Common use of Protecting Your Personal Information Clause in Contracts

Protecting Your Personal Information. At Great-West Life, we recognize and respect the importance of privacy. Personal information about you is kept in a confidential file at the offices of Great-West Life or the offices of an organization authorized by Great-West Life. Great-West Life may use service providers located within or outside Canada. We limit access to personal information in your file to Great-West Life staff or persons authorized by Great-West Life who require it to perform their duties, to persons to whom you have granted access, and to persons authorized by law. Your personal information may be subject to disclosure to those authorized under applicable law within or outside Canada. We use the personal information to administer the group benefits plan under which you are covered. This includes many tasks, such as:  determining your eligibility for coverage under the plan  enrolling you for coverage  investigating and assessing your claims and providing you with payment  managing your claims  verifying and auditing eligibility and claims  creating and maintaining records concerning our relationship  underwriting activities, such as determining the cost of the plan, and analyzing the design options of the plan  preparing regulatory reports, such as tax slips We may exchange personal information with your health care providers, your plan administrator, any insurance or reinsurance companies, administrators of government benefits or other benefit programs, other organizations, or service providers working with us or the above when relevant and necessary to administer the plan. As plan member, you are responsible for the claims submitted. We may exchange personal information with you or a person acting on your behalf when relevant and necessary to confirm coverage and to manage the claims submitted. You may request access or correction of the personal information in your file. A request for access or correction should be made in writing and may be sent to any of Great-West Life’s offices or to our head office. For a copy of our Privacy Guidelines, or if you have questions about our personal information policies and practices (including with respect to service providers), write to Great-West Life’s Chief Compliance Officer or refer to ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. Benefit Summary 1 Commencement and Termination of Coverage 5 Dependent Coverage 6 Beneficiary Designation 6 Employee Basic Life Insurance 7 Dependent Basic Life Insurance 8 Optional Life Insurance 9 Accidental Death, Dismemberment and Specific Loss (AD&D) Insurance 10 Healthcare 16 Dentalcare 33 Coordination of Benefits 41 Diagnostic and Treatment Support Services (Best Doctors® Service) 42 Spouse $5,000 Child $2,500 If you are covered under this plan as both an employee and a spouse, you are limited to the $500,000 maximum Deductible Nil Reimbursement Levels Out-of-Country Care - Non-Emergency Expenses 50% - Emergency Expenses 100% In-Canada Prescription Drug Expenses 80% All Other Expenses 100% Basic Expense Maximums Hospital Semi-private room Home Nursing Care $5,000 for a maximum of 12 months per condition In-Canada Prescription Drugs Included Viscosupplementation $600 each calendar year Hearing Aids $500 every 5 calendar years Incontinence Supplies $1,000 each calendar year Custom-fitted Orthopedic Shoes $200 each calendar year Custom-made Foot Orthotics $200 each calendar year Myoelectric Arms $10,000 per prosthesis External Breast Prosthesis 1 every 12 months Surgical Brassieres 2 each calendar year Mechanical or Hydraulic Patient Lifters $2,000 per lifter once every 5 years Outdoor Wheelchair Ramps $2,000 lifetime Blood-glucose Monitoring Machines 1 every 4 years Transcutaneous Nerve Stimulators $700 lifetime Extremity Pumps for Lymphedema $1,500 lifetime Custom-made Compression Hose $100 each calendar year Wigs for Cancer Patients $500 lifetime Paramedical Expense Maximums Chiropractors, Podiatrists, Naturopaths, Osteopaths, Psychologists, Social Workers, Physiotherapists, Massage Therapists, Speech Therapists, Occupational Therapists and Acupuncturists $750 combined each calendar year Visioncare Expense Maximums Eye Examinations - dependent children Out-Of-Country Care Expense Maximums - Emergency Care Unlimited - Non-Emergency Care $3,000 every 3 calendar years Lifetime Healthcare Maximum Unlimited Payment Basis The dental fee guide in effect in your province of residence on the date treatment is rendered Deductible Nil Reimbursement Levels Basic Coverage 80% Major Coverage 50% Plan Maximum $1,500 each calendar year You are eligible to participate in the plan after 4 months of continuous employment. You are considered continuously employed only if you satisfy the actively at work requirement throughout the eligibility waiting period.  You must apply for coverage no later than 31 days after you become eligible. After 31 days, you must provide evidence of insurability for you and your dependents before you can participate.  You must be actively at work when coverage takes effect, otherwise the coverage will not be effective until you return to work. Increases in your benefits while you are covered by this plan will not become effective unless you are actively at work.  Temporary and seasonal employees, and part-time employees who work less than 20 hours per week may not join the plan. Your coverage terminates when your employment ends, you are no longer eligible, you stop paying the required premiums, or the policy terminates, whichever is earliest.  Your dependents' coverage terminates when your insurance terminates or your dependent no longer qualifies, whichever is earlier.  Your coverage may be extended if it would have terminated because you are not actively at work due to disease or injury, temporary lay-off or leave of absence. Your employer will provide you with details.  When your coverage terminates, you may be entitled to an extension of benefits under the plan. Your employer will provide you with details.

