School District 22

Vernon |

CUPE Local 5523

Eligibility

Minimum hours per week

Core LTD: 15 hours per week

All Other Benefits: 17.5 hours per week or more

Extended Health Care

BENEFIT PROVIDER: Pacific Blue Cross

POLICY NUMBER: 53705

Waiting period

1st of the month following 65 working days or 6 months, whichever is earlier

Claim deadline

December 31 of the following year

Calendar year deductible

$50 (Single/Family)

Reimbursement

80% until $1,000 paid, then 100%

Lifetime maximum

Unlimited

Survivor extension

N/A

Termination age

Retirement (No age limit)

Dependent Child definition

Up to age 21, or any age if in full time attendance at school or if disabled.

Spouse definition

The person legally married to the Member or a person who has been residing with the Member in a common-law relationship for at least 1 year and who is publicly represented as the Member’s spouse. Only one spouse is eligible for coverage at any one time.

Medical referral travel benefit

n/a

Prescription Drugs

Drug formulary

Blue Rx

Pay-direct drug card

Yes

Per prescription deductible

n/a

Sexual dysfunction

Not Covered

Oral contraceptives

Not Covered (unless prescribed for reason other than birth control)

Fertility drugs

Not Covered

Smoking cessation drugs

Not Covered

Medical Services & Supplies

Medi-assist

Included

Emergency out-of-province reimbursement

100%

Emergency out-of-province maximum

Unlimited

Hospital room

Private or Semi-private

Private duty nursing

In-home nursing care covered

Hearing aids – Adults

$1,000 per 60 months

Hearing aids – Children

$1,000 per 60 months

Ambulance

Covered

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

Covered

All Medical Equipment must be purchased from an Authorized Medical Supplier to be considered under your plan. Reasonable and Customary pricing will apply. Authorization by the Benefit Provider is required for equipment that costs more than $5,000.

Orthopedic shoes

1 pair per lifetime. Replacements as needed from normal wear and tear.

Orthotics

1 pair per lifetime

Accidental dental

Covered

Vision Care

Maximum – Adults

$350 per 24 months

Maximum – Children

$350 per 24 months

Eye exams

$75 per 24 months

Paramedical Services

Acupuncture

$500 per year

Chiropractor

$500 per year

Massage therapy

Unlimited (Reasonable and Customary limits apply)

Naturopathy

$500 per year

Osteopathy

Not Covered

Physiotherapy

Unlimited (Reasonable and Customary limits apply)

Podiatry

$500 per year

Counselling Services

$500 per year (Psychologist only)

Speech therapy

$500 per year

Dental Coverage

BENEFIT PROVIDER: Pacific Blue Cross

POLICY NUMBER: 53705

Waiting period

1st of the month following 65 working days or 6 months, whichever is earlier

Claim deadline

12 months from date of service

Calendar year deductible

n/a

Dental fee guide

PBC Schedule 2

Specialist coverage

n/a

Survivor extension

n/a

Termination age

Last day of the month following the month in which you retire

Dependent Child definition

Up to age 21, or if in full time attendance at school, or to any age if disabled.

Spouse definition

The person legally married to the Member or a person who has been residing with the Member in a common-law relationship for at least 1 year and who is publicly represented as the Member’s spouse. Only one spouse is eligible for coverage at any one time.

Basic Services

Reimbursement

85%

Maximum

n/a

Adult check-up

1 per 9 months

Child check-up

1 per 9 months

Adult fluoride

Covered

Major restorative services

Reimbursement

60%

Maximum

n/a

Orthodontic services

Reimbursement

60%

Maximum

$1,500 per lifetime

Age limit

Covers adults and children

Joint Early Intervention Services

BENEFIT PROVIDER: Desjardins Insurance

Services

The Joint Early Intervention Service (JEIS) is a mandatory program providing proactive service to members to facilitate their return to work in a caring, safe, and timely manner. Members are contacted within six (6) working days of the start of their absence from work by a Healthcare Management Specialist (HCMS). The HCMS makes sure members receive the best possible care and, if appropriate, a coordinated rehabilitation plan. If members are unable to return to work after the LTD qualifying period, the HCMS helps them transfer to the LTD program. A primary factor for the success of the JEIS program is the collaboration and joint support of both union and employers.

Income Replacement

Long Term Disability

BENEFIT PROVIDER: Desjardins Insurance

POLICY NUMBER: 64090L

Waiting period

3 months of continuous Active Employment with the Employer

Benefit amount

Core LTD: 70% of monthly earnings from the Employer

Other LTD: Covered, provides cost of living adjustment based on Consumer Price Index up to 4%. First increase occurs after the end of the Elimination Period plus one year.

