INSURANCE BENEFIT PROGRAM. 28.01 The parties agree to continue with the Company paying the full cost of all benefits, the following insurance welfare program. The following is a summary of the plan and the language of the respective policies will govern. Provided by a Life Insurance Carrier or private coverage which will be mirror coverage to the following: A. LIFE INSURANCE Schedule: Flat benefit of $45,000.00 Accidental Death & Dismemberment (AD & D) of $45,000.00 Reduction Provision: Coverage reduces by 100% at age 65. Coverage terminates at the earlier of age 65 or retirement. B. PRESCRIPTION DRUGS Plan: $0 deductible, 100% reimbursement Drugs: Prescription only (Drugs written on prescription, but considered OTC {over the counter} drugs are not covered) Original invoice and proof of payment must be provided to the Company for reimbursement. C. PRESCRIPTION DRUGS - RETIREES Retiring employees, who retire at the age of 65, will continue to be covered by the drug benefit program only, for a normal one month’s supply of drugs for the month that they retire, and a normal one month’s supply for the month following retirement. D. SICKNESS AND ACCIDENT BENEFITS Sickness and accident benefits of $562.00 per week effective Feb. 18, 2019, will be paid from the first day of accident, first day of hospitalization if admitted as an in-patient and hospitalized overnight, or the day following surgery in an outpatient department of a hospital, Doctor’s office or medical clinic and the fourth day of sickness (counted from the first day seen by a medical practitioner) for a period of thirty (30) weeks. This benefit is paid by dividing the weekly rate by seven (7) and the daily rate thus established is paid for each day of entitlement. This Plan is registered with the E.I. and all rebates revert to the Company. If the weekly EI benefit changes this clause will reflect the dollar amount in accordance to EI Regulations. Employees receiving sickness and accident benefits may be examined by a doctor agreed to by the Company and the Union. Doctor's Notes - if requested by Company to allow person to return to work, Company will pay cost of note to a maximum of $20.00. Proof of payment (receipt) required prior to reimbursement. E. VISION CARE (1) This Plan provides the following benefits to subscribers and eligible dependants once in any consecutive twenty-four (24) month period. The total coverage per family member will be $325.00. Original invoice and proof of payment must be provided to the Company for reimbursement. (2) If not covered by a government agency and/or alternate insurance policy, the Company will cover the cost of one eye exam per two-year period, to a maximum of $80.00 per person. Original medical receipt and proof of payment must be provided to the Company for reimbursement This will cover: (1) The actual cost of lenses or frames. (2) Contact lenses when dispensed in lieu of corrective lenses. (3) Orthoptics training. LIMITATIONS: (1) Eyeglasses must be purchased for the sole use of subscriber or eligible dependent. (2) If the subscriber or eligible dependent chooses frames, lenses, contact lenses or orthoptics training costing more than the allotted cost, then the excess charge will be their responsibility. (3) No benefits are eligible unless they are prescribed by a medical doctor, ophthalmologist or optometrist and the purchase is made while coverage is in force. EXCLUSIONS: The following items and charges are not covered vision care benefits. (1) Industrial safety glasses. (2) Charges for expenses covered in whole or in part by the Workers' Compensation Board, any other agency or department of any federal, provincial or municipal government, or any other third party. (3) Repairs of frames which are broken, or replacement of lost frames. F. DENTAL (1) FEES: The following fee schedule will apply: Effective February 18, 2019 - 2018 ODA Fee Schedule Effective February 18, 2020 - 2019 ODA Fee Schedule Effective February 18, 2021 - 2020 ODA Fee Schedule (2) PLAN: Basic 100% co-insurance $2,000.00 maximum per year (covers fillings, cleaning, extractions, etc.) Major 50% co-insurance subject to $2,500.00 maximum. (covers inlays, onlays, crowns, prosthodontics [bridge or denture], surgical services, anti-biotical drugs etc. etc. Bridges or dentures replaced every 3 years, if necessary. Dentures 50% co-insurance once every 3 years. Breaks caused by accident or relining covered 100% when necessary. Ortho 50% subject to $2,000.00 lifetime. As of February 17, 1996, employees shall be employed for two (2) years before being eligible for this benefit. G. DEDUCTIBLE: 0 individual/0 family per calendar year. H DEPENDENT DEFINITION: Spouse, unmarried children from 14 days to age 21. Full-time unmarried students to age 21. I TERMINATION PROVISION: Terminates at age 65. J REIMBURSEMENT OF CLAIMS Eligible receipts should be submitted to the Personnel Department properly completed on the prescribed form, along with proof of payment, no later than sixty (60) days from the date of payment. Coverage of Insurance Benefit Program is in force once the employee is in the Union and Coverage terminates on the employee's last working day. Original invoice and proof of payment must be provided to the Company for reimbursement. K DISCRETIONARY FUND A $500.00 per annum discretionary fund can be used by an employee to absorb any medical expenses not covered by the benefit package, from February 18 to February 17. If any funds are used for a medical item or procedure as recognized by Canada Revenue Agency, upon company receipt of the paid invoice, funds will be reimbursed up to the $500.00 annual limit, on a tax-free basis. If these funds are not fully utilized by the end of the contract year, the remaining fund balance will be paid as a taxable disbursement through payroll within two (2) pay periods.