Protecting Your Personal Information. At Great-West Life, we recognize and respect the importance impor- tance of privacy. Personal information about When you is kept in apply for coverage or benefits, we establish a confidential file at the offices of Great-West Life or the offices of an organization authorized by Great-West Life. Great-West Life may use service providers located within or outside Canadapersonal information. We limit access to personal information in your file to Great-West Life staff or persons authorized by Great-West Life who require it to perform their duties, to persons to whom you have granted access, and to persons authorized by law. Your personal information may be subject to disclosure to those authorized under applicable law within or outside Canada. We use the personal information to administer the group benefits benefit plan under which you are covered. This includes many tasks, . such as:  determining your eligibility for coverage under the plan  enrolling you for coverage  investigating and assessing your claims and providing you with payment  pay- ment managing your claims  verifying and auditing eligibility and claims  creating and maintaining records concerning our relationship  underwriting activities, such as determining the cost of the plan, and analyzing the design options of the plan  preparing regulatory reports, such as tax slips We Your employer has an agreement with Great-West Life in which your employer has financial responsibility for some or all of the benefits in the plan and we process claims on your employer's behalf. may exchange personal information with your health care providers, . your plan administrator, any insurance or reinsurance companies, other administrators of government benefits or other benefit programs, other organizationsorga- nizations, or service providers working with us or the above when relevant and necessary to administer the plan. As neces- All claims under this plan are submitted through you as plan member, you are responsible for the claims submitted. We may exchange personal information about claims with you or and a person acting on your behalf when relevant and necessary to confirm coverage eligibility and to mutually manage the claims submittedclaims. You may request access or correction of the personal For more information in your file. A request about our privacy guidelines, please ask for access or correction should be made in writing and may be sent to any of Great-West Life’s offices or to our head officePrivacy Guidelines brochure. Company Defined Contribution Pension Plan for mem- bers of the New Brunswick and bargaining unit with the following features: Effective Date January Eligibility members of the Company Defined Benefit Pension Plan become members of the Company Defined Contribution Pension Plan on Jan- uary 1,2005; and full-time bargaining unit employees not currently members of the Company Defined Benefit Pension and new hires shalljoin the Compa- ny Defined Contribution Pension Plan after completion of two (2) years of employment. Contributions The Company will contribute of wages for straight time hours worked in a calendar year for each full-time member of the bargaining unit. For a copy new employees entering the plan after January contributions will be equal to of our Privacy Guidelines, or if you have questions about our personal information policies and practices (including with respect straight time hours worked up to service providers), write to Great-West Life’s Chief Compliance Officer or refer to ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. Benefit Summary 1 Commencement and Termination of Coverage 5 Dependent Coverage 6 Beneficiary Designation 6 Employee Basic Life Insurance 7 Dependent Basic Life Insurance 8 Optional Life Insurance 9 Accidental Death, Dismemberment and Specific Loss (AD&D) Insurance 10 Healthcare 16 Dentalcare 33 Coordination of Benefits 41 Diagnostic and Treatment Support Services (Best Doctors® Service) 42 Spouse $5,000 Child $2,500 If you are covered under this plan as both an employee and a spouse, you are limited to the $500,000 maximum Deductible Nil Reimbursement Levels Out-of-Country Care - Non-Emergency Expenses 50% - Emergency Expenses 100% In-Canada