Minimum benefit

$50 per month

Maximum benefit

$10,000 per month

Non-evidence maximum

n/a

Elimination period

Core LTD: 120 calendar days

Other LTD: 180 calendar days

Taxability status

Core LTD: Taxable Other LTD: Taxable

Termination age

A Member, who is not receiving LTD Benefits shall cease to be entitled to coverage for LTD Benefits one hundred twenty days prior to the last day of the month during which the Member attains age 65 or thirty-five (35) years of pensionable service and a minimum age of fifty-five (55) pursuant to the terms of the Municipal Pension Plan or other school district pension arrangement.

For Members receiving LTD Benefits, the Maximum Benefit Period ends the earliest of normal retirement age as defined under the Municipal Pension Plan (currently 65 years of age), or 35 years of service and a minimum age of 55.

Earnings definition

A Member’s basic rate of pay, including premiums/allowances paid for Regular Duties performed during a regular work year and vacation pay, but excluding overtime.

Extended health and/or dental coverage continuation

The Core LTD Program shall fund the Member’s portion of premiums for EHC (including medical referral travel benefits, if applicable) and dental while in receipt of Core LTD Benefits for the period starting the first of the month following completion of the Elimination Period, and ending on the earlier of the last day of the month in which the Member is no longer eligible for Core LTD Benefits or the last day of the final month of the Member’s twenty-four-month Regular Duties period outlined in the definition of Disabled.

Group Life

BENEFIT PROVIDER: Pacific Blue Cross

POLICY NUMBER: 53705

Waiting period

1st of the month following 65 working days or 6 months, whichever is earlier

Benefit amount

2 times Annual Earnings rounded to next higher $500

Maximum

$300,000

Non-evidence maximum

n/a

Age reduction

To $500 at age 65

Waiver of premium definition

Matches Core LTD

Coverage during disability

Life coverage for a disabled employee will terminate at the earlier of age 65 or 35 years of pensionable service under the Municipal Pension Plan or any other registered pension plan arising out of employment with an Employer and a minimum age of 55, whichever is earlier.

Living benefit

Up to 50% of your Basic Life benefit to a maximum of $50,000 for members under age 65

Termination age

Earlier of age 70 or retirement

Earnings definition

Employee’s salary from the employer not including any bonus, overtime or incentive pay.

Conversion privilege

Available

Basic Accidental Death & Dismemberment

BENEFIT PROVIDER: AIG

POLICY NUMBER: BSC 9104906

Waiting period

1st of the month following 65 working days or 6 months, whichever is earlier

Benefit amount

Matches Basic Life

Maximum

$300,000

Non-evidence maximum

Matches Core LTD

Age reduction

To $500 at age 65

Waiver of premium definition

Matches Core LTD

Coverage during disability

Basic Accident coverage for a disabled employee will terminate at the earlier of age 65 or 35 years of pensionable service under the Municipal Pension Plan or any other registered pension plan arising out of employment with an Employer and a minimum age of 55, whichever is earlier.

Termination age

Earlier of age 70 or retirement

Conversion privilege

Available

Optional Accidental Death & Dismemberment

BENEFIT PROVIDER: AIG

POLICY NUMBER: PAI 9104940

Waiting period

1st of the month following 65 working days or 6 months, whichever is earlier

Benefit amount

Units of $10,000

Maximum

$500,000

Child only

Each Dependent Child – 25% of your Principal Sum

Spouse only

60% of your Principal Sum

Spouse and Child

Spouse’s amount will equal 50% of your Principal Sum and each of your eligible Dependent Children will be covered for 15% of your Principal Sum

Waiver of premium definition

Matches Core LTD

Coverage during disability

Optional Accident coverage for a disabled employee will terminate at the earlier of age 65 or 35 years of pensionable service under the Municipal Pension Plan or any other registered pension plan arising out of employment with an Employer and a minimum age of 55, whichever is earlier.

Aggregate limit per accident

Nil

Termination age

Earlier of age 70 or retirement

Spouse definition

Legal Husband or Wife, or an individual who, immediately prior to his or her loss, has been residing with the employee for a period of not less than one (1) year and who has been publicly represented as the Husband or Wife of the employee during such period.

Child definition

Natural children, legally adopted children or step-children of the employee, dependant upon the employee for maintenance and support, and:

a) are under twenty-one (21) years of age and unmarried, or

b) under twenty-five (25) years of age and unmarried and in attendance at an institution of higher learning, or

c) by reason of mental or physical infirmity, are incapable of self-sustaining employment, reside with the employee and are totally dependant upon the employee for support within the terms of the Income Tax Act of Canada”

Conversion privilege

Available

Disclaimer:

This summary contains information about your group benefits plan. This summary provides only brief descriptions of the coverage available. Full coverage details are contained within the Plan documents, including limitations, exclusions, definitions and termination provisions. If there are any conflicts between the summary and the official Plan documents, the official Plan documents shall govern.

The information contained on this website is provided for general information purposes only. Every effort has been made to ensure that this information is accurate, but this site is not a substitute for the official Plan documents, nor is it an employment contract. In the event there is a discrepancy between this website and the official Plan documents, the official Plan documents will prevail. For more information, or if you have questions about the information provided on this website please contact your School District Benefits Administrator.