GM Benefit Report (Active) |
|
| Happy New Year everyone. As result of our recent negotiations there have been some gains made to our HC Benefits . | |
| Please keep this leaflet for your own reference and direct any questions to your HC Benefit Reps . | |
Prescription Drugs |
|
| Reimbursement | 90% of eligible expenses |
| 100% after you incur $310 in out-of-pocket expenses | |
| Coverage limited to: -The cost of the lowest-priced generic drug (or brand name drug if lower) | |
| -Drugs listed on the “Controlled Drug Formulary” or by special Authorization | |
| Dispensing fees | 90% of the actual dispensing fee, to a maximum of $9 per prescription |
| Over the Counter Drugs | Eliminated effective January 1, 2013 (other than certain life-sustaining drugs) |
Dental Care |
|
| Maximum Benefit | $2800 per person each benefit year (October 1 – September 30) for basic services, crowns |
| and major services combined. | |
| Fee Guide | 1 year rolling lag, effective January 1, 2017 (ODA or licensed denture therapists’ schedule of fees) |
| Basic Services | 100% of eligible dental expenses |
| Crowns | 100% of eligible dental expenses |
| Major Services | 50% of eligible expenses |
| Orthodontic | 50% of eligible expenses (To a lifetime maximum of $3600 per covered dependent under age 21) |
| Dental Implants | 50% of eligible expenses for standard implantology including the structure, installation, and |
| crown (initial and replacement) | |
Vision Care |
|
| Reimbursement | Routine eye exams up to $85 every 24 months (if OHIP plan excludes coverage) |
| Plan maximum depends on lens type (once every 24 months per person) | |
| -$220 for single vision lenses and frames -$230 for contact lenses | |
| -$275 for bi-focal lenses and frames -$345 for multi-focal lenses and frames | |
| -$345 for laser eye surgery (one time) | |
Paramedical Services |
|
| Reimbursement | Chiropractor: $25 per visit to a maximum of $465 each benefit year |
| Chiropodist/Podiatrist: $11.45 per visit to a maximum of $325 each benefit year | |
| Massage Therapist: $45 per visit to a maximum of $200 each benefit year | |
| Naturopath: $25 per visit to a maximum of $325 each benefit year | |
| Registered Clinical Psychologist or Master of Social Work (MSW) : $50 per visit to a maximum | |
| of $625 per calendar year. Master of Psychology recognized for counselling Services | |
| Speech Therapist: Up to $1100 per calendar year (Including up to $125 for the initial accessment) | |
| Physiotherapist: $50 per visit to a maximum of $200 each benefit year (need Doctor referral) | |
Child Care |
|
| Reimbursement | Child Care subsidy of $6 per day for dependent children ages 3 and up to and including 10 who |
| do not qualify for subsidized daycare | |
| In Soildarity, | |
| Mark Roy/905 641 6444 Lawrence Robson 905 641 6444 | |