Prescription Drug Expenses 80% All Other Expenses 100% Basic Expense Maximums Hospital Semi-private room Home Nursing Care $5,000 for a maximum of 12 months hours in a calendar year. of pensionable earnings per condition In-Canada Prescription Drugs Included Viscosupplementation $600 month for each calendar year Hearing Aids $500 every 5 calendar years Incontinence Supplies $1,000 each calendar year Custom-fitted Orthopedic Shoes $200 each calendar year Custom-made Foot Orthotics $200 each calendar year Myoelectric Arms $10,000 per prosthesis External Breast Prosthesis 1 every 12 months Surgical Brassieres 2 each calendar year Mechanical or Hydraulic Patient Lifters $2,000 per lifter once every 5 years Outdoor Wheelchair Ramps $2,000 lifetime Blood-glucose Monitoring Machines 1 every 4 years Transcutaneous Nerve Stimulators $700 lifetime Extremity Pumps for Lymphedema $1,500 lifetime Custom-made Compression Hose $100 each calendar year Wigs for Cancer Patients $500 lifetime Paramedical Expense Maximums Chiropractors, Podiatrists, Naturopaths, Osteopaths, Psychologists, Social Workers, Physiotherapists, Massage Therapists, Speech Therapists, Occupational Therapists and Acupuncturists $750 combined each calendar year Visioncare Expense Maximums Eye Examinations - dependent children Out-Of-Country Care Expense Maximums - Emergency Care Unlimited - Non-Emergency Care $3,000 every 3 calendar years Lifetime Healthcare Maximum Unlimited Payment Basis The dental fee guide in effect in your province of residence on the date treatment is rendered Deductible Nil Reimbursement Levels Basic Coverage 80% Major Coverage 50% Plan Maximum $1,500 each calendar year You are eligible to participate in the plan after 4 months of continuous employment. You are considered continuously employed only if you satisfy the actively at work requirement throughout the eligibility waiting period.  You must apply for coverage no later than 31 days after you become eligible. After 31 days, you must provide evidence of insurability for you and your dependents before you can participate.  You must be actively at work when coverage takes effect, otherwise the coverage will not be effective until you return to work. Increases in your benefits while you are covered by this plan will not become effective unless you are actively at work.  Temporary and seasonal employees, and partfull-time member of the bargaining unit. As of Company contribute of pensionable earnings per month for each full-time member of unit. The Pension Formula will be calculated as follows: For forty (40)hour employees who work less than 20 the hourly rate (excluding any applicable premiums) applicable percentage X hours per week may not join month. For thirty-two (32) hour employees the planbase hour- ly rate (excluding any applicable premiums) X ap- plicable percentage X hours per month. Your coverage terminates when your employment ends, you are no longer eligible, you stop paying the required premiums, or the policy terminates, whichever is earliest.  Your dependents' coverage terminates when your insurance terminates or your dependent no longer qualifies, whichever is earlier.  Your coverage may be extended if it would have terminated because you The twenty (20) hour employees are not actively at work due to disease or injury, temporary lay-off or leave of absence. Your employer will provide you with details.  When your coverage terminates, you may be entitled to an extension the pension benefit. The Company shall forward all contributions monthly, together with a list of benefits under all eligible members being re- ported each month, within twenty (20) days of the planend of the work month. Your employer The Union may file a grievance with the Company if contributions are not remitted by the due date. The contributions will provide you be credited to a separate ac- count established for each member and the member will determine how his account will be invested with- in a selection of investment funds available from the Financial Institution as determined by the Company from time to time in consultation with detailsthe Union. No member contributions are required. Company contributions are vested after com- pletion of two (2)years of pension plan membership.

