Health And Welfare Benefits - Benefits At A Glance

Dental

  • 100% for preventative and routine services (such as exams, polishing, routing scaling, extractions, basic surgery).
  • 100% for minor restorative (such as stainless steel crowns, fillings, gum surgery, root canal).
  • 100% prosthodontic services (such as dentures, bridges)
  • 50% for major restorative (such as inlays, onlays, crowns); and
  • 50% for orthodontics (such as braces). ***UPDATE***
  • $1,500 maximum per covered person, per year for all dental services combined.
  • Payment of claims is based on the fee guide that was in place two years before the Ontario Dental Association's current fee guide.


Drug

  • 100% for Level 1 formulary drugs (based on the Ontario government's drug formulary, and includes at least one drug for every medical condition);
  • 80% for Level 2 formulary drugs (any drug not included in Level 1 coverage); and
  • 80% for maintenance drugs (those you are required to take for a long period of time) not purchased through Alliance Pharmacy Group, regardless of Level 1 or Level 2 status.
  • You must pay all pharmacy dispensing fees.
  • Overall maximum of $20,000 per year, per covered person for all health benefits, including drugs.


Health

  • Eligible expenses not covered by OHIP are reimbursed at 100%
  • Accidental dental
  • Ambulance (one way only)
  • Convalescent hospital
  • Diagnostic and outpatient services provided in a hospital
  • Hearing aids (excluding costs for testing, repairs and batteries)
  • In home care by a registered nurse, with Green Shield Canada approval
  • Medical aids and appliances authorized by a doctor
  • Medical Alert bracelet, with Trustee approval
  • Paramedical - acupuncturist, chiropractor, chiropodist, Christian Science practitioner, naturopath, osteopath, podiatrist or massage therapist if prescribed by a doctor. Note: Massage therapist is covered only for the plan member, and must be performed by a registered massage therapist.
  • Psychological assessments by a registered clinical psychologist, if prescribed by a doctor (excludes treatment)
  • Physiotherapy, if prescribed by a doctor
  • Prosthetics, if authorized by a doctor.



Vision
Up to $300 for one pair of single vision, bi-focal, tri-focal lenses, frames, safety glasses and eye examination

  • Once per calendar year (January - December) for active members
  • Once every two calendar years for dependents, retirees with reduced coverage and surviving family

OR

  • One set of contact lenses per covered person, per calendar year.


Travel Medical

  • Reasonable expenses for services and supplies required because of a medical emergency while you or your family are traveling outside of your home province or territory
  • Coverage is for a maximum of 90 days and up to $1 million per person, per calendar year.

Short term disability

  • Disability due to injury or illness not related to work
  • Benefit is only payable if Employment Insurance (EI) is denied or has been exhausted
  • Weekly benefit of $450
  • If you are disabled for less than a week, the daily benefit rate is $90
  • Waiting period for illness of 7 days
  • No waiting period for injury
  • Maximum disability period is 26 weeks
  • Benefit payments are considered taxable income

Long term disability

  • Disability that extends beyond a period of 26 weeks of STD
  • Maximum monthly benefit of $2,400
  • Maximum benefit period is the last day of the month in which you reach age 62
  • Benefit payments are considered taxable income


Life insurance

  • $20,000 benefit payable to your names beneficiary (ies) or estate; $10,000 for local 666 retirees.
  • Advance life insurance payment of up to 50% ($10,000) of your coverage is available for terminal illness with less than two years to live. This amount will be deducted from final payment made to your beneficiary (ies) after your death.
  • Life insurance applies to the member's life only.