Required Number of Hours. ▪ as per the Collective Agreement Deductible ▪ $15 single/$25 family deductible for drug expenses ▪ nil for all other expenses Combined Maximum ▪ unlimited Coinsurance ▪ Drugs ▪ Hospital ▪ Vision ▪ Other Eligible Expenses ▪ 100% ▪ 100% ▪ 100% ▪ 80% professional and paramedical services ▪ 100% for all other expenses ▪ Drug Features ▪ drugs available only by prescription (plus certain life- sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up and dispensing fee maximums by province ▪ Hospital Room ▪ private or semiprivate ▪ Nursing Care ▪ max $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist – Podiatrist – Psychologist/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ Vision Care ▪ max of $250 per person in any 24 consecutive months (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident ▪ extra care (wigs or hairpieces up to $500 lifetime per person) ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment ▪ max of $5 million lifetime per person ▪ Travel Assistance ▪ Included * Less any amount paid by the government plan Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ same as Major Medical
Appears in 1 contract
Sources: Collective Agreement
Required Number of Hours. ▪ as per the Collective Agreement Deductible ▪ $15 single/$25 family deductible for drug expenses ▪ nil for all other expenses Combined Maximum ▪ unlimited Coinsurance ▪ Drugs ▪ Hospital ▪ Vision ▪ Other Eligible Expenses ▪ 100% ▪ 100% ▪ 100% ▪ 80% professional and paramedical services ▪ 100% for all other expenses ▪ Drug Features ▪ drugs available only by prescription (plus certain life- sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up mark-up and dispensing fee maximums by province ▪ Hospital Room ▪ private or semiprivate semi private ▪ Nursing Care ▪ max $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist Physio-therapist – Podiatrist – Psychologist/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 1,500 per person per year ▪ max of $500 per person per year (effective Oct., 01, 2017) ▪ max of $500 per person per year ▪ Vision Care ▪ max of $250 per person in any 24 consecutive months (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident ▪ extra care (wigs or hairpieces up to $500 lifetime per person) ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment Plan Features ▪ max of $5 million lifetime per person ▪ Travel Assistance ▪ Included included * Less any amount paid by the government plan Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ same as Major Medical
Appears in 1 contract
Sources: Collective Agreement
Required Number of Hours. ▪ same as per the Collective Agreement Deductible Major Medical Dental Fee Guide ▪ $15 single/$25 family deductible for drug expenses current in province of residence Deductibles Single Family ▪ nil for all other expenses Combined Maximum ▪ unlimited nil Coinsurance ▪ Drugs Part I Preventive ▪ Hospital Minor Restorative ▪ Vision Part II Major Restorative ▪ Other Eligible Expenses Part III Orthodontic ▪ 100% ▪ 100% ▪ 10050% ▪ 8050% professional and paramedical services Orthodontic Dependent Children Age Basis ▪ 100% for all other expenses under 19 years old Benefit Maximum ▪ Drug Features Part I – unlimited ▪ drugs available only by prescription (plus certain life- sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up and dispensing fee maximums by province ▪ Hospital Room ▪ private or semiprivate ▪ Nursing Care ▪ max Part II - $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist – Podiatrist – Psychologist1,500/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum ▪ max of $500 per person per year ▪ max of Part III - $500 per person per year 2,500 lifetime Recall Exam ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ Vision Care ▪ max of $250 per person in any 24 consecutive months (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident X-Rays ▪ extra care (wigs or hairpieces up to $500 lifetime per person) bitewing – once every 6 months ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment ▪ max of $5 million lifetime per person ▪ Travel Assistance ▪ Included * Less any amount paid by the government plan full mouth – once every 24 months Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: compulsory ▪ dependent coverage: not applicable Required Number of Hours ▪ same as Major Medical Benefit Formula ▪ less than 4 years of service: 66 2/3% of pre-disability earnings ▪ 4 years of service or more: 75% of pre-disability earnings Maximum Benefit ▪ $15,000 a month Qualifying Period ▪ 15 weeks or expiration of sick leave credits whichever is greater All Source Maximum ▪ 80% of gross pre-disability earnings