Protecting Your Personal Information. At Great-West Life, we recognize and respect the importance of privacy. Personal information about When you is kept in apply for coverage or benefits, we establish a confidential file at the offices confidentialfile of Great-West Life or the offices of an organization authorized by Great-West Life. Great-West Life may use service providers located within or outside Canadapersonal information. We limit access to personal information in your file to Great-West Life staff or persons authorized by Great-West Life who require it to perform their duties, to persons to whom you have granted access, and to persons authorized by law. Your personal information may be subject to disclosure to those authorized under applicable law within or outside Canada. We use the personal information to administer the group benefits benefit plan under which you are covered. This includes many tasks, such as:  determining your eligibility for eligibilityfor coverage under the plan  enrolling you for coverage  investigating and assessing your claims and providing you with payment  managing your claims  verifying and auditing eligibility and claims  creating and maintaining records concerning our relationship  underwriting activities, such as determining the cost of the plan, and analyzing the design options of the plan  preparing regulatory reports, such as tax slips Your employer has an agreement with Life in which your employer has financial responsibility for some or all of the benefits in the plan and we process claims on your employer’s behalf. We may exchange personal information with your health care providers, your plan administrator, any other insurance or reinsurance companies, administrators of government benefits or other benefit programs, other organizations, or service providers working with us or the above when relevant and necessary to administer the plan. As All claims under this plan are submitted through you as plan member, you are responsible for the claims submitted. We may exchange personal information about claims with you or and a person acting on your behalf when relevant and necessary to confirm coverage eligibility and to mutually manage the claims submittedclaims. The personal information in your file will be kept in the offices of West Life or in the offices of an organization authorized by us. You may request access to review or correction of correct the personal information in your file. A request for access to review or correction correct your file should be made in writing and may be sent to any of Great-West Life’s offices or to our head officeoffice at: The Life Assurance Company Group Compliance Box Winnipeg, Claims submissions should not be sent to this address. Please use the address on the claim form or contact your plan administrator for details. For a copy of our Privacy Guidelines, or if you have questions more information about our personal information policies and practices (including with respect to service providers)privacy guidelines, write to Great-please ask for West Life’s Chief Compliance Officer or refer to ▇▇▇Privacy Guidelines brochure.▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. Benefit Summary 1 Commencement and Termination of Coverage 5 Dependent Coverage 6 Beneficiary Designation 6 Employee Basic Life Insurance 7 Dependent Basic Life Insurance 8 Optional Life Insurance 9 Accidental Death, Dismemberment and Specific Loss (AD&D) Insurance 10 Healthcare 16 Dentalcare 33 Coordination of Benefits 41 Diagnostic and Treatment Support Services (Best Doctors® Service) 42 Spouse $5,000 Child $2,500 If you are covered under this plan as both an employee and a spouse, you are limited to the $500,000 maximum Deductible Nil Reimbursement Levels Out-of-Country Care - Non-Emergency Expenses 50% - Emergency Expenses 100% In-Canada Prescription Drug Expenses 80% All Other Expenses 100% Basic Expense Maximums Hospital Semi-private room Home Nursing Care $5,000 for a maximum of 12 months per condition In-Canada Prescription Drugs Included Viscosupplementation $600 each calendar year Hearing Aids $500 every 5 calendar years Incontinence Supplies $1,000 each calendar year Custom-fitted Orthopedic Shoes $200 each calendar year Custom-made Foot Orthotics $200 each calendar year Myoelectric Arms $10,000 per prosthesis External Breast Prosthesis 1 every 12 months Surgical Brassieres 2 each calendar year Mechanical or Hydraulic Patient Lifters $2,000 per lifter once every 5 years Outdoor Wheelchair Ramps $2,000 lifetime Blood-glucose Monitoring Machines 1 every 4 years Transcutaneous Nerve Stimulators $700 lifetime Extremity Pumps for Lymphedema $1,500 lifetime Custom-made Compression Hose $100 each calendar year Wigs for Cancer Patients $500 lifetime Paramedical Expense Maximums Chiropractors, Podiatrists, Naturopaths, Osteopaths, Psychologists, Social Workers, Physiotherapists, Massage Therapists, Speech Therapists, Occupational Therapists and Acupuncturists $750 combined each calendar year Visioncare Expense Maximums Eye Examinations - dependent children Out-Of-Country Care Expense Maximums - Emergency Care Unlimited - Non-Emergency Care $3,000 every 3 calendar years Lifetime Healthcare Maximum Unlimited Payment Basis The dental fee guide in effect in your province of residence on the date treatment is rendered Deductible Nil Reimbursement Levels Basic Coverage 80% Major Coverage 50% Plan Maximum $1,500 each calendar year You are eligible to participate in the plan after 4 months of continuous employment. You are considered continuously employed only if you satisfy the actively at work requirement throughout the eligibility waiting period.  You must apply for coverage no later than 31 days after you become eligible. After 31 days, you must provide evidence of insurability for you and your dependents before you can participate.  You must be actively at work when coverage takes effect, otherwise the coverage will not be effective until you return to work. Increases in your benefits while you are covered by this plan will not become effective unless you are actively at work.  Temporary and seasonal employees, and part-time employees who work less than 20 hours per week may not join the plan. Your coverage terminates when your employment ends, you are no longer eligible, you stop paying the required premiums, or the policy terminates, whichever is earliest.  Your dependents' coverage terminates when your insurance terminates or your dependent no longer qualifies, whichever is earlier.  Your coverage may be extended if it would have terminated because you are not actively at work due to disease or injury, temporary lay-off or leave of absence. Your employer will provide you with details.  When your coverage terminates, you may be entitled to an extension of benefits under the plan. Your employer will provide you with details.

