The following table is a summary of all your plan. Consult the ‘Welfare & Pension Plans – February 2015’ booklet for more detailed information about your Benefit Plan. Please send all claims directly to London Benefit Payments, address:
London Benefit Payments
PO Box 5160 Station B
London, ON
N6A 0C6
| Active Members | ||
|---|---|---|
| Life Insurance for Member | $100,000 | |
| Life Insurance for Spouce | $15,000 | |
| Life Insurance for Child | $10,000 | |
| Accidental Death & Dismemberment | $100,000 | |
| Short Term Disability (WI) - Maximum 26 weeks (combined with EI sick benefits) | $500/Week | |
| Out of Country Coverage | Unlimited | |
| Active Members over 65 and Retired Members | ||
| Life Insurance for Retired/Active over 65 | $10,000 | |
| Life Insurance for Spouse | $7,500 |
|
| Life Insurance for Child | $5,000 | |
| Out of Country Coverage | $20,000 |
|
| All Members | ||
| Maximum aggregate covered expenses per individual - (excluding Global Medical Assistance covered expenses and Out-of-Country emergency expenses) | $40,000/year $2,000 annually reinstated |
|
| Prescription Drugs - ($15/$30 deductible/year; max $10.50 dispensing fee) | 100% Max. $10,000/calendar year |
|
| Vaccines | ||
| Employee Assistance Program (EAP) - counselling | 1-877-207-8833 | |
| Best Doctors -access to expert medical specialists to make the right decisions about their care. | ||
| Critical Illness -no pre-existing conditions or illnesses are covered, only illnesses diagnoses after Jan. 1/2020 *some exclusions apply. | ||
| Smoking Cessation | $500 max/lifetime per covered person | |
| Hospital - semi private | $240/day maximum | |
| Vision Care - Includes one eye exam Maximum $80 every 24 months | $300/ 24 months | |
| Safety Eyewear (Prescription) ** Provided though Benefits Office and Vision Clinic, Optic House. Contact Benefits Office for form. | $150/ 24 months | |
| Custom Made Orthotics | $500 max/calendar year |
|
| Physiotherapist | $1000 max/calendar year Maximum $60/visit (maximum combined) |
|
| Other Healthcare and Paramedical Services - Chiropractor, Podiatrist, Osteopath, Massage Therapy, Speech Therapy, Acupuncture, Psychologist, Dietician, Naturopath, Chiropodist, Christian Science Practitioner, Masters in Social Work, Registered Psychotherapist | $1,200 max/calendar year Maximum $80/visit (maximum combined) |
|
| Basic Dental Coverage | 100% - unlimited | |
| Major Dental Coverage | 100% - max $1,500/calendar year | |
| Orthodontic Dental Treatment | 67% - max $3,000 lifetime | |
| Accidental Dental Injury | 100% - unlimited | |
| Dental fee guide in effect in your province of residence on date treatment is rendered |