SD92 – Principals & VPs

EXTENDED HEALTH CARE

Insurer: Pacific Blue Cross

Policy Number: 20092

Reimbursement

100%

Annual deductible

$25

Lifetime maximum

N/A

Termination Age

Retirement

Medical referral travel benefit

Included;
Maximum for Meals and Accomodation: Combined $45 per day for 7 days
Maximum for Mileage: $0.20 per KM

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

N/A

Oral Contraceptives

Covered

Fertility

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

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

$400/5 years for covered employee, $800/ 5 years for dependent children

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

Covered

Othopedic shoes

One pair per person on prescription by a physician/podiatrist. Replacements only as necessary due to normal wear and tear.

Orthotics

Yes

Vision Care

Maximum

$300 every 24 months

Eye exams

$100 per person per 2 calendar years

Prescription sunglasses

Covered

Paramedical Services

Massage therapist

$500 maximum per person per calendar year.

Physiotherapy

$500 maximum per person per calendar year.

Chiropractor

$500 maximum per person per calendar year.

Psychology

$500 maximum per person per calendar year.

Naturopath

$500 maximum per person per calendar year.

Podiatry

$500 maximum per person per calendar year.

Acupuncture

$500 maximum per person per calendar year.

Speech therapy

$500 maximum per person per calendar year.

Osteopath

N/A

Christian Science

N/A

DENTAL CARE

Insurer: Pacific Blue Cross

Policy Number: 20092

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

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

60%

Maximum

$2,500/Lifetime

Age limit

Covers adults and children

GROUP LIFE

Insurer: Pacific Blue Cross

Policy Number: 79520

Schedule

3 x annual earnings

Maximum

$400,000

Termination age

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

Matches Life benefit

Maximum

$400,000

Optional Accident

Available