Definition of Disability ▪ 2 years own occupation Indexation of Benefits ▪ no Pre-existing Condition Clause ▪ yes Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: compulsory ▪ dependent coverage: not applicable Required Number of Hours ▪ same as Major Medical Benefit Formula ▪ 1.5x basic annual salary, rounded to next highest $1,000, if not already a multiple of $1,000 Reduction Formula ▪ employee at age 65: coverage immediately reduces at age 65 & on each anniversary thereafter to the following percentage of original amount: 85% at age 65 70% at age 66 55% at age 67 40% at age 68 25% at age 69 Maximum Benefit ▪ without evidence: $600,000 ▪ with evidence: $1,000,000 ▪ combined maximums with Optional Life Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: not compulsory ▪ dependent coverage: not applicable Required Number of Hours ▪ same as Major Medical Benefit Formula ▪ 1x or 2x basic annual salary, rounded to next highest $1,000, if not already a multiple of $1,000 Maximum Benefit ▪ without evidence: $600,000 ▪ with evidence: $1,000,000 ▪ combined maximums with Basic Life Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: not applicable ▪ dependent coverage: not compulsory Required Number of Hours ▪ same as Major Medical
Appears in 1 contract
Sources: Collective Agreement
Required Number of Hours. ▪ as As per the Collective Agreement Deductible ▪ $15 single/$25 family deductible for drug expenses ▪ nil for all other expenses Combined Maximum ▪ unlimited Coinsurance Unlimited ▪ Drugs ▪ 100% ▪ Hospital ▪ 100% ▪ Vision ▪ 100% ▪ Other Eligible Expenses ▪ 100% ▪ 100% ▪ 100% ▪ 80% professional and paramedical services ▪ 100% for all other expenses ▪ Drug Features ▪ drugs Drugs available only by prescription (plus certain life- sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay Pay direct drug card ▪ includes Includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up mark-up and dispensing fee maximums by province ▪ Prescription drugs with valid drug identification number (DIN) ▪ Over the counter products are not eligible ▪ Use of a pay direct drug card to purchase prescription drugs, which includes Manulife Managed Formulary, mandatory generic drug program, and reasonable and customary pharmacy mark-ups by province ▪ Anti-obesity drugs ▪ Smoking cessation drugs to $300 life time maximum per person ▪ Fertility drugs are subject to a lifetime maximum of $15,000 per person ▪ Charges for oral contraceptives, intrauterine devices and diaphragms Gender affirmation: $10,000 maximum per person per lifetime for non-elective, medical necessary treatment ▪ Coverage is coordinated with provincial coverage, where it exists ▪ Hospital Room ▪ Private or semi private or semiprivate ▪ Nursing Care ▪ max Max $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist – Podiatrist – Psychologist/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum Acupuncture ▪ max Max of $500 per person per year Chiropractor ▪ max Max of $500 per person per year Osteopath ▪ max Max of $500 per person per year* Massage Therapist ▪ max Max of $500 per person per year Naturopath ▪ max Max of $500 per person per year* Physio-therapist ▪ max Max of $500 per person per year Podiatrist ▪ max Max of $500 per person per year* Psychologist/Social Worker/ Psychotherapist ▪ max Max of $500 1,500 per person per year Speech Therapist ▪ max of $500 per person per year ▪ max Max of $500 per person per year ▪ Vision Care ▪ max Max of $250 per person in any 24 consecutive months (frames, lenses, laser) ▪ one One eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max Max of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing Nursing home accommodation – max $20 a day ▪ ambulance Ambulance services to and from the nearest appropriate medical care ▪ medical Medical supplies and services to specified maximums ▪ accidental Accidental dental treatment within 6 months of the accident ▪ extra Extra care (wigs or hairpieces up to $500 lifetime per person) ▪ Emergency Out-of-Country ▪ emergency Emergency medical services Plan Features ▪ referral Referral treatment ▪ max Max of $5 million lifetime per person ▪ Travel Assistance ▪ Included * Less any amount paid by the government plan Premium Cost Sharing ▪ as As per the Collective Agreement Waiting Period ▪ same Same as Major Medical Participation Basis ▪ same Same as Major Medical
Appears in 1 contract
Sources: Collective Bargaining Agreement
