School District 39

Vancouver |

CUPE Local 15

ELIGIBILITY

Minimum hours per week

Core LTD: 15 hours per week

All Other Benefits: As per collective agreement

Extended Health Care

BENEFIT PROVIDER: Pacific Blue Cross

POLICY NUMBER: 53766

Waiting period

1st of the month following permanent appointment

Claim deadline

June 30 of the following year

Calendar year deductible

$50 (Single/Family); not applicable to vision care

Reimbursement

100%

Lifetime maximum

$25,000 per 24 months

Survivor extension

When a Member dies, Dependent coverage will continue with further payment of contributions until the earliest of the following occurs:

  1. 6 months after the date of the Member’s death.
  2. the date the person ceases to be a Dependent other than as a result of the Member’s death.
  3. the date the Contract is terminated.

Termination age

Retirement

Dependent Child definition

Up to age 19, or 25 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.

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

Fertility drugs

$3,000 per lifetime

Smoking cessation drugs

Not Covered

Medical Services & Supplies

Medi-assist

Included

Emergency out-of-province reimbursement

100%

Emergency out-of-province maximum

Combined with In-Province Maximum

Hospital room

Private or Semi-private

Private duty nursing

In-home nursing care covered; physician’s referral required

Hearing aids – Adults

$1,500 per 36 months

Hearing aids – Children

$1,500 per 36 months plus an additional $400 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

Foot Orthotics & Orthopedic Shoes have a combined limit of 1 unit per person per lifetime. Replacements as needed from normal wear and tear.

Orthotics

Foot Orthotics & Orthopedic Shoes have a combined limit of 1 unit per person per lifetime. Replacements as needed from normal wear and tear.

Accidental dental

Covered

Vision Care

Maximum – Adults

$500 per 24 months

Maximum – Children

$500 per 24 months

Eye exams

Not Covered

Paramedical Services

Acupuncture

$500 per calendar year

Chiropractor

$1,000 per calendar year

Massage therapy

26 visits per calendar year

Naturopathy

$1,000 per calendar year

Osteopathy

Not Covered

Physiotherapy

Unlimited (Reasonable and Customary limits apply)

Podiatry

$200 per calendar year

Counselling Services

$1,000 per calendar year for Psychologist

$1,000 per calendar year for Clinical Counsellors

Social Workers not covered

Speech therapy

$500 per calendar year

Dental Coverage

BENEFIT PROVIDER: Pacific Blue Cross

POLICY NUMBER: 53766

Waiting period

1st of the month following permanent position

Claim deadline

12 months from date of service

Calendar year deductible

N/A

Dental fee guide

PBC Schedule 2

Specialist coverage

Fee Guide plus 10%

Survivor extension

When a Member dies, Dependent coverage under this Contract will continue with further payment of contributions by You until the earliest of the following occurs:

1. 6 months after the date of the Member’s death.

2. the date the person ceases to be a Dependent other than as a result of the Member’s death.

3. the date the Contract is terminated

Termination age

Retirement

Dependent Child definition

Up to age 21, or 25 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 24 months and who is publicly represented as the Member’s spouse. Only one spouse is eligible for coverage at any one time.

Basic Services

Reimbursement

95%

Maximum

N/A

Adult check-up

2 per calendar year

Child check-up

2 per calendar year

Adult fluoride

Covered

Major restorative services

Reimbursement

75%

Maximum

N/A

Orthodontic services

Reimbursement

70%

Maximum

$6,000 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

70% of monthly earnings from the Employer

Minimum benefit

$50 per month

Maximum benefit

$10,000 per month

Non-evidence maximum

N/A

Elimination period

120 calendar days

Taxability status

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: 53766

Waiting period

1st of the month following permanent appointment

Benefit amount

$100,000

Maximum

$100,000

Non-evidence maximum

N/A

Age reduction

N/A

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

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.