Eligibility
Minimum hours per week
Core LTD: 15 hours per week
All Other Benefits: n/a
Extended Health Care
BENEFIT PROVIDER: Pacific Blue Cross
POLICY NUMBER: 53714
Waiting period
1st of the month following 3 months probation. If no probation is necessary: 1st of the month following date of employment
Claim deadline
December 31 of the following year
Calendar year deductible
Nil
Reimbursement
100%
Lifetime maximum
$500,000
Survivor extension
n/a
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 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
Prescription Required
Pay-direct drug card
Yes
Per prescription deductible
n/a
Sexual dysfunction
Not Covered
Oral contraceptives
Not Covered
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
$500,000
Hospital room
Semi Private or Private Room
Private duty nursing
30 days per year (in hospital)
Hearing aids – Adults
$900 per 24 months
Hearing aids – Children
$900 per 24 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
$400 per calendar year for adults, $200 per calendar year for children
Orthotics
$400 per 24 months
Accidental dental
Covered
Vision Care
Maximum – Adults
$400 per 24 months, prescription sunglasses not covered
Maximum – Children
$400 per 24 months, prescription sunglasses not covered
Eye exams
1 per 24 months
Paramedical Services
Acupuncture
$200 maximum per calendar year
Chiropractor
$400 maximum per calendar year. Maximum is combined with Naturopath
Massage therapy
$400 maximum per calendar year. Maximum is combined with Physiotherapy
Naturopathy
$400 maximum per calendar year. Maximum is combined with Chiropractor
Osteopathy
Not Covered
Physiotherapy
$400 maximum per calendar year. Maximum is combined with Massage
Podiatry
$200 maximum per calendar year
Counselling Services
$300 maximum per calendar year (Psychologist only)
Speech therapy
$200 maximum per calendar year
Dental Coverage
BENEFIT PROVIDER: Pacific Blue Cross
POLICY NUMBER: 53714
Waiting period
1st of the month following 3 months probation. If no probation is necessary: 1st of the month following date of employment
Claim deadline
12 months from date of service
Calendar year deductible
n/a
Dental fee guide
PBC Schedule 3
Specialist coverage
General Practioner Fee Guide plus 10%
Survivor extension
n/a
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 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
90%
Maximum
N/A
Adult check-up
2 per calendar year
Child check-up
2 per calendar year
Adult fluoride
Covered
Major restorative services
Reimbursement
60%
Maximum
N/A
Orthodontic services
Reimbursement
60%
Maximum
$2,500 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
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: 53714
Waiting period
1st of the month following 3 month probation. If no probation is necessary: 1st of the month following date of employment
Benefit amount
1 times Annual Earnings rounded to next higher $1,000
Maximum
$400,000
Non-evidence maximum
n/a
Age reduction
50% 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
Basic earnings are the 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.