Required Number of Hours. ▪ same as per the Collective Agreement Deductible Major Medical Dental Fee Guide ▪ $15 single/$25 family deductible for drug expenses current in province of residence Deductibles ▪ nil for all other expenses Combined Maximum ▪ unlimited nil Coinsurance ▪ Drugs Part I Preventive ▪ Hospital Minor Restorative ▪ Vision Part II Major Restorative ▪ Other Eligible Expenses Part III Orthodontic ▪ 100% ▪ 100% ▪ 10050% ▪ 8050% professional and paramedical services Orthodontic Dependent Children Age Basis ▪ 100% for all other expenses under 19 years old Benefit Maximum ▪ Drug Features Part I – unlimited ▪ drugs available only by prescription (plus certain life- sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up and dispensing fee maximums by province ▪ Hospital Room ▪ private or semiprivate ▪ Nursing Care ▪ max Part II - $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist – Podiatrist – Psychologist1,500/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum ▪ max of $500 per person per year ▪ max of Part III - $500 per person per year 2,500 lifetime Recall Exam ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ Vision Care ▪ max of $250 per person in any 24 consecutive months (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident X-Rays ▪ extra care (wigs or hairpieces up to $500 lifetime per person) bitewing – once every 6 months ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment ▪ max of $5 million lifetime per person ▪ Travel Assistance ▪ Included * Less any amount paid by the government plan full mouth – once every 24 months LONG TERM DISABILITY Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: compulsory ▪ dependent coverage: not applicable Required Number of Hours ▪ same as Major MedicalMedical Benefit Formula ▪ less than 4 years of service: 66 2/3% of pre-disability earnings ▪ 4 years of service or more: 75% of pre-disability earnings Maximum Benefit ▪ $15,000 a month Qualifying Period ▪ 15 weeks or expiration of sick leave credits whichever is greater All Source Maximum ▪ 80% of gross pre-disability earnings Definition of Disability ▪ 2 years own occupation Indexation of Benefits ▪ no Pre-existing Condition Clause ▪ yes BASIC LIFE INSURANCE Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical PLAN FEATURES Participation Basis ▪ employee coverage: compulsory ▪ dependent coverage: not applicable Required Number of Hours ▪ same as Major Medical Benefit Formula ▪ 1.5x basic annual salary, rounded to next highest $1,000, if not already a multiple of $1,000 Reduction Formula ▪ employee at age 65: coverage immediately reduces at age 65 & on each anniversary thereafter to the following percentage of original amount: 85% at age 65 70% at age 66 55% at age 67 40% at age 68 25% at age 69 Maximum Benefit ▪ without evidence: $600,000 ▪ with evidence: $1,000,000 ▪ combined maximums with Optional Life OPTIONAL LIFE INSURANCE Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: not compulsory ▪ dependent coverage: not applicable Required Number of Hours ▪ same as Major Medical Benefit Formula ▪ 1x or 2x basic annual salary, rounded to next highest $1,000, if not already a multiple of $1,000 Maximum Benefit ▪ without evidence: $600,000 ▪ with evidence: $1,000,000 ▪ combined maximums with Basic Life DEPENDENT LIFE Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: not applicable ▪ dependent coverage: not compulsory Required Number of Hours ▪ same as Major Medical Benefit Formula ▪ Spouse ▪ Each Child ▪ $10,000 ▪ $5,000 BASIC ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: compulsory ▪ dependent coverage: not applicable Required Number of Hours ▪ same as Major Medical Benefit Formula ▪ 1.5x basic annual salary, rounded to next highest $1,000, if not already a multiple of $1,000 REDUCTION FORMULA ▪ employee at age 65: coverage immediately reduces at age 65 & on each anniversary thereafter to the following percentage of original amount: 85% at age 65 70% at age 66 55% at age 67 40% at age 68 25% at age 69 PLAN FEATURES VOLUNTARY AD&D Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: not compulsory ▪ dependent coverage: not compulsory Required Number of Hours ▪ same as Major Medical Benefit Formula ▪ Personal Coverage ▪ Family Coverage ▪ units of $10,000 to maximum of $500,000 ▪ spouse, no children: 50% of employee coverage ▪ spouse and children: 40% of employee coverage for spouse & 10% for each child ▪ children only: 15% of employee coverage for each child DATED AT_ , ONTARIO, THIS DAY OF , 201_. FOR THE EMPLOYER FOR THE UNION Between: And:
Appears in 1 contract
Sources: Collective Agreement
