Out-of-Country Medical Coverage Sample Clauses

Out-of-Country Medical Coverage. 34.9.1 Effective January 1, 2018, the Employer will provide all employees with the option to enrol in in out-of-country medical coverage. Employees who choose to enrol in this coverage will be responsible for 100% of the monthly premium.

Out-of-Country Medical Coverage. Emergency OOC claims are covered at 100%. Coverage includes Out-of-Province emergency medical, doctor’s fees, hospital charges etc. over and above provincial health plan. There is a $5,000,000 lifetime maximum for each covered person, and no person over age 80 will be covered. Trips are limited to a maximum of sixty (60) consecutive days. Coverage terminates upon member’s attainment of age 80 or earlier retirement. DENTAL BENEFITS Fee Guide: Dental services are covered up to fee listed in the current year’s Ontario Dental Association (ODA) suggested fee guide, subject to the provisions below. Coinsurance: Basic Dental Services are payable at 100%. Major Dental Services are payable at 50%. Orthodontic Services are payable at 50% (for dependent children under age 19 only). Maximum: Basic and Major Dental Services have a combined maximum of $2,000 per covered person per calendar year. Orthodnotic Services have a maximum of $2,500 per lifetime. Termination: Coverage terminates upon the member’s retirement. Covered Charges Covered charges are those for needed dental care, services or supplies, as described below and received while the Member is covered, for either a disease or injury that is non-occupational. The following services or supplies are covered subject to benefit maximums: Basic Dental Services:  Oral exams, including scaling and cleaning of teeth, but not more than once every 6 months;  Periodontal scaling and/or root planning (limited to 10 units per year for all procedures combined);  Occlusal adjustments/equilibration (limited to 8 units per year);  Topical applications of sodium or stannous fluoride but not more than one application every 6 months;  Dental x-rays, except that bite-wing x-rays are limited to one set every 6 months;  Fillings;  Extractions;  Oral surgery, including excision of impacted wisdom teeth;  Antibiotic drug injections;  Anaesthesia and its administration in connection with oral surgery or other covered dental services;  Space maintainers, including stainless steel crowns for primary teeth that have several cavities which would otherwise require fillings or which are non-restorable using normal restorative dental material;  Repair, relining, or rebasing of dentures;  Repair, resurfacing or re-cementing of crowns, inlays, onlays or bridges;  Periodontic treatment for disease of the bone and gums of the mouth, including tissue grafts and occlusal guards, but not athletic guards; and  Endodontic treatment, incl...