Protecting Your Personal Information. At Great-West Life, we recognize and respect the importance of privacy. Personal information about When you is kept in apply for coverage or benefits, we establish a confidential file at the offices confidentialfile of Great-West Life or the offices of an organization authorized by Great-West Life. Great-West Life may use service providers located within or outside Canadapersonal information. We limit access to personal information in your file to Great-West Life staff or persons authorized by Great-West Life who require it to perform their duties, to persons to whom you have granted access, and to persons authorized by law. Your personal information may be subject to disclosure to those authorized under applicable law within or outside Canada. We use the personal information to administer the group benefits benefit plan under which you are covered. This includes many tasks, such as:  determining your eligibility for coverage under the plan  enrolling you for coverage  investigating and assessing your claims and providing you with payment  managing your claims  verifying and auditing eligibility and claims  creating and maintaining records concerning our relationship  underwriting activities, such as determining the cost of the plan, and analyzing the design options of the plan  preparing regulatory reports, such as tax slips Your employer has an agreement with Great-West Life in which your employer has financial responsibility for some or all of the benefits in the plan and we process claims on your employer’s behalf. We may exchange personal information with your health care providers, your plan administrator, any other insurance or reinsurance companies, administrators of government benefits or other benefit programs, other organizations, or service providers working with us or the above when relevant and necessary to administer the plan. As All claims under this plan are submitted through you as plan member, you are responsible for the claims submitted. We may exchange personal information about claims with you or and a person acting on your behalf when relevant and necessary to confirm coverage eligibility and to mutually manage the claims submittedclaims. You may request access or correction of the personal For more information in your file. A request about our privacy guidelines, please ask for access or correction should be made in writing and may be sent to any of Great-West Life’s offices or Guidelines brochure. Your employer has entered into an agreement with The Life Assurance Company whereby your employer will have full liability for Weekly Income and Visioncare benefits outlined in this booklet. This means your employer has agreed to our head officefund these benefits and they are, therefore, uninsured. For a copy of our Privacy GuidelinesAll claims will, or if you have questions about our personal information policies and practices (including with respect to service providers)however, write to Great-be processed by West Life’s Chief Compliance Officer or refer to ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. Benefit Summary 1 Commencement and Termination Schedule of Coverage 5 Benefits Changes in Insurance Benefits Eligibility Definition of Dependent Coverage 6 Beneficiary Designation 6 Employee Basic Life Insurance 7 Dependent Basic Life Insurance 8 Optional Life Insurance 9 for Employees Accidental Death, Dismemberment and Specific Loss (AD&D) of Sight Insurance 10 Healthcare 16 Dentalcare 33 Coordination Weekly Income Benefits Visioncare Termination of Coverage Continuation of Health Benefits 41 Diagnostic and Treatment Support Services (Best Doctors® Service) 42 Spouse $5,000 Child $2,500 If you are covered under this plan as both an employee and a spouse, you are limited for Dependents How to the $500,000 maximum Deductible Nil Reimbursement Levels Out-of-Country Care - Non-Emergency Expenses 50% - Emergency Expenses 100% In-Canada Prescription Drug Expenses 80% All Other Expenses 100% Basic Expense Maximums Hospital Semi-private room Home Nursing Care $5,000 for Make Your Claims SCHEDULE OF BENEFITS FOR EMPLOY Effective December Effective December Effective December Effective December Weekly Income Benefits of your weekly insurable earnings up to a maximum of 12 months per condition InEffective December Effective December to a maximum of to a maximum of * Your amounts of Life and Insurance will each terminate automatically at age If you retire on or after December you will receive of Life Insurance. Deductible Co-Canada