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 |
|