Appears in 1 contract
Sources: Collective Agreement
INSURANCE BENEFIT PROGRAM. 28.01 The parties agree to continue with the Company paying the full cost of all benefits, the following insurance welfare program. The following is a summary of the plan and the language of the respective policies will govern. .
28.01 Provided by a Life Insurance Carrier or private coverage which will be mirror coverage to the following:
A. LIFE INSURANCE Schedule: Flat benefit of $45,000.00 30,000.00 Accidental Death & Dismemberment (AD & D) of $45,000.00 30,000.00 Reduction Provision: Coverage reduces by 100% at age 65. Coverage terminates at the earlier of age 65 or retirement.
B. PRESCRIPTION DRUGS Plan: $0 deductible, 100% reimbursement Drugs: Prescription only (Drugs written on prescription, but considered OTC {over the counter} drugs are not covered) Original invoice and proof of payment must be provided to the Company for reimbursement.)
C. PRESCRIPTION DRUGS - RETIREES Retiring employees, employees who retire at the age of 65, will continue to be covered by the drug benefit program only, for a normal one month’s monthís supply of drugs for the month that they retire, and a normal one month’s monthís supply for the month following retirement.
D. SICKNESS AND ACCIDENT BENEFITS Sickness and accident benefits of $562.00 425.00 per week effective Feb. 18, 20192004, will be paid from the first day of accident, first day of hospitalization if admitted as an in-patient and hospitalized overnight, or the day following surgery in an outpatient department of a hospital, Doctor’s office or medical clinic and the fourth day of sickness (counted from the first day seen by a medical practitioner) for a period of thirty twenty-six (3026) weeks. This benefit is paid by dividing the weekly rate by seven (7) and the daily rate thus established is paid for each day of entitlement. This Plan is registered with the E.I. and all rebates revert to the Company. If the weekly EI benefit changes this clause will reflect the dollar amount in accordance to EI Regulations. Employees receiving sickness and accident benefits may be examined by a doctor agreed to by the Company and the Union. Doctor's Notes - if requested by Company to allow person to return to work, Company will pay cost of note to a maximum of $20.0010.00. Proof of payment (receipt) required prior to reimbursement.
E. VISION CARE
(1) This Plan provides the following benefits to subscribers and eligible dependants once in any consecutive twenty-four (24) month period. The total coverage per family member will be $325.00. Original invoice and proof of payment must be provided to the Company for reimbursement.
(2) If not covered by a government agency and/or alternate insurance policy, the Company will cover the cost of one eye exam per two-year period, to a maximum of $80.00 per person. Original medical receipt and proof of payment must be provided to the Company for reimbursement This will cover:
(1) The actual cost of lenses or frames.
(2) Contact lenses when dispensed in lieu of corrective lenses.
(3) Orthoptics training. LIMITATIONS:
(1) Eyeglasses must be purchased for the sole use of subscriber or eligible dependent.
(2) If the subscriber or eligible dependent chooses frames, lenses, contact lenses or orthoptics training costing more than the allotted cost, then the excess charge will be their responsibility.
(3) No benefits are eligible unless they are prescribed by a medical doctor, ophthalmologist or optometrist and the purchase is made while coverage is in force. EXCLUSIONS: The following items and charges are not covered vision care benefits.
(1) Industrial safety glasses.
(2) Charges for expenses covered in whole or in part by the Workers' Compensation Board, any other agency or department of any federal, provincial or municipal government, or any other third party.
(3) Repairs of frames which are broken, or replacement of lost frames.
F. DENTAL
(1) FEES: The following fee schedule will apply: Effective February 18, 2019 - 2018 ODA Fee Schedule Effective February 18, 2020 - 2019 ODA Fee Schedule Effective February 18, 2021 - 2020 ODA Fee Schedule (2) PLAN: Basic 100% co-insurance $2,000.00 maximum per year (covers fillings, cleaning, extractions, etc.) Major 50% co-insurance subject to $2,500.00 maximum. (covers inlays, onlays, crowns, prosthodontics [bridge or denture], surgical services, anti-biotical drugs etc. etc. Bridges or dentures replaced every 3 years, if necessary. Dentures 50% co-insurance once every 3 years. Breaks caused by accident or relining covered 100% when necessary. Ortho 50% subject to $2,000.00 lifetime. As of February 17, 1996, employees shall be employed for two (2) years before being eligible for this benefit.
G. DEDUCTIBLE: 0 individual/0 family per calendar year. H DEPENDENT DEFINITION: Spouse, unmarried children from 14 days to age 21. Full-time unmarried students to age 21. I TERMINATION PROVISION: Terminates at age 65. J REIMBURSEMENT OF CLAIMS Eligible receipts should be submitted to the Personnel Department properly completed on the prescribed form, along with proof of payment, no later than sixty (60) days from the date of payment. Coverage of Insurance Benefit Program is in force once the employee is in the Union and Coverage terminates on the employee's last working day. Original invoice and proof of payment must be provided to the Company for reimbursement. K DISCRETIONARY FUND A $500.00 per annum discretionary fund can be used by an employee to absorb any medical expenses not covered by the benefit package, from February 18 to February 17. If any funds are used for a medical item or procedure as recognized by Canada Revenue Agency, upon company receipt of the paid invoice, funds will be reimbursed up to the $500.00 annual limit, on a tax-free basis. If these funds are not fully utilized by the end of the contract year, the remaining fund balance will be paid as a taxable disbursement through payroll within two (2) pay periods.
Appears in 1 contract
Sources: Collective Agreement