Highlight
of Benefits - January 1, 2007
Supplementary Healthcare Expense
In the event you incur an eligible healthcare expense or
service, you will be paid a percentage (coinsurance) of such expenses or
service in excess of the deductible for that year up to the specific
benefit maximum. Presently there is a $25 deductible per individual and
$50 deductible per family per benefit year (July 1st to June 30th). The
deductible is the portion of the eligible expense or service which you
are required to pay in any benefit year before you receive benefits. As
well the coinsurance levels are as follows: 80% of Prescription Drug
Expenses (up to $25,000 per family per benefit year), 80% of
out-of-Province/Canada referral expenses and 100% of all other eligible
expenses. Some other benefit maximums are as follows: Full Paramedical
up to $200 per benefit year per person although Physiotherapy $600 per
person, etc.
Emergency Travel Medical (ETM)
ETM benefit provides emergency treatment for you and your
eligible dependents while traveling outside of your province of
residence. Coverage per trip is $5 million per person for up to 60 days.
Coverage terminates at the earlier of age 65 or retirement.
Employee Family Assistance Program (EFAP)
EFAP provides coverage for you and your eligible dependents
up to 12 sessions per family per calendar year. Counseling covers
personal difficulties related to work-related stress, family problems,
legal and financial difficulties, alcohol and drug dependencies,
gambling and other addictions, sexual harassment and abuse, etc.
Vision
Eyeglasses, lenses, frames and Prescription Safety Glasses
- $200 per individual every 24 consecutive months (every 12 months for
Dependents under age 18). Eye Examinations - $40 maximum once every
24 consecutive months.
Dental
In the event you incur an eligible dental expense or service,
you will be paid a percentage (coinsurance) of such expenses or service
up to the specific benefit maximum provided the service or expense does
not exceed the Fee Guide for General Practitioners of the Alberta Dental
Association. The coinsurance levels are as follows: 90% for Minor
Services, 50% for Major Services and 50% for Orthodontics. The maximum
combined benefit for Minor and Major is $1,500 per person per benefit
year and $2,000 lifetime maximum for Orthodontics. There are specific
limitations such as standard oral examinations, bite wings x-rays and
cleaning of teeth are limited to once per benefit year.
Life Insurance, Dependant Life and Accidental Death &
Dismemberment (AD&D)
All members are eligible for an amount of Life and AD&D
insurance equal to $40,000. The amount of Insurance reduces to $3,000
at age 65 and terminates at earlier of age 70 or retirement (following
Hour bank depletion and/or self-pay period). Dependant Life coverage
provides up to $5,000 spouse and $2,500 each child.
Disability Insurance
Long Term Disability benefit is $1,500 per month after a 1
year waiting period (i.e. Weekly Income period). The monthly benefit
may be reduced subject to a 75% All Source Maximum. Coverage terminates
the earlier of age 60 or retirement.
Weekly Income benefit is $400 per week. Benefits begin the 1st
day of disability due to an accident and on the 8th day of
disability due to sickness. The maximum duration of benefits is 52
weeks.
This
Information Highlight Sheet does not replace the Booklet or the
Insurance Policy.
If you have any questions or comments please call the Administrator at
1-888-204-1234
