SD61 – Exempt Staff

EXTENDED HEALTH CARE

Insurer: Pacific Blue Cross

Policy Number: 20061

Reimbursement

Choice 1: 20%;
Choice 2 & 3: 80%;
Choice 4: 100%

Annual deductible

N/A

Lifetime maximum

Unlimited

Termination Age

Retirement

Medical referral travel benefit

N/A

Survivor extension

Yes, to a maximum of 24 months

Prescription Drugs

Drug formulary

Prescription Required

Pay-direct drug card

No

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)

Fees for a registered nurse for special duty nursing in an acute case when ordered by the attending physician.

Hearing aids

Choice 1 & 2 : $2500 every 4 years;
Choice 3: $3000 every 4 years;
Choice 4: $3500 every 4 years

Other services and supplies (subject to reasonable and customary limits as defined by insurer)

Covered

Othopedic shoes

Choice 1 & 2: $300 per year;
Choice 3: $400 per year;
Choice 4: $500 per year (All choices cover adults & children)

Orthotics

Choice 1 & 2: $300 per year;
Choice 3: $400 per year;
Choice 4: $500 per year (All choices cover adults & children)

Vision Care

Maximum

Choice 1: Not Covered;
Choice 2: $275/24 months;
Choice 3: $350/24 months;
Choice 4: $550/24 months

Eye exams

Choice 1: Not Covered;
Choice 2: $275/24 months;
Choice 3: $350/24 months;
Choice 4: $550/24 months

Prescription sunglasses

Covered

Paramedical Services

Massage therapist

Choice 1, 2 : $450 per year;
Choice 3: $700 per year;
Choice 4: $900 per year

Physiotherapy

Choice 1, 2 : $450 per year;
Choice 3: $700 per year;
Choice 4: $900 per year

Chiropractor

Choice 1, 2 : $450 per year;
Choice 3: $700 per year;
Choice 4: $900 per year

Psychology

Choice 1, 2 : $450 per year;
Choice 3: $700 per year;
Choice 4: $900 per year

Naturopath

Choice 1, 2 : $450 per year;
Choice 3: $700 per year;
Choice 4: $900 per year

Podiatry

Choice 1, 2 : $450 per year;
Choice 3: $700 per year;
Choice 4: $900 per year

Acupuncture

Choice 1, 2 : $450 per year;
Choice 3: $700 per year;
Choice 4: $900 per year

Speech therapy

Choice 1, 2 : $450 per year;
Choice 3: $700 per year;
Choice 4: $900 per year

Osteopath

N/A

Christian Science

N/A

DENTAL CARE

Insurer: Pacific Blue Cross

Policy Number: 20061

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 24 months

Basic Services

Reimbursement

Choice 1: 20%;  Choice 2, 3, 4: 100%

Maximum

Choice 1: $1,000 per calendar year;
Choice 2, 3, 4 : Unlimited

Adult check-up

Once every 9 months

Child check-up

Once every 6 months

Endodontic/Periodontic Services

Reimbursement

Part of Basic Coverage;
Choice 1: 20%;
Choice 2, 3, 4: 100%

Maximum

Choice 1: $1,000 per calendar year; Choice 2, 3, 4 : Unlimited

Major Restorative Services

Reimbursement

Choice 1, 2: 50%;
Choice 3: 80%;
Choice 4: 60%

Maximum

Choice 1, 2 : $1,000 per calendar year;
Choice 3: $3,000 per calendar year;
Choice 4: Unlimited

Orthodontic Services

Reimbursement

Choice 1: 50%;
Choice 2: Not Covered;
Choice 3: 60%;
Choice 4: 75%

Maximum

Choice 1: $2,000 lifetime maximum;
Choice 2: Not Covered;
Choice 3: $3,000 lifetime maximum;
Choice 4: $5,000 lifetime maximum

Age limit

Covers adults and children

GROUP LIFE

Insurer: Pacific Blue Cross

Policy Number: 79520

Schedule

Choice 1: $50,000;
Choice 2: $100,000;
Choice 3: $200,000;
Choice 4: $300,000;
Choice 5: $400,000

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 – 9428791 | Optional – 9428793

Principal sum

Choice 1: $50,000;
Choice 2: $100,000;
Choice 3: $200,000;
Choice 4: $300,000;
Choice 5: $400,000

Maximum

$400,000

Optional Accident

Available