Eligibility
Minimum hours per week
Extended Health and Dental: N/A
All Other Benefits: 17.5 hours per week
Extended Health Care
BENEFIT PROVIDER: Pacific Blue Cross
POLICY NUMBER: 53725
Waiting period
N/A
Claim deadline
December 31 of the following year
Calendar year deductible
$25 (Single/Family)
Reimbursement
80% until $1,000 paid per family per calendar year, then 100%
Lifetime maximum
$1,000,000 per lifetime
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 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
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
Combined with In-Province Maximum
Hospital room
Private or Semi-private Room
Private duty nursing
In-home nursing care covered. Physician referral required.
Hearing aids – Adults
$400 per 5 calendar years
Hearing aids – Children
$400 per 5 calendar years
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
Covered (Reasonable and Customary)
Orthotics
Covered (Reasonable and Customary)
Accidental dental
Covered
Vision Care
Maximum – Adults
$200 per 2 calendar year
Prescription sunglasses: Not covered
Maximum – Children
$200 per 2 calendar years
Prescription sunglasses: Not covered
Eye exams
$15 per 24 months
Paramedical Services
Acupuncture
$100 per person per calendar year
Chiropractor
$200 per person per calendar year; to a maximum of $500 per calendar year per family
Massage therapy
Unlimited (Reasonable and Customary limits apply)
Naturopathy
$200 per person per calendar year; to a maximum of $500 per calendar year per family
Osteopathy
$200 per calendar year per person, $500 per calendar year per family
Physiotherapy
Unlimited (Reasonable and Customary limits apply)
Podiatry
$200 per person per calendar year; to a maximum of $500 per calendar year per family
Counselling Services
Not Covered
Speech therapy
$200 per person per calendar year
Dental Coverage
BENEFIT PROVIDER: Pacific Blue Cross
POLICY NUMBER: 53725
Waiting period
n/a
Claim deadline
12 months from date of service
Calendar year deductible
n/a
Dental fee guide
Current Province of Residence
Specialist coverage
PBC 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 and who is publicly represented as the Member’s spouse. Only one spouse is eligible for coverage at any one time.
Basic Services
Reimbursement
100%
Maximum
n/a
Adult check-up
2 per person per calendar year
Child check-up
2 per person per calendar year
Adult fluoride
2 per person per calendar year
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
91-120th day of disability: 60% of monthly earnings
After 120 day elimination period: 70% of monthly earnings
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: 90 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: 53725
Waiting period
3 months of continuous employment
Benefit amount
3 times Annual Earnings rounded to next higher $1,000
Maximum
$150,000
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
The member’s salary from the employer not including any bonus, overtime or incentive pay
Conversion privilege
Available
Optional Life
BENEFIT PROVIDER: Pacific Blue Cross
POLICY NUMBER: 53725
Eligibility
Employee and Spouse
Waiting period
3 months of continuous employment
Benefit amount
Units of $10,000
Maximum
$300,000
Age reduction
Reduces by 50% at age 65
Waiver of premium definition
Matches Core LTD
Coverage during disability
Optional Life coverage (employee and spouse, if applicable) 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
Spouse definition
Legal spouse or common-law spouse (Opposite or same sex. Must be continuously cohabitating for a minimum of 12 months.) Only one spouse can be covered as a dependent at any given time.
Conversion privilege
Employee: Available
Spouse: Not Available
Application deadline
Applicant must apply and be accepted prior to their 65th birthday
Child Optional Life
BENEFIT PROVIDER: Pacific Blue Cross
POLICY NUMBER: 53725
Waiting period
3 months of continuous employment
Benefit amount
Units of $2,500
Maximum
$10,000
Waiver of premium definition
Matches Core LTD
Coverage during disability
Child Optional 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.
Termination age
Earlier of age 70 or retirement
Child definition
Up to age 21, or 25 if in full time attendance at school, or any age, if disabled. A child is effective from birth. If the child is institutionalized the benefit will not be effective until the child ceases to be confined.
Conversion privilege
Not available
Optional Accidental Death & Dismemberment
BENEFIT PROVIDER: AIG
POLICY NUMBER: PAI 9104940
Waiting period
3 months of continuous employment
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, dependent 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 dependent 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.
