GM Benefits Report

GM Benefit Report

November 2020 (Active Members) New Contract Update

Please keep this leaflet for your own reference and direct any questions to your Benefit Reps.

PRESCRIPTION DRUGS

Reimbursement 90% of eligible expenses

100% after you incur $310 for 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 $3000 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, 2021 (ODA or licensed denture therapists’ schedule of fees)
Basic Services: 100% of eligible dental expenses
Crowns: Repair or Recementing of Crowns, Inlays, Bridgework or Dentures. 100% of eligible dental expenses
Major Services: 50% of eligible expenses, Initial instillation of fixed bridgework (including Inlays and Crowns as abutments)
Orthodontic 50% of eligible expenses (to a lifetime maximum of $3800 per covered dependent under age 21)
Dental Implants 50% 0f 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)
  $270 for single vision lenses and frames         -$280 for contact lenses
  $325 for bi-focal lenses and frames         -$395 for multi-focal lenses and frames
  $450 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, no Dr referral needed
  Naturopath: $25 per visit to a maximum of $325 each benefit year
  Registered Clinical Psychologist or Master of Social Work (MSW) : $75 per visit to a maximum  of $700 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 assessment)
  Physiotherapist: $50 per visit to a maximum of $200 each benefit year (need Doctor referral)
   

CHILD CARE

Reimbursement: Child Care expanded to include coverage for For-Profit Regulated and Registered Daycare facilities. $16 on Full-day benefits for ages 0-6. $9 on half-Day and before/after school benefits, annual maximum of $3000 per year, per eligible child.
Child Care subsidy of $9 per day for dependent children ages 3 and up to and including 10 who do not qualify for subsidized daycare

 

Durable Medical Equipment

Reimbursement: Continue Glucose monitoring systems added to an annual maximum of $1,600.

 

In Solidarity,

Lawrence Robson – Benefit Rep & Erika Mauro – Alternate Rep

905-682-2611 Union Hall  905-641-6444 In Plant

PRINT THE GM Benefit Report

 

 

 

Leave a Reply