Required Number of Hours. ▪ as per the Collective Agreement Deductible ▪ $15 single/$25 family deductible for drug expenses ▪ nil for all other expenses Combined Maximum ▪ unlimited Coinsurance ▪ Drugs ▪ 100% Hospital ▪ 100% Vision ▪ 100% Other Eligible Expenses ▪ 100% ▪ 100% ▪ 100% ▪ 80% professional and paramedical services ▪ 100% for all other expenses ▪ Drug Features ▪ drugs available only by prescription (plus certain life- life-sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up and dispensing fee maximums by province ▪ Hospital Room ▪ private or semiprivate ▪ semi private Nursing Care ▪ max $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist – Podiatrist – Psychologist/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum ▪ – Acupuncture max of $500 per person per year ▪ – Chiropractor max of $500 per person per year ▪ – Osteopath max of $500 per person per year* ▪ – Massage Therapist max of $500 per person per year ▪ – Naturopath max of $500 per person per year* ▪ – Physio-therapist max of $500 per person per year ▪ – Podiatrist max of $500 per person per year* ▪ – Psychologist/Social Worker max of $1,500 per person per year (effective Oct. 1, 2017) – Speech Therapist max of $500 per person per year ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ Vision Care ▪ max of $250 per person in any 24 consecutive months (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident ▪ extra care (wigs or hairpieces up to $500 lifetime per person) ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment ▪ max of $5 million lifetime per person ▪ Travel Assistance ▪ Included included * Less any amount paid by the government plan DENTAL Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ same as Major Medical
Appears in 1 contract
Sources: Collective Agreement
Required Number of Hours. ▪ as per the Collective Agreement Deductible ▪ family $15 single/$25 family deductible 25, single $15.00 for drug expenses ▪ nil for all other expenses Combined Maximum ▪ unlimited Coinsurance ▪ Drugs ▪ 100% ▪ Hospital ▪ 100% ▪ Vision ▪ 100% ▪ Other Eligible Expenses ▪ 100% ▪ 100% ▪ 100% ▪ 80% professional and paramedical services ▪ 100% for all other expenses ▪ Drug Features ▪ drugs available only by prescription (plus certain life- sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up and dispensing fee maximums by province ▪ Hospital Room ▪ private or semiprivate ▪ Nursing Care ▪ max $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist – Podiatrist – Psychologist/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum Psychologist ▪ max of $500 per person per year – Chiropractor ▪ max of $500 per person per year – Osteopath ▪ max of $500 per person per year* ▪ max of $500 per person per year – Naturopath ▪ max of $500 per person per year* ▪ max of $500 per person per year – Podiatrist ▪ max of $500 per person per year* – Speech Therapist ▪ max of $500 per person per year – Massage Therapist ▪ max of $500 per person per year – Acupuncture (performed by physician) ▪ n/a – Physio-therapist ▪ max of $500 per person per year ▪ Vision Care ▪ max of $250 200 per person in any 24 consecutive months (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident ▪ extra care (wigs or hairpieces up to $500 lifetime per person) ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment ▪ max of $5 1 million lifetime per person ▪ Travel Assistance ▪ Included ManuAssist plan * Less any amount paid by the government plan Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ same as Major Medical
Appears in 1 contract
Sources: Collective Agreement
Required Number of Hours. ▪ as per the Collective Agreement Deductible ▪ $15 single/$25 family deductible for drug expenses ▪ nil for all other expenses Combined Maximum ▪ unlimited Coinsurance ▪ Drugs ▪ 100% ▪ Hospital ▪ 100% ▪ Vision ▪ 100% ▪ Other Eligible Expenses ▪ 100% ▪ 100% ▪ 100% ▪ 80% professional and paramedical services ▪ 100% for all other expenses expenses ▪ Drug Features ▪ drugs available only by prescription (plus certain life- sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up mark-up and dispensing fee maximums by province ▪ Anti-obesity drugs ▪ Smoking cessation drugs to $300 life time maximum per person ▪ Fertility drugs are subject to a lifetime maximum of $15,000 per person. ▪ charges for oral contraceptives, intrauterine devices and diaphragms ▪ Hospital Room ▪ private or semiprivate semi private ▪ Nursing Care ▪ max $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist – Podiatrist – Psychologist/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum – Acupuncture ▪ max of $500 per person per year – Chiropractor ▪ max of $500 per person per year – Osteopath ▪ max of $500 per person per year* – Massage Therapist ▪ max of $500 per person per year – Naturopath ▪ max of $500 per person per year* – Physio-therapist ▪ max of $500 per person per year – Podiatrist ▪ max of $500 per person per year* – Psychologist/Social Worker ▪ max of $500 1,500 