SD82 – Retired Teachers & Exempt
EXTENDED HEALTH CARE
Insurer: N/A
Policy Number: N/A
Reimbursement
N/A
Annual deductible
N/A
Lifetime maximum
N/A
Termination Age
N/A
Medical referral travel benefit
N/A
Survivor extension
N/A
Prescription Drugs
Drug formulary
N/A
Pay-direct drug card
N/A
Per prescription deductible
N/A
Sexual dysfunction
N/A
Oral Contraceptives
N/A
Fertility
N/A
Smoking cessation
N/A
Medical Services & Supplies
Medi-assist
N/A
Emergency out-of-province reimbursement
N/A
Emergency out-of-province maximum
N/A
Hospital
N/A
Private duty nursing (including in-home)
N/A
Hearing aids
N/A
Other services and supplies (subject to reasonable and customary limits as defined by insurer)
N/A
Orthopedic shoes
N/A
Orthotics
N/A
Vision Care
Maximum
N/A
Eye exams
N/A
Prescription sunglasses
N/A
Paramedical Services
Massage therapist
N/A
Physiotherapy
N/A
Chiropractor
N/A
Psychology
N/A
Naturopath
N/A
Podiatry
N/A
Acupuncture
N/A
Speech therapy
N/A
Osteopath
N/A
Christian Science
N/A
DENTAL CARE
Insurer: N/A
Policy Number: N/A
Annual deductible
N/A
Dental fee guide
N/A
Specialist fee guide
N/A
Termination Age
N/A
Survivor extension
N/A
Basic Services
Reimbursement
N/A
Maximum
N/A
Adult check-up
N/A
Child check-up
N/A
Endodontic/Periodontic Services
Reimbursement
N/A
Maximum
N/A
Major Restorative Services
Reimbursement
N/A
Maximum
N/A
Orthodontic Services
Reimbursement
N/A
Maximum
N/A
Age limit
N/A
GROUP LIFE
Insurer: Pacific Blue Cross
Policy Number: 79520
Schedule
50% of the average of the insured person’s best 5 years of annual earnings
Maximum
N/A
Termination age
N/A
Age reduction
N/A
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