Prescription Drugs Included Viscosupplementation $600 each calendar year Hearing Aids $500 every 5 calendar years Incontinence Supplies $1,000 each calendar year Custom-fitted Orthopedic Shoes $200 each calendar year Custom-made Foot Orthotics $200 each calendar year Myoelectric Arms $10,000 per prosthesis External Breast Prosthesis 1 every 12 months Surgical Brassieres 2 each calendar year Mechanical insurance Percentage Eye Examination, Eyeglass or Hydraulic Patient Lifters $2,000 per lifter once every 5 years Outdoor Wheelchair Ramps $2,000 lifetime Blood-glucose Monitoring Machines 1 every 4 years Transcutaneous Nerve Stimulators $700 lifetime Extremity Pumps for Lymphedema $1,500 lifetime Custom-made Compression Hose $100 each calendar year Wigs for Cancer Patients $500 lifetime Paramedical Expense Maximums Chiropractors, Podiatrists, Naturopaths, Osteopaths, Psychologists, Social Workers, Physiotherapists, Massage Therapists, Speech Therapists, Occupational Therapists and Acupuncturists $750 combined each calendar year Visioncare Expense Maximums Eye Examinations - dependent children Out-Of-Country Care Expense Maximums - Emergency Care Unlimited - Non-Emergency Care $3,000 every 3 calendar years Lifetime Healthcare Maximum Unlimited Payment Basis The dental fee guide in effect in your province of residence on the date treatment is rendered Deductible Nil Reimbursement Levels Basic Coverage 80% Major Coverage 50% Plan Maximum $1,500 each calendar year You are eligible to participate in the plan after 4 months of continuous employment. You are considered continuously employed only if you satisfy the actively at work requirement throughout the eligibility waiting period.  You must apply for coverage no later than 31 days after you become eligible. After 31 days, you must provide evidence of insurability for you and your dependents before you can participate.  You must be actively at work when coverage takes effect, otherwise the coverage will not be effective until you return to work. Increases in your benefits while you are covered by this plan will not become effective unless you are actively at work.  Temporary and seasonal employeesContact Lens, and part-time employees who work less than 20 hours per week may not join the plan. Your coverage terminates when your employment ends, you are no longer eligible, you stop paying the required premiums, or the policy terminates, whichever is earliest.  Your dependents' coverage terminates when your insurance terminates or your dependent no longer qualifies, whichever is earlier.  Your coverage may be extended if it would have terminated because you are not actively at work due to disease or injury, temporary lay-off or leave of absence. Your employer will provide you with details.  When your coverage terminates, you may be entitled to an extension of benefits under the plan. Your employer will provide you with details.Contact Lenses for Special Conditions Maximum period)

Protecting Your Personal Information. At Great-West Life, we recognize and respect the importance of privacy. Personal information about you is kept in a confidential file at the offices of Great-West Life or the offices of an organization authorized by Great-West Life. Great-West Life may use service providers located within or outside Canada. We limit access to personal information in your file to Great-West Life staff or persons authorized by Great-West Life who require it to perform their duties, to persons to whom you have granted access, and to persons authorized by law. Your personal information may be subject to disclosure to those authorized under applicable law within or outside Canada. We use the personal information to administer the group benefits plan under which you are covered. This includes many tasks, such as:  • determining your eligibility for coverage under the plan  • enrolling you for coverage  • investigating and assessing your claims and providing you with payment  • managing your claims  • verifying and auditing eligibility and claims  • creating and maintaining records concerning our relationship  • underwriting activities, such as determining the cost of the plan, and analyzing the design options of the plan  • preparing regulatory reports, such as tax slips We may exchange personal information with your health care providers, your plan administrator, any insurance or reinsurance companies, administrators of government benefits or other benefit programs, other organizations, or service providers working with us or the above when relevant and necessary to