per person per year ▪ max of $500 per person per year year, includes Psychotherapists (effective Oct., 01, 2018) – Speech Therapist ▪ max of $500 per person per year ▪ Vision Care ▪ max of $250 per person in any 24 consecutive months Plan Features (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max ▇▇▇ of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day day ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident ▪ extra care (wigs or hairpieces up to $500 lifetime per person) person) ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment ▪ max of $5 million lifetime per person person ▪ Travel Assistance ▪ Included included * Less any amount paid by the government plan plan Premium Cost Sharing ▪ as per the Collective Agreement Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ same as Major Medical
Appears in 1 contract
Sources: Collective Agreement
Required Number of Hours. ▪ as per the Collective Agreement Deductible ▪ $15 single/$25 family deductible for drug expenses ▪ nil for all other expenses Combined Maximum ▪ unlimited Coinsurance ▪ Drugs ▪ 100% ▪ Hospital ▪ 100% ▪ Vision ▪ 100% ▪ Other Eligible Expenses ▪ 100% ▪ 100% ▪ 100% ▪ 80% professional and paramedical services ▪ 100% for all other expenses ▪ Drug Features ▪ drugs available only by prescription (plus certain life- life-sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up mark-up and dispensing fee maximums by province ▪ Anti-obesity drugs ▪ Smoking cessation drugs to $300 life time maximum per person ▪ Fertility drugs are subject to a lifetime maximum of $15,000 per person. ▪ charges for oral contraceptives, intrauterine devices and diaphragms ▪ Hospital Room ▪ private or semiprivate semi private ▪ Nursing Care ▪ max $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist – Podiatrist – Psychologist/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum Acupuncture ▪ max of $500 per person per calendar year Chiropractor ▪ max of $500 per person per calendar year Osteopath ▪ max of $500 per person per calendar year* Massage Therapist ▪ max of $500 per person per calendar year Naturopath ▪ max of $500 per person per calendar year* Physio-therapist ▪ max of $500 per person per calendar year Podiatrist ▪ max of $500 per person per calendar year* Psychologist/Social Worker/Psychotherapist Clinical Counsellor, Marriage and Family Therapist, and Psychoanalyst ▪ max of $1,500 per person per year Speech Therapist ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ max of $500 per person per calendar year ▪ Vision Care ▪ max of $250 per person in any 24 consecutive months (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident ▪ extra care (wigs or hairpieces up to $500 lifetime per person) Gender affirmation (April 1, 2023): ▪ $10,000 maximum per person per lifetime for non-elective, medical necessary treatment ▪ Coverage is coordinated with provincial coverage, where it exists ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment ▪ max of $5 million lifetime per person ▪ Travel Assistance ▪ Included included * Less any amount paid by the government plan Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ same as Major Medical
Appears in 1 contract
Sources: Collective Agreement
Required Number of Hours. ▪ same as Major Medical Dental Fee Guide ▪ current in province of residence Single ▪ nil Family ▪ nil ▪ Part I Preventive ▪ 100% ▪ Minor Restorative ▪ 100% ▪ Part II Major Restorative ▪ 50% ▪ Part III Orthodontic ▪ 50% Orthodontic Dependent Children Age Basis ▪ under 19 years old Benefit Maximum ▪ Part I – unlimited ▪ Part II - $1,500/year ▪ Part III - $2,500 lifetime Recall Exam ▪ 6 months X-Rays ▪ bitewing – once every 6 months ▪ full mouth – once every 24 months Premium Cost Sharing ▪ as per the Collective Agreement Deductible Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: compulsory ▪ dependent coverage: not applicable Required Number of Hours ▪ same as Major Medical Benefit Formula ▪ less than 4 years of service: 66 2/3% of pre- disability earnings ▪ 4 years of service or more: 75% of pre-disability earnings Maximum Benefit ▪ $15,000 a month Qualifying Period ▪ 15 single/$25 family deductible for drug expenses ▪ nil for all other expenses Combined weeks or expiration of sick leave credits whichever is greater All Source Maximum ▪ unlimited Coinsurance ▪ Drugs ▪ Hospital ▪ Vision ▪ Other Eligible Expenses ▪ 100% ▪ 100% ▪ 100% ▪ 80% professional and paramedical services of gross pre-disability earnings Definition of Disability ▪ 100% for all other expenses 2 years own occupation Indexation of Benefits ▪ Drug Features no Pre-existing Condition Clause ▪ drugs available only by prescription (plus