue Cross

Policy Number: 20052

Reimbursement

Flex Choice 1: 20%
Flex Choice 2: 80% to the first $2,000 paid out, 100% thereafter
Flex Choice 3: 100%

Annual deductible

Flex Choice 1: $100 per person or $100 per family per calendar year
Flex Choice 2: $100 per person or $100 per family per calendar year
Flex Choice 3: No deductible

Lifetime maximum

Flex Choice 1: Unlimited
Flex Choice 2: Unlimited
Flex Choice 3: Unlimited

Termination Age

Retirement

Medical referral travel benefit

Included;
Maximum for Meals: N/A
Maximum for Mileage: $0.20 per KM
Maximum for Accomodation: $30 per day for 3 days

Survivor extension

Yes, to a mximum of 4 months

Prescription Drugs

Drug formulary

Blue Rx

Pay-direct drug card

Flex Choice 1: Yes
Flex Choice 2: Yes
Flex Choice 3: Yes

Per prescription deductible

$0

Sexual dysfunction

Covered

Oral Contraceptives

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

N/A

Hospital

Private or Semi-Private
Flex Choice 1: 100%
Flex Choice 2: 100%
Flex Choice 3: 100%

Private duty nursing (including in-home)

Covered; acute cases as ordered by physician

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 (adults and children)

Orthotics

$500 per calendar year (adults and children)

Vision Care

Maximum

Flex Choice 1: No vision coverage
Flex Choice 2: $200 every 2 calendar years
Flex Choice 3: $475 every 2 calendar years

Eye exams

Flex Choice 1: No vision coverage
Flex Choice 2: one exam per two calendar years – separate from vision care maximum
Flex Choice 3: one exam per two calendar years – separate from vision care maximum

Prescription sunglasses

Flex Choice 1: No coverage
Flex Choice 2 and Choice 3: Covered

Paramedical Services

Massage therapist

Flex Choice 1: $300 per calendar year
Flex Choice 2: $300 per calendar year
Flex Choice 3: $600 per calendar year

Physiotherapy

Flex Choice 1: $300 per calendar year
Flex Choice 2: $300 per calendar year
Flex Choice 3: $600 per calendar year

Chiropractor

Flex Choice 1: $300 per calendar year
Flex Choice 2: $300 per calendar year
Flex Choice 3: $600 per calendar year

Psychology

Flex Choice 1: $1500 per calendar year
Flex Choice 2: $1500 per calendar year
Flex Choice 3: $1500 per calendar year

Naturopath

Flex Choice 1: $300 per calendar year
Flex Choice 2: $300 per calendar year
Flex Choice 3: $600 per calendar year

Podiatry

Flex Choice 1: $300 per calendar year
Flex Choice 2: $300 per calendar year
Flex Choice 3: $600 per calendar year

Acupuncture

Flex Choice 1: $300 per calendar year
Flex Choice 2: $300 per calendar year
Flex Choice 3: $600 per calendar year

Speech therapy

Flex Choice 1: $1500 per calendar year
Flex Choice 2: $1500 per calendar year
Flex Choice 3: $1500 per calendar year

Osteopath

N/A

Christian Science

N/A

DENTAL CARE

Insurer: Pacific Blue Cross

Policy Number: 20052

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 4 months

Basic Services

Reimbursement

Flex Choice 1: 80%;
Flex Choice 2 & 3: 100%

Maximum

Flex Choice 1: $2,000 combined with Major Services;
Flex Choice 2 & 3: Unlimited

Adult check-up

As indicated in the Fee schedule/Fee guide

Child check-up

As indicated in the Fee schedule/Fee guide

Endodontic/Periodontic Services

Reimbursement

Flex Choice 1: 80%;
Flex Choice 2 & 3: 100%

Maximum

Flex Choice 1: $2,000 combined with Major Services;
Flex Choice 2 & 3: Unlimited

Major Restorative Services

Reimbursement

Flex Choice 1: 50%;
Flex Choice 2: 60%; Flex Choice 3: 80%

Maximum

Flex Choice 1: $2,000 combined with Basic Services;
Flex Choice 2 & 3: Unlimited

Orthodontic Services

Reimbursement

Flex Choice 1: Not covered;
Flex Choice 2: 50%;
Flex Choice 3: 60%

Maximum

Flex Choice 1: not covered;
Flex Choice 2 & 3: Unlimited

Age limit

N/A

GROUP LIFE

Insurer: Pacific Blue Cross

Policy Number: 79520

Schedule

3 x annual earnings

Maximum

N/A

Termination age

October 1st following the end of the school year in which your 65th birthday occurs, coverage reduces to 1.5 times annual earnings

Age reduction

N/A

Waiver of premium definition

Matches LTD

Optional life

Available

GROUP ACCIDENT

Insurer: AIG Insurance Company of Canada

Policy Number: Basic – N/A | Optional – 9428793

Principal sum

N/A

Maximum

N/A

Optional Accident

Available