administer the plan. As plan member, you are responsible for the claims submitted. We may exchange personal information with you or a person acting on your behalf when relevant and necessary to confirm coverage and to manage the claims submitted. You may request access or correction of the personal information in your file. A request for access or correction should be made in writing and may be sent to any of Great-West Life’s offices or to our head office. For a copy of our Privacy Guidelines, or if you have questions about our personal information policies and practices (including with respect to service providers), write to Great-West Life’s Chief Compliance Officer or refer to ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. Benefit Summary 1 Commencement and Termination of Coverage 5 Dependent Coverage 6 Beneficiary Designation 6 Employee Basic Life Insurance 7 Dependent Basic Life Insurance 8 Optional Life Insurance 9 Accidental Death, Dismemberment and Specific Loss (AD&D) Insurance 10 Healthcare 16 Dentalcare 33 Coordination of Benefits 41 Diagnostic and Treatment Support Services (Best Doctors® Service) 42 Benefit Summary‌ Spouse $5,000 Child $2,500 subject to approval of evidence of insurability If you are covered under this plan as both an employee and a spouse, you are limited to the $500,000 maximum Deductible Nil Reimbursement Levels Out-of-Country Care - Non-Emergency Expenses 50% - Emergency Expenses 100% In-Canada Prescription Drug Expenses 80% All Other Expenses 100% Basic Expense Maximums Hospital Semi-private room Home Nursing Care $5,000 for a maximum of 12 months per condition In-Canada Prescription Drugs Included Viscosupplementation $600 each calendar year Hearing Aids $500 every 5 calendar years Incontinence Supplies $1,000 each calendar year Custom-fitted Orthopedic Shoes $200 each calendar year Custom-made Foot Orthotics $200 each calendar year Myoelectric Arms $10,000 per prosthesis External Breast Prosthesis 1 every 12 months Surgical Brassieres 2 each calendar year Mechanical or Hydraulic Patient Lifters $2,000 per lifter once every 5 years Outdoor Wheelchair Ramps $2,000 lifetime Blood-glucose Monitoring Machines 1 every 4 years Transcutaneous Nerve Stimulators $700 lifetime Extremity Pumps for Lymphedema $1,500 lifetime Custom-made Compression Hose $100 each calendar year Wigs for Cancer Patients $500 lifetime Paramedical Expense Maximums Chiropractors, Podiatrists, Naturopaths, Osteopaths, Psychologists, Social Workers, Physiotherapists, Massage Therapists, Speech Therapists, Occupational Therapists and Acupuncturists $750 combined each calendar year Visioncare Expense Maximums Eye Examinations - dependent children under age - all others Out-Of-Country Care Expense Maximums - Emergency Care Unlimited - Non-Emergency Care $3,000 every 3 calendar years Lifetime Healthcare Maximum Unlimited Payment Basis The dental fee guide in effect in your province of residence on the date treatment is rendered Deductible Nil Reimbursement Levels Basic Coverage 80% Major Coverage 50% Plan Maximum $1,500 each calendar year COMMENCEMENT AND TERMINATION OF COVERAGE‌ You are eligible to participate in the plan after 4 months of continuous employment. You are considered continuously employed only if you satisfy the actively at work requirement throughout the eligibility waiting period.  • You must apply for coverage no later than 31 days after you become eligible. After 31 days, you must provide evidence of insurability for you and your dependents before you can participate.  • You must be actively at work when coverage takes effect, otherwise the coverage will not be effective until you return to work. Increases in your benefits while you are covered by this plan will not become effective unless you are actively at work.  • Temporary and seasonal employees, and part-time employees who work less than 20 hours per week may not join the plan. Your coverage terminates when your employment ends, you are no longer eligible, you stop paying the required premiums, or the policy terminates, whichever is earliest.  • Your dependents' coverage terminates when your insurance terminates or your dependent no longer qualifies, whichever is earlier.  • Your coverage may be extended if it would have terminated because you are not actively at work due to disease or injury, temporary lay-off or leave of absence. Your employer will provide you with details.  • When your coverage terminates, you may be entitled to an extension of benefits under the plan. Your employer will provide you with details.