What's New

The following improvements have been made to the Plan effective April 1, 2009:

A new Golden Level has been added for members 75 and over see Golden Level for further information. In addition, any December 31, 2008 producer contribution balances (up to a maximum of $3,298.55) will be placed in a health spending benefit and can be used for reimbursement of any qualifying medical or dental expenses.

Qualifying Medical Expenses commencing April 1st following the members 70th birthday up to the members 75th birthday are limited to an annual maximum of $3,000 per person.

The $450 per individual per year maximum for Orthotic Devices will now be applicable every 2 years.

The Vision care maximum for dependents in Level 03 has been reduced to $150 per dependent every 24 months and Level 04 has been reduced to $250 per dependent every 24 months.  (There is no change to the Vision care maximums for members - $300 for Level 03 and $500 for Level 04 every 24 months).  

The prescription drug coverage provided in Levels 02, 03 and 04, will no longer cover dispensing fee charges. 

Information for Benefit Plan Members

Alcohol and Drug Counseling

Services are provided under the umbrella of the Member Assistance Program (MAP) benefit with Family Services. Counseling is available to provide confidential and professional alcohol, drug and addiction counseling and referral services for you and your family.  Specially trained addiction counselors are available 24 hours a day / 7 days a week by telephoning Family Services’ dedicated toll-free number: 1-800-668-9920.

Generic Drugs

This increase has led physicians and medical institutions across Canada to make more of an effort to prescribe ‘generic’ drugs rather than more costly brand name drugs. Plan sponsors across the country are also working to keep costs to a minimum by offering coverage for generic prescription medications rather than brand name drugs.

What is a generic drug?

When a manufacturer’s patent protection for a brand name drug has expired, other manufacturers are allowed to produce and sell the medication at a lower, more competitive price. These ‘generic’ drugs must pass the same rigorous tests for safety, effectiveness and quality as the brand name form. In order for a generic equivalent of a brand name drug to be approved, it must release its active ingredient into the body at the same rate as the brand name drug. Only non-medicinal ingredients can differ; these are the substances that give drugs their shape and color. The true difference between a generic form and a brand name form is that the brand name drug was marketed first and is usually more expensive.

What does my plan cover?

Your drug plan covers the cost of generic drugs. However, where no generic drug exists, a brand name drug replacement will be provided. Under your plan, if you choose to buy the more expensive brand name drug, or if your doctor specifies “no generic substitutes” the cost will be covered up to the generic equivalent, and you must pay the pharmacist the remaining amount. Before your doctor prescribes a medication for you, it’s a good idea to discuss generic options and your plan coverage so he or she can prescribe your medications appropriately. 

What impact will this change in coverage have on me?

Perhaps the biggest difference you will see is a reduction in the amount of money you spend out-of-pocket on prescription medications. Because the cost of generic medications is significantly lower, the percentage you are required to pay (your co-pay) is lower. For example, if you are a regular user of the asthma drug, Ventolin 1mg/ml Solution, which typically has a unit cost of 0.9655, the generic equivalent Gen-Salbutamol has a unit cost of 0.6083. If you have a 20% co-pay, you will see a savings of $3.93 (This calculation assumes a quantity dispensed of 50ml and a dispensing or professional fee of $7.00. The dispensing fee will vary by pharmacy.)

Because generic drugs must pass the same extensive tests for safety, effectiveness and quality as brand name drugs, there is no need to worry about the effectiveness of the treatment. In most cases, generic drugs are already prescribed where they are available.

This switch to generic prescription drugs will help you contain or even reduce personal and health plan costs, without compromising the quality of your coverage. It will also help plan sponsors ensure the cost of the plan remains affordable.