MEMBER LIFE INSURANCE

All Eligible Members

Amount of Insurance

Under age 65

$ 100,000

Age 65 to age 69

$ 50,000

Age 70 and over

$ 5,000

MEMBER ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE

All Eligible Members

Amount of Insurance

Under age 65

$ 100,000

Age 65 to age 69

$ 50,000

Age 70 and over

Nil

MEMBER CRITICAL CONDITION BENEFIT

All Eligible Members

Amount of Insurance

Under age 65

$ 50,000

MEMBER & FAMILY ASSISTANCE PROGRAM

Counseling available through Family Services for you and your family.

MEMBER & FAMILY ALCOHOL & DRUG COUNSELING PROGRAM

Alcohol & Drug counseling services available for you and your family through Family Services.

Co-Insurance (paid by the plan):

90%: of all eligible expenses (except 100% of all eligible out of country emergency expenses).

Maximum - Eligible Members:

Under age 70:

• Unlimited (subject to appropriate benefit maximums shown in benefit booklet).

Age 70 to age 74:

• All health care benefit expenses (except Emergency Out of Country  Coverage, which terminates on March 31st following the Member’s 70th birthday) to an annual maximum of $3,000 per person starting on the April 1st following the Member’s 70th birthday.

Age 75 or over:

• At age 75 you qualify for the Golden Level, your health care benefits and those of your dependents will terminate when you reach age 75 unless you are receiving producer contributions while working. Producer contribution balances up to a maximum of $3,967.31 will be placed in a health spending benefit and can be used for reimbursement of any qualifying medical expense.

HEALTH CARE BENEFITS

BENEFIT MAXIMUMS

Prescription Drugs:

• Manulife Financial: Pay Direct Drug Card,
• drugs available only by prescription, and with the following limits:

• dispensing fee not covered
• to reimburse the least costly course of treatment, whether it is a generic or brand name drug
• the cost of over-the-counter drugs are not covered regardless of whether they have been prescribed or not 

• 90 day supply at one time, once classed as a maintenance drug (no dispensing fee)

Vision Care:

• Prescription lenses (including contact lenses), frames, and the fitting of glasses; up to $500 for member $250 for dependents in any consecutive 24 month period
• Contact lenses for certain specified conditions; up to $200 every 24 consecutive months

• Semi-private hospital room and board charges in excess of ward accommodation up to $10,000 per Plan year

Convalescent Hospital:

• Semi-private room and board charges in excess of ward accommodation in a convalescent home or rehabilitation hospital for a maximum of 180 days per disability

Nursing (out of hospital):

• Private duty nursing for acutely ill patients when not confined to a hospital, based on a minimum of one four hour shift per day to a maximum of $5,000 per Plan year

• To a maximum of $400 per Plan year

Medical Practitioners:

• Up to $600 each per Plan Year for licensed/registered medical practitioners
• Practitioners must meet Income Tax Act and Provincial Legislation requirements

Eye Examinations:

• When no coverage exists under the medicare plan in your province of residence, to a maximum of $40 per examination once every 24 consecutive months

Hearing Aids:

• Purchase, repair or replacement to a maximum of $600 every 5 consecutive Plan years

Orthopaedic Appliances, Custom-made Orthotics & Orthopaedic  Shoes (when the shoes are attached to and form part of a brace):

• When prescribed to a maximum of $450 per individual per Plan year

Orthopaedic Shoes (when not attached to or forming part of a brace):

• When prescribed a to a maximum of $300 per individual per Plan year

Custom-made Orthotics:

• When prescribed a to a maximum of $450 per individual every 2 Plan years

Prosthetic Appliances:

• For initial purchase up to a lifetime maximum of $10,000
• Replacements are only eligible when needed due to changes in physical condition

I U D ’s:

• When prescribed by a licensed physician to a maximum of 2 per Plan year

Fertility Drugs & InVitro Drugs to be covered:

• A predetermination for all expenses over $500 should be done prior to treatment to determine which expenses will be covered. Up to a combined lifetime maximum of $5,000. Eligible Fertility & InVitro procedures may be payable from your health spending account if applicable.

Anti-Smoking Aids:

• Available by prescription only and up to a lifetime maximum of $500

• Up to $5,000 per injury

• All claims incurred outside your province of residence, must first be submitted to your provincial Health Plan for reimbursement. Any eligible unpaid balance may then be submitted to Manulife for payment under the Benefit Plan. The Plan will reimburse eligible health care expenses incurred outside your province of residence, but within Canada, at the same benefit level as expenses incurred within your province of residence.

• Emergency Out of Country expenses (limited to a 90 day absence):

Lifetime maximum - $1,000,000 per person's lifetime

Annual Reinstatement - $10,000 per individual

• Average ward accommodation in Canada
• Benefit terminates on March 31st following the Member’s 70th birthday