certain life- sustaining drugs that do yes Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: compulsory ▪ dependent coverage: not legally require applicable Required Number of Hours ▪ same as Major Medical Benefit Formula ▪ 1.5x basic annual salary, rounded to next highest $1,000, if not already a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up and dispensing fee maximums by province ▪ Hospital Room ▪ private or semiprivate ▪ Nursing Care ▪ max $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist – Podiatrist – Psychologist/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum ▪ max multiple of $500 1,000 Reduction Formula ▪ employee at age 65: coverage immediately reduces at age 65 & on each anniversary thereafter to the following percentage of original amount: 85% at age 65 70% at age 66 55% at age 67 40% at age 68 25% at age 69 Maximum Benefit ▪ without evidence: $600,000 ▪ with evidence: $1,000,000 ▪ combined maximums with Optional Life Premium Cost Sharing ▪ as per person per year the Collective Agreement Waiting Period ▪ max same as Major Medical Participation Basis ▪ employee coverage: not compulsory ▪ dependent coverage: not applicable Required Number of Hours ▪ same as Major Medical Benefit Formula ▪ 1x or 2x basic annual salary, rounded to next highest $1,000, if not already a multiple of $500 1,000 Maximum Benefit ▪ without evidence: $600,000 ▪ with evidence: $1,000,000 ▪ combined maximums with Basic Life Premium Cost Sharing ▪ as per person per year the Collective Agreement Waiting Period ▪ max same as Major Medical Participation Basis ▪ employee coverage: not applicable ▪ dependent coverage: not compulsory Required Number of Hours ▪ same as Major Medical ▪ Spouse ▪ $500 per person per year* 10,000 ▪ max of Each Child ▪ $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ Vision Care ▪ max of $250 per person in any 24 consecutive months 5,000 Basic Accidental Death & Dismemberment (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident ▪ extra care (wigs or hairpieces up to $500 lifetime per person) ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment ▪ max of $5 million lifetime per person ▪ Travel Assistance ▪ Included * Less any amount paid by the government plan AD&D) Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: compulsory ▪ dependent coverage: not applicable Required Number of Hours ▪ same as Major MedicalMedical Benefit Formula ▪ 1.5x basic annual salary, rounded to next highest $1,000, if not already a multiple of $1,000 Reduction Formula ▪ employee at age 65: coverage immediately reduces at age 65 & on each anniversary thereafter to the following percentage of original amount: 85% at age 65 70% at age 66 55% at age 67 40% at age 68 25% at age 69 Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ employee coverage: not compulsory ▪ dependent coverage: not compulsory Required Number of Hours ▪ same as Major Medical ▪ Personal Coverage ▪ units of $10,000 to maximum of $500,000 ▪ Family Coverage ▪ spouse, no children: 50% of employee coverage ▪ spouse and children: 40% of employee coverage for spouse & 10% for each child ▪ children only: 15% of employee coverage for each child This is a summary of your benefits. While every effort has been made to ensure the accuracy of this information, complete information on your benefits can be found in the policy contract on the CBS Intranet. Should any difference occur between this information and the contract, the contract will prevail. Updated October 1, 2018 LETTER OF UNDERSTANDING Between: And: Whereas employees not included in the bargaining unit will perform donor screening; Therefore, the parties hereby agree to the following:
Appears in 1 contract
Sources: Collective Agreement
Required Number of Hours. ▪ as per the Collective Agreement Deductible ▪ $15 single/$25 family deductible for drug expenses ▪ nil for all other expenses Combined Maximum ▪ unlimited Coinsurance ▪ Drugs ▪ 100% Hospital ▪ 100% Vision ▪ 100% Other Eligible Expenses ▪ 100% ▪ 100% ▪ 100% ▪ 80% professional and paramedical services ▪ 100% for all other expenses ▪ Drug Features ▪ drugs available only by prescription (plus certain life- life-sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up and dispensing fee maximums by province ▪ Hospital Room ▪ private or semiprivate ▪ semi private Nursing Care ▪ max $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist – Podiatrist – Psychologist/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum ▪ – Acupuncture max of $500 per person per year ▪ – Chiropractor max of $500 per person per year ▪ – Osteopath max of $500 per person per year* ▪ – Massage Therapist max of $500 per person