GROUP INSURANCE COVERAGE SUMMARY GARANTIES. Multi-employer Group Insurance Program FNQBN-RBA

Transcription

1 GROUP INSURANCE COVERAGE SUMMARY GARANTIES Multi-employer Group Insurance Program FNQBN-RBA March 2014

2 Multi-employer Group Insurance Plan RAPNQ- RBA of Insurance Coverage Basic life insurance Member Option 1 1 time annual salary Option 2 2 times annual salary Maximum amount Without proof: $100,000 With proof: $200,000 Reduction 50% at age 65 Dependents $5,000 spouse $2,500 dependent child Long-term disability coverage waiting period End of coverage Accidental death or dismemberment Member Same amount as basic life insurance Same as basic life insurance Critical illness coverage Member,000 None Dependents,000 dependent child End of coverage On the 65 th birthday Short-term disability coverage Member: Option 1 Native: 70% (non-taxable) Non-native: 66.67% (taxable) Waiting period Duration of benefits Taxation of benefits End of payment of benefits End of coverage Option 2 Native: SUB - 75% (non-taxable) Non-native: SUB - 70% (taxable) Accident: 14 days Hospitalization: 14 days Illness: 14 days 17 weeks Taxable or non-taxable Same as basic life insurance Long-term disability coverage Member: Option 1 Native: 70% (non-taxable) Non-native: 60% (non-taxable) Waiting period Option 2 End of own occupation period for definition of total disability Taxation of benefits End of payment of benefits Age 65 End of coverage Age 65 Native: 75% (non-taxable) Non-native: 66 2/3% (non-taxable) Accident: 133 days Hospitalization: 133 days Illness: 133 days 24 months after a same total period of disability Non-taxable Same as basic life insurance 2

3 Multi-employer Group insurance Plan of Insurance Coverage Health insurance Choice 1 Choice 2 Costs exempt from deductibles and reimbursed Hospitalization Semi-private room Semi-private room Travel insurance $5,000,000 /insured person $5,000,000 /insured person Travel assistance 24 hours 24 hours Travel cancellation $5,000 /insured/trip $/insured/trip Prescription drugs and other care Choice 1 Choice 2 Annual deductible Individual Family Single parent $50 $100 $100 Co-insurance 75% Payment card Direct Direct Annual deductible Combined with prescription drugs Prescription drugs 75% Sclerosing injection $20 / treatment $20 / treatment IUD 75% Vision care Choice 1 Choice 2 Combined with prescription drugs Eyeglasses, laser eye treatment*, contact lenses Combined maximum of $200 eligible / 24 months - Combined maximum of $200 eligible / 24 months - Healthcare professionals Choice 1 Choice 2 Co-insurance Maximum per visit for all paramedical treatment Admissible maximum of $35 / visit Admissible maximum of $35 / visit Orthotherapist Kinesitherapist $500 per calendar year for all $300 per calendar year for all Massage therapist Acupuncturist $500 per calendar year $300 per calendar year Homeopath and homeopathic remedies $500 per calendar year $300 per calendar year Dietician $500 per calendar year $300 per calendar year Naturopath $500 per calendar year $300 per calendar year Occupational therapist $500 per calendar year $300 per calendar year Chiropractor $500 per calendar year $300 per calendar year X-rays (chiro) $50 per calendar year $50 per calendar year Audiologist $500 per calendar year $300 per calendar year Speech therapist $500 per calendar year $300 per calendar year Osteopath $500 per calendar year $300 per calendar year Physiotherapist and physical rehabilitation therapist $500 per calendar year for all $300 per calendar year for all Psychologist, psychiatrist, psychoanalyst and social $500 per calendar year for all $300 per calendar year for all worker Podiatrist $500 per calendar year $300 per calendar year Other medical costs Choice 1 Choice 2 Insulin pump accessories* Ambulance Transport by airplane or train* Laboratory analyses* Hearing aid $600 / 48 months- $600 / 48 months - Respirator (breathing apparatus)* $10,000 for duration of contract - $10,000 for duration of contract - 3

