SD 59 – Principals & VPs
EXTENDED HEALTH CARE
Insurer: Pacific Blue Cross
Policy Number: 20159
Reimbursement
80% until $1,000 paid per person per calendar year, 100% thereafter
Annual deductible
$50
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
Included;
Maximum for Meals and Accomodation: combined $40 per day for 3 days
Maximum for Mileage: $0.20 per KM
Survivor extension
Yes, to a maximum of 24 months
Prescription Drugs
Drug formulary
Blue Rx
Pay-direct drug card
Yes
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)
$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
$650 every 24 months
Eye exams
1 every 24 months – separate from vision care maximum
Prescription sunglasses
Covered
Paramedical Services
Massage therapist
$1,000 per calendar year
Physiotherapy
$1,000 per calendar year
Chiropractor
$1,000 per calendar year
Psychological Counselling Services
$1,500 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: 20159
Annual deductible
N/A
Dental fee guide
PBC Schedule 2
Specialist fee guide
Fee Guide +10%
Termination Age
Retirement
Survivor extension
Yes, to a mximum of 24 months
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
80%
Maximum
N/A
Orthodontic Services
Reimbursement
75%
Maximum
$5,000/Lifetime
Age limit
Covers adults and children
GROUP LIFE
Insurer: Pacific Blue Cross
Policy Number: 79520
Schedule
3X annual earnings
Maximum
$400,000
Termination age
Earlier of age 70 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 – 9428792 | Optional – 9428793
Principal sum
3X annual earnings
Maximum
$400,000
Optional Accident
Available
OPTIONAL CRITICAL ILLNESS
Insurer: SSQ
Policy Number: 1N230
Principal sum
$10,000 minimum, in units of $5,000, to a maximum of $150,000. (Guaranteed Issue Amount: $50,000)
Maximum
$150,000 (Active Employees & Spouses); $3,000 (Dependent Children)