per year ▪ – Naturopath max of $500 per person per year* ▪ – Physio-therapist max of $500 per person per year ▪ – Podiatrist max of $500 per person per year* ▪ – Psychologist/Social Worker max of $1,500 per person per year (effective Oct., 01, 2017) – Speech Therapist max of $500 per person per year ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ Vision Care ▪ max of $250 per person in any 24 consecutive months (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident ▪ extra care (wigs or hairpieces up to $500 lifetime per person) ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment ▪ max of $5 million lifetime per person ▪ PLAN FEATURES Travel Assistance ▪ Included included * Less any amount paid by the government plan DENTAL Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ same as Major MedicalMedical Required Number of Hours same as Major Medical Dental Fee Guide current in province of residence Deductibles Single Family nil nil Coinsurance Part I Preventive 100% Minor Restorative 100% Part II Major Restorative 50% Part III Orthodontic 50% (Eligible Dependent Children only) Orthodontic Dependent Children Age Basis under 19 years old Benefit Maximum Part I – unlimited Part II - $1,500/year Part III - $2,500 lifetime Recall Exam 6 months X-Rays bitewing – once every 6 months full mouth – once every 24 months LONG TERM DISABILITY Premium Cost Sharing as per the Collective Agreement Waiting Period same as Major Medical Participation Basis employee coverage: compulsory dependent coverage: not applicable Required Number of Hours same as Major Medical Benefit Formula less than 4 years of service: 66 2/3% of pre-disability earnings 4 years of service or more: 75% of pre-disability earnings Maximum Benefit $15,000 a month without Evidence of Insurability, $23,000 a month with satisfactory Evidence of Insurability as per Manulife. Qualifying Period 15 weeks or expiration of sick leave credits whichever is greater All Source Maximum 80% of gross pre-disability earnings Definition of Disability 2 years own occupation as per Manulife Indexation of Benefits no Pre-existing Condition Clause yes BASIC LIFE INSURANCE Premium Cost Sharing as per the Collective Agreement Waiting Period same as Major Medical Participation Basis employee coverage: compulsory dependent coverage: not applicable Required Number of Hours same as Major Medical Benefit Formula 1.5x basic annual salary, rounded to next highest $1,000, if not already a multiple of $1,000 Reduction Formula employee at age 65: coverage immediately reduces at age 65 & on each anniversary thereafter to the following percentage of original amount: 85% at age 65 70% at age 66 PLAN FEATURES 55% at age 67 40% at age 68 25% at age 69 Maximum Benefit without evidence: $600,000 with evidence: $1,000,000 combined maximums with Optional Life OPTIONAL LIFE INSURANCE Premium Cost Sharing as per the Collective Agreement Waiting Period same as Major Medical Participation Basis employee coverage: not compulsory dependent coverage: not applicable Required Number of Hours same as Major Medical Benefit Formula 1x or 2x basic annual salary, rounded to next highest $1,000, if not already a multiple of $1,000 Maximum Benefit without evidence: $600,000 with evidence: $1,000,000 combined maximums with Basic Life DEPENDENT LIFE Premium Cost Sharing as per the Collective Agreement Waiting Period same as Major Medical Participation Basis employee coverage: not applicable dependent coverage: not compulsory Required Number of Hours same as Major Medical Benefit Formula Spouse Each Eligible Child $10,000 $5,000 BASIC ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) Premium Cost Sharing as per the Collective Agreement Waiting Period same as Major Medical Participation Basis employee coverage: compulsory dependent coverage: not applicable Required Number of Hours same as Major Medical Benefit Formula 1.5x basic annual salary, rounded to next highest $1,000, if not already a multiple of $1,000 REDUCTION FORMULA employee at age 65: coverage immediately reduces at age 65 & on each anniversary thereafter to the following percentage of original amount: 85% at age 65 70% at age 66 55% at age 67 40% at age 68 25% at age 69 VOLUNTARY AD&D Premium Cost Sharing as per the Collective Agreement Waiting Period same as Major Medical Participation Basis employee coverage: not compulsory dependent coverage: not compulsory Required Number of Hours same as Major Medical Benefit Formula Employee Coverage units of $10,000 to maximum of $500,000 Family Coverage spouse, no children: 50% of employee coverage spouse and eligible children: 40% of employee coverage for spouse & 10% for each child