SD83 – Teachers on Call

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

Othopedic 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: Pacific Blue Cross

Policy Number: 20083

Annual deductible

N/A

Dental fee guide

PBC Schedule 2

Specialist fee guide

Fee Guide +10%

Termination Age

The last day of the month in which the Member’s employer terminate or ceases to be eligible for coverage under the benefit, or the last day of the month in which the Member retires

Survivor extension

Yes, to a maximum of 3 months

Basic Services

Reimbursement

85%

Maximum

N/A

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

85%

Maximum

N/A

Major Restorative Services

Reimbursement

60%

Maximum

N/A

Orthodontic Services

Reimbursement

75%

Maximum

N/A

Age limit

N/A

GROUP LIFE

Insurer: N/A

Policy Number: N/A

Schedule

N/A

Maximum

N/A

Termination age

N/A

Age reduction

N/A

Waiver of premium definition

N/A

Optional life

N/A

GROUP ACCIDENT

Insurer: N/A

Policy Number: N/A

Principal sum

N/A

Maximum

N/A

Optional Accident

N/A