Overall Benefits Plan New Plan Current Plan Who is eligible Mandatory Health and Dental for Available to all teachers. 1.0 FTE members Mandatory basic life insurance. Voluntary Health and Dental for permanent members and eligible Accidental Death and LTOs working less than 1.0 and for Dismemberment was members on non-status leaves available, at the teacher’s expense. Mandatory Basic Life and AD&D for all active permanent members and eligible LTOs.
Medical Supplies and Services New Plan Current Plan Ambulance Transport to/from nearest facility same Includes air ambulance Glucometers $150/benefit year No limit Hearing Aids $1000/ 5 benefit years $1500/ 5 benefit years Orthotics $350/ benefit year One pair per calendar year Orthopaedic Shoes Two pairs/benefit year (custom) $500 max/pair Orthopaedic Shoes $500/benefit year for modifications (stock) and adjustments
Medical Supplies and Services New Plan Current Plan Private Duty Nursing $50 000/benefit year No limit Surgical stockings 6 pairs /benefit year $250 Wigs $500 lifetime max same
Paramedical ($max/benefit year) New Plan Current Plan No per visit fee cap $50/visit max No deductible $10/individual, $20/family ded. Chiropractor/ $1000 combined/benefit year $450 each Osteopath Dietician/Nutritionist $500 combined/benefit year No coverage Massage Therapist $1000/ benefit year (doctor’s $450/ benefit year (no referral referral required) required) Naturopath $1000/ benefit year $450 Physiotherapist/ $1000 combined Physiotherapist - $450 Athletic Therapist/ Athletic Therapist, Occupational Occupational Therapist Therapist - no coverage
Paramedical ($max/benefit year) New Plan Current Plan No per visit fee cap $50/visit max No deductible $10/individual, $20/family ded. Podiatrist/ $450 combined/benefit year same Chiropodist Psychologist, $1500 combined/benefit year $450 Marriage and Family Therapist, Registered Social Worker Speech-Language $1000/ combined/ benefit year Speech therapy - $450/ benefit Pathologist, year Communicative Audiologist - no coverage Disorders Assistants, Audiologist
Hospital New Plan Current Plan Hospital room semi-private Private room Semi-private room in covered Covered private OHIP-funded facilities (for example, the Shouldice Hospital, Homewood
Vision Care New Plan Current Plan Glasses, contact $500 max/2 benefit years $500 max /2 benefit years lenses, laser eye (1 benefit year for children ($250 /year for children under surgery under 18) 18) Laser eye surgery is included Laser eye surgery - one time in this. payment of $725 Eye exams Once every 2 years, cost is Once every 24 months included in the above $500 max Visual Training $200 lifetime Visual therapy and remediation exercises under care of opthamologist - no limit
Travel Medical (out of Canada) New Plan Current Plan Emergency medical 100% 100% with some limitations services Up to 60 days/trip Up to 180 days/trip $5 million lifetime max $5 million lifetime max
Life and Accident Insurance New Plan Current Plan Basic Life 1x annual salary to $400 000 $25 000 or 1,2,3,4x salary as max combined selected by teacher 50% reduction at age 65 Upon retirement, until age 65 Ends at retirement members could remain in plan Supplemental Life Option of 1 or 2x annual Additional coverage to max of salary to $400 000 max comb. $500 000 available. 50% reduction from age 65 Combined max $525 000 Maximum combined with Basic Life Ends at retirement Member paid Accidental Death and Coverage matches Life Max $350 000 Dismemberment 50% reduction from age 65 Member paid Ends at retirement or age 70 Medical evidence required (whichever comes first)
Life and Accident Insurance New Plan Current Plan - Spousal Optional Life and AD&D - AD&D available to coverage up to $400 000 teachers, to a max of Spousal/ $350 000, member paid Partner - Spousal Optional Life ends at member’s Optional Life retirement or when spouse reaches age - Spousal optional life and AD&D 65, whichever comes first insurance available up to $100 000 Child Optional - Spousal Optional AD&D ends when Life member retires or reaches age 70, or - Dependent Optional life spouse reaches 65, whichever comes first coverage available up to $50 000 - Child Optional Life coverage up to $25 000, member-paid - Coverage remains upon retirement, until age 65. Member paid
Prescription Drugs New Plan Current Plan Pay direct benefits Yes Yes card Deductible $2 deductible/prescription $10/year per person $20/year per family Dispensing fee max $11 Not specified Limits Maintenance medications limited to 7 dispensing fees/prescription/12 months Also included Diabetic supplies, preventative Diabetic supplies, vaccines, Fertility drugs up to $12 000 vaccines, fertility drugs lifetime max. (no limit), anti-obesity drugs
Dental Insurance New Plan Current Plan Basic dental 100% of check ups, x-rays, fillings, other Same Recall exams: every 9 months - adults Full xrays, exams Every 6 months - children under 19 every 3 years Full exams and xrays once every 24 months Periodontic/ 100% of root canals and related Same Endodontic services 100% of scaling, root planing, gum 8 units every 12 treatments, etc. months 14 units of scaling and root planing combined/benefit year
Dental Insurance New Plan Current Plan Major restorative 60% of crowns, bridges, dentures, 50% of costs services implants, inlays, onlays No maximum $2000 max/benefit year Crown, onlays or denture replacement once every 5 benefit years Dental implant max: lowest cost alternative treatment option Orthodontics 50% coverage for adults and children 50% $3500 lifetime max $3000 lifetime max
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