eligible children only: 15% of employee coverage for each eligible child Effective October 1, 2017 Re: Use of Personal Vehicle Given that the use of one’s own vehicle is a bona fide requirement of nurses working at mobile clinics from time to time, it is the expectation of the parties that those nurses will maintain adequate automobile insurance for such use. Dated at Ottawa, Ontario this 14 day of May , 2020. FOR THE EMPLOYER FOR THE UNION “▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇” “▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇” Labour Relations Officer “▇▇▇ ▇▇▇▇▇▇” “▇▇▇ ▇▇▇▇▇▇▇▇▇▇▇” Re: Position of Coordinator, Medical Services, Ottawa The parties hereby agree to the following:
Appears in 1 contract
Sources: Collective Agreement
Required Number of Hours. ▪ as per the Collective Agreement Deductible ▪ $15 single/$25 family deductible for drug expenses ▪ nil for all other expenses Combined Maximum ▪ unlimited Coinsurance ▪ Drugs ▪ 100% ▪ Hospital ▪ 100% ▪ Vision ▪ 100% ▪ Other Eligible Expenses ▪ 100% ▪ 100% ▪ 100% ▪ 80% professional and paramedical services ▪ 100% for all other expenses ▪ Drug Features ▪ drugs available only by prescription (plus certain life- sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up and dispensing fee maximums by province ▪ Hospital Room ▪ private or semiprivate ▪ Nursing Care ▪ max $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist – Podiatrist – Psychologist/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum Acupuncture Chiropractor Osteopath Naturopath Podiatrist Speech Therapist Massage Therapist Acupuncture (performed by physician) Physio-therapist Psychologist/Social Worker ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ n/a ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ ▪ Vision Care ▪ max of $250 per person in any 24 consecutive months (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day Plan Feature ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident ▪ extra care (wigs or hairpieces up to $500 lifetime per person) ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment ▪ max of $5 1 million lifetime per person ▪ Travel Assistance ▪ Included * Less any amount paid by the government plan Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ same as Major Medical
Appears in 1 contract
Sources: Collective Agreement
Required Number of Hours. ▪ as per the Collective Agreement Deductible ▪ $15 single/$25 family deductible for drug expenses ▪ nil for all other expenses Combined Maximum ▪ unlimited Coinsurance ▪ Drugs ▪ Hospital ▪ Vision ▪ Other Eligible Expenses ▪ 100% ▪ 100% ▪ 100% ▪ 80% professional and paramedical services ▪ 100% for all other expenses ▪ Drug Features ▪ drugs available only by prescription (plus certain life- sustaining drugs that do not legally require a prescription) with a valid Drug Identification Number (DIN) ▪ pay direct drug card ▪ includes claims management features such as, dynamic maintenance, generic drug substitution, and reasonable and customary pharmacy ▇▇▇▇-up mark-up and dispensing fee maximums by province ▪ Hospital Room ▪ private or semiprivate semi private ▪ Nursing Care ▪ max $25,000 per person every 3 years ▪ Paramedical – Acupuncture – Chiropractor – Osteopath – Massage Therapist – Naturopath – Physiotherapist Physio-therapist – Podiatrist – Psychologist/Social Worker – Speech Therapist – Massage Therapist ▪ 80% paramedical services to applicable maximum ▪ max of $500 per person per year ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 per person per year ▪ max of $500 per person per year* ▪ max of $500 1,500 per person per year ▪ max of $500 per person per year (effective Oct., 01, 2017) ▪ max of $500 per person per year ▪ Vision Care ▪ max of $250 per person in any 24 consecutive months (frames, lenses, laser) ▪ one eye exam every 2 calendar years (reasonable and customary costs) ▪ Hearing Aids ▪ max ▇▇▇ of $300 per person in any 5 consecutive calendar years ▪ Other ▪ nursing home accommodation – max $20 a day ▪ ambulance services to and from the nearest appropriate medical care ▪ medical supplies and services to specified maximums ▪ accidental dental treatment within 6 months of the accident ▪ extra care (wigs or hairpieces up to $500 lifetime per person) ▪ Emergency Out-of-Country ▪ emergency medical services Plan Features ▪ referral treatment ▪ max of $5 million lifetime per person ▪ Travel Assistance ▪ Included included * Less any amount paid by the government plan Premium Cost Sharing ▪ as per the Collective Agreement Waiting Period ▪ same as Major Medical Participation Basis ▪ same as Major Medical
Appears in 1 contract
Sources: Collective Agreement