Eligibility
Minimum hours per week
Core LTD: 15 hours per week
All Other Benefits: 12 and 10 month employees working 50% of full time employment
Extended Health Care
BENEFIT PROVIDER: Pacific Blue Cross
POLICY NUMBER: 53744
Waiting period
60 working days
Claim deadline
December 31 of the following year
Calendar year deductible
$100 (Single/Family)
Reimbursement
80% until $1,000 paid per family per calendar year, then 100%
Lifetime maximum
Unlimited
Survivor extension
Dependent coverage following the member’s death will continue 24 months without further payment of premium contributions, until the earliest of the following occurs:
a. the date the person ceases to be a Dependent other than as a result of the Member’s death;
b. the date the contract is terminated.
If an eligible dependent has coverage under another benefits plan, they are still eligible for survivor benefits up to the duration of the contractual limits. This would apply to both of the following scenarios:
1. The dependent already has coverage under another plan upon the member’s death.
2. The dependent later becomes eligible under another plan after the member’s death.
Please note, if a dependent child is or becomes a member on their own plan, they would no longer be eligible as a dependent under a parent’s plan.
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
Blue Rx
Pay-direct drug card
Yes
Per prescription deductible
n/a
Sexual dysfunction
Not Covered
Oral contraceptives
Covered
Fertility drugs
$7,500 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 room
Private duty nursing
In-home nursing care covered
Hearing aids – Adults
$4,000 per 5 calendar years
Hearing aids – Children
$4,000 per 2 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
$400 per calendar year for adults, $200 per calendar year for children
Orthotics
$400 per 2 calendar years
Accidental dental
Covered
Vision Care
Maximum – Adults
$625 per 24 months – prescription sun glasses included in vision maximum
Maximum – Children
$625 per 24 months – prescription sun glasses included in vision maximum
Eye exams
$125 per 24 months
Paramedical Services
Acupuncture
$600 per calendar year
Chiropractor
$600 per calendar year (Chiropractic x-rays are included in this maximum)
Massage therapy
$1,200 per calendar year
Naturopathy
$600 per calendar year
Osteopathy
Not Covered
Physiotherapy
$1,000 per calendar year
Podiatry
$600 per calendar year
Counselling Services
$1,500 per calendar year combined for Psychologists, Clinical Counsellors and Social Workers
Speech therapy
$600 per calendar year
Dental Coverage
BENEFIT PROVIDER: Pacific Blue Cross
POLICY NUMBER: 53744
Waiting period
60 working days
Claim deadline
12 months from date of service
Calendar year deductible
n/a
Dental fee guide
PBC Schedule 3
Specialist coverage
General Practitioner 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 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
100%
Maximum
$1,000 per calendar year combined with Major services
Adult check-up
2 per calendar year
Child check-up
2 per calendar year
Adult fluoride
Covered
Major restorative services
Reimbursement
60%
Maximum
$1,000 per calendar year combined with Basic services
Orthodontic services
Reimbursement
60%
Maximum
$1,000 per Lifetime
Age limit
n/a
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
Weekly Indemnity (Short Term Disability)
BENEFIT PROVIDER: Desjardins Insurance
POLICY NUMBER: 64090S-92
Waiting period
60 working days
Benefit amount
75% of weekly earnings
Maximum benefit
Current EI maximum
Elimination period
Accident and Hospitalization: Nil; Illness: 5 days
Maximum benefit period
52 weeks
Benefit pro-rating
7 days (calendar)
Payment schedule
If a 10 month or 11 month employee becomes Totally Disabled during the months they are Not Actively At Work, the Elimination Period will commence on the initial date of Total Disability and payment of Weekly Indemnity Benefits will begin on the later of the end of the Elimination period or September 1st, so long as the Member remains Totally Disabled. If a 10 month Member is Totally Disabled and in receipt of Weekly Indemnity Benefits as of June 30th, Weekly Indemnity will cease and the employee will not be entitled to Weekly Indemnity benefits payments from July 1st through August 31st, inclusive. If still Totally Disabled on the September 1st following, Weekly Indemnity benefit payments will resume. If an 11 month employee is Totally Disabled and in receipt of Weekly Indemnity as of July 31st, Weekly Indemnity benefit payments will cease and the employee will not be entitled to Weekly Indemnity payments from August 1st through August 31st, inclusive. If still Totally Disabled on September 1st following, Weekly Indemnity benefit payments will resume.
Taxability status
Taxable
Waiver of premium definition
Included
Termination age
Earlier of age 65 or retirement.
Earnings definition
The member’s salary from the employer not including any bonus, overtime or incentive pay
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: 53744
Waiting period
60 working days
Benefit amount
$35,000
Maximum
$35,000
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: 53744
Eligibility
Employee and Spouse
Waiting period
60 working days
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: 53744
Waiting period
60 working days
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
Basic Accidental Death & Dismemberment
BENEFIT PROVIDER: AIG
POLICY NUMBER: BSC 9104906
Waiting period
60 working days
Benefit amount
Matches Basic Life
Maximum
$35,000
Non-evidence maximum
n/a
Age reduction
n/a
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
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.