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CHANGES TO BENEFITS
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Effective March 1, 2020 – Self-Payments
The Self-Payment rates as of March 1, 2020 are as follows:
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Ontario Residents |
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| Active Age 16 – 64 |
$320.00 |
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$345.60 |
| Active Over 65 |
$241.00 |
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$260.28 |
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| Active on LTD |
$160.00 |
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$172.80 |
| Retired on LTD |
$149.00 |
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$160.92 |
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| Retirees Age 50-54 |
$320.00 |
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$345.60 |
| Retirees Age 55-64 |
$298.00 |
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$321.84 |
| Retirees Age 65 & Over |
$224.00 |
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$241.92 |
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Effective April 1, 2019
Dental Benefits have been updated to provide reimbursement at 90% in accordance with the 2019 Schedule of Fees.
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Effective March 1, 2019 – Self-Payments
The Self-Payment rates as of March 1, 2019 are as follows:
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Ontario Residents |
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| Active Age 16 – 64 |
$312.00 |
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$336.96 |
| Active Over 65 |
$234.00 |
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$252.72 |
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| Active on LTD |
$156.00 |
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$168.48 |
| Retired on LTD |
$145.00 |
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$156.60 |
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| Retirees Age 50-54 |
$312.00 |
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$336.96 |
| Retirees Age 55-64 |
$289.00 |
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$312.12 |
| Retirees Age 65 & Over |
$217.00 |
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$234.36 |
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Effective July 1, 2018
The Board of Trustees confirmed that medicinal marijuana is not a covered expense under the Plan.
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Effective June 7, 2018
The Plan is not considering payment of Libre Diabetic Testing Kits (or other such kits) at this time.
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Effective April 1, 2018
Dental benefits have been updated to provide reimbursement at 90% in accordance with the 2018 Schedule of fees.
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Effective March 1, 2018
All Self-Payments must be made using the Preauthorized Debit Plan. When making your first Self-Payment, your Application and PAD Agreement must be received in the Fund Office prior to losing your Hour Bank.
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Effective January 1, 2017
The waiting period for Weekly Disability benefits has been reduced from 2 weeks to 1 week. The maximum payment duration for Weekly Disability benefits increased to 51 weeks, combined with E.I. Sickness and Accident Benefits.
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Effective January 1, 2017
The following changes were introduced for the prescription drug benefit:
Lower Cost Alternative (LCA) Pricing – The Plan covers 90% of the LCA price for drug categories in which there is a LCA drug. Plan Members who choose the higher cost drug will be responsible for the amounts in excess of the LCA drug cost.
Prior Authorization – Drugs categorized as Prior Authorization drugs require prior approval based on medical diagnosis and form of treatment.
Dispensing Fee Limit – The Plan limits dispensing fees to $13.00.
Fertility Drug Maximum – Fertility drugs are limited to $5,000 per calendar year and $15,000 per lifetime.
The Plan’s maximum remains at $10,000 per person per calendar year. Prescription drugs are administered by NexgenRx.
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Effective June 1, 2015
In the event of a Plan Member’s death, and provided the Plan Member is eligible, the Life Insurance benefit is now $150,000.
Accidental Death benefits increased from $125,000 to $150,000. Accidental Dismemberment benefits also increased. Details can be found in the Plan booklet.
Weekly Disability benefits are $524.00 per week and the Long-Term Disability benefit is now $2,269 per month.
The Vision Care benefit increased to $500 every two calendar years per person.
Eye exams increased to a maximum of $90 for one eye exam in a two calendar year period.
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Effective January 1, 2013
Paramedical expenses will only be covered if medically necessary and must be prescribed by a physician or specialist once per year. Physician referrals are required for services provided by a qualified osteopath, chiropractor, podiatrist, chiropodist, physiotherapist, registered massage therapist, registered acupuncturist, naturopath and Christian Science practitioner. The Plan will also accept Chiropractic referrals from a Chiropractor.
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Effective October 1, 2012
Massage therapy expenses must be performed by an accredited provider. A massage therapist must have 2200 hours /2 years of schooling program in order to be an accredited provider in Alberta.
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MISCELLANEOUS
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Employee Family Assistance Program (EFAP)
Call Toll Free:
| English: | 1-877-207-8833 |
| French: | 1-877-307-1080 |
| or TTY Hearing Assistance: | 1-877-371-9978 |
Lifeworks, by Morneau Shepell provides confidential Employee and family assistance, crisis services 24 hours a day, or to book an appointment for professional counseling services during regular office hours.
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Incapacitated Children
Plan Members who are registering a functionally impaired Dependent child must provide proof of incapacity within 31 days following the Dependent’s 21st birthday. The Dependent child must also meet the requirements for a Dependent child, under the Plan rules.
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