4 Other medical costs (continued) Choice1 Choice 2 Orthopedic devices* Therapeutic appliances* $10,000 for duration of contract - $10,000 for duration of contract - Ostomy appliances* Support stockings* 3 pairs/calendar year per 3 pairs/calendar year per insured person - insured person - Orthopaedic shoes* Deep shoes* $100 / calendar year - $100 / calendar year - Dental surgery following an accident to the natural in the 12 months following in the 12 months teeth the accident following the accident Cosmetic surgery following an accident* $5,000 in the 36 months following the accident $5,000 in the 36 months following the accident Detoxification treatment* $80/day, $2,500 for duration of contract - $80/day, $2,500 for duration of contract - Ultrasound* $300 /calendar year per insured person $300 /calendar year per insured person Electrocardiogram* Wheelchair and walker* Blood glucose monitor* $300 /36 months/insured person $300 /36 months/insured Nursing care* - $300 /day, $10,000 per calendar year/insured person - person - $300 /day, $10,000 per calendar year/insured person - Intraocular lenses implants* $1,000 for the duration of the contract - $1,000 for the duration of the contract - Hospital bed* Convalescent home* Semi-private 60 days / calendar year - Semi-private 60 days / calendar year - Transcutaneous electrical nerve stimulator* $1,000 /60 months - $1,000 /60 months - Foot orthoses* $525 /pair - $525 /pair - Insulin pump* $10,000 for duration of contract - $10,000 for duration of contract - Hairpiece following chemotherapy $300 for duration of contract - $300 for duration of contract - External prosthesis and artificial limb $5,000 /prosthesis - $5,000 /prosthesis - Breast prosthesis* $1,000 / 24 months - $1,000 / 24 months - X-rays* Magnetic resonance imaging* $1,000 /calendar year - Surgical brassiere* $200 for duration of contract - CAT scans* $1,000 /calendar year - Other provisions Termination Upon retirement Upon retirement *Medical Prescription required *Health insurance (Non-native): Multi-employer Group insurance Plan of Insurance Coverage $1,000 /calendar year - $200 for duration of contract - $1,000 /calendar year - If you are eligible for private coverage, you are obliged to subscribe to this plan and cover your spouse and children if they are not already covered by such a plan. If you become eligible for a private coverage while you are covered by the public drug insurance program, you must unsubscribe to the public plan and subscribe to the private plan. 4

5 Multi-employer Group Insurance Plan of Insurance Coverage Health insurance Native Plan 1 Choice 1 Costs exempt from deductibles and reimbursed Hospitalization Travel insurance Travel assistance Travel cancellation insurance Semi-private room $5,000,000 /insured person 24 hours $5,000 /insured/trip Vision care Eyeglasses, laser eye treatment*, contact lenses Combined maximum of $200 / 24 months - *Prescription required Dental care coverage Annual deductible Individual Family Single parent Co-insurance Diagnostic, prevention and space maintainers Minor restorative services Endodontics Periodontics Rebase, reline, adjustment and repair of removable dentures Repair of fixed bridges and crowns Oral surgery Complementary general services Extensive restoration and fixed prosthesis Recall examination Maximum reimbursement Reimbursement Termination Base 1 examination per 6 months $1,500 the first year $1,500 per subsequent year Dental care payment card 5

6 Multi-employer Groups Insurance Plan Services offered DIAGNOSIS + If you are diagnosed with a critical illness, it will be one of the most difficult situations that you and your loved ones will ever have to face. Diagnosis+ provides reassurance by helping you to obtain a confirmation of your diagnosis and where applicable, the treatment options available to you. Diagnosis+ will provide your physician with unique resources and the expertise of a highly qualified specialist. A medical specialist and team from the McGill University. We are sure that your physician has your best interests at heart and will appreciate the possibility of obtaining the most up-to-date information about your health condition. Medical Conditions Covered Stroke and related conditions Severe burns Coma Alzheimer s disease Parkinson s disease Cardiovascular disease and heart attack Loss of eyesight HIV/AIDS Vital organ transplant Other life-threatening conditions Diseases of the musculoskeletal system Cancer Kidney failure Neurological degenerative diseases (e.g., multiple sclerosis) Diseases requiring amputation Acute bone and lung disease Loss of speech Deafness Severe trauma Services offered HEALTH SUPPORT SERVICE Health support Service can provide assistance to employers. Several resources are available to you: How to find out if an employee is at risk of absenteeism Consult our online videos Telephone counselling services for managers within the organization Maximum 1.5 hours per consultation, unlimited number of consultations Intervention in crisis situations Support available 24/7 6

7 Multi-employer Group Insurance Plan Services offered HEALTH SUPPORT SERVICE As an employee, the Health Support Service can help you with various situations, such as: Stress or anxiety Difficulties at work Depression Marital or family problems Addiction Financial or legal problems Diabetes, obesity or other physical problems, etc. 3 hours of telephone counselling 6 hours of counselling at an office or on a secure website 1 hour of legal or financial counselling Completely confidential Support available 24/7 CUSTOMER SERVICE RBA Claudine Rhéaume ext. 228 claudine.rheaume@rbagroupefinancier.com Nathalie Morel ext. 250 nathalie.morel@rbagroupefinancier.com Yvan Déry ext. 245 yvan.dery@rbagroupefinancier.com Toll free: