Extended Health Services Plan. Prescription Drugs - $2.00 co-pay per occurance for life of contract -Extended Health Care - 100% co-insurance -Private Duty Nursing Benefits carry a maximum of $5,000. -Contributions - $1.00 per week - Single, for life of contract - $2.00 per week - Family, for life of contract
Extended Health Services Plan. This Extended Health Services Plan incorporated into and forms part of the Group's Schedule of Eligible Services which forms part of the Green Shield Benefit Plan Group Agreement. Refer to the General Information and Outline of Benefits in your Employee Benefit Booklet for additional maximums, limitations and general exclusions which may apply. Eligible Services shown below will not be eligible unless they are usual, reasonable and customary taking all factors into account, and are medically necessary for the treatment of an illness or injury. Drug benefits may be subject to a different payment. Refer to the Outline of Benefits for details. SCHEDULE OF ELIGIBLE SERVICES Accidental Dental Coverage, charges incurred for care or services by a dentist for the repair or replacement of teeth which are broken as a result of a direct accidental blow to the mouth (and not by an object intentionally placed in the mouth). Benefits will be paid in accordance with the Ontario Dental Association Suggested Fee Guide for General Practitioners in effect at the time of treatment. Treatment must commence within ninety days following the date of the accident and the care or services completed within one year from such date. Reimbursement will be made up to the fees set out in the General Practitioners Fee Guide in effect on the date of treatment. A Dental Accident Report Form and your dental x-rays must be submitted to Green Shield for prior approval. Failure to comply may result in non-payment. Ambulance Transportation, when required as the result of an accident or acute physical disability by professional land ambulance. Blood and Blood Products when required for transfusions. Laboratoryand Diagnostic Services, when done for the diagnosis of an illness. Hospital Accommodation Private Hospital, accommodation charges in a licensed hospital up to a lifetime maximum of per day for days. Paramedical Services Physiotherapist equal to the allowed amount by the Ontario Health Insurance Plan. Clinical Psychologist for the first visit and per hour for subsequent visits up to a maximum of per calendar year. Speech up to a maximum of per calendar year. A certificate must be provided to Green Shield by your attending physician indicating the medical necessity of the treatment. O Registered Massage Therapist per treatment up to a of treatments per calendar year. A certificate must be provided to Green Shield by your attending physician indicating the medical necessity of the treatment. O...
Extended Health Services Plan. Prescription Drugs w-pay per occurrence effective June co-pay per occurrence effective April -Extended Health Care co-insurance -Private Duty Nursing Benefits carry a maximum of -Contributions per week Single, for life of contract per week Family, for life of contract 2 Vision Plan months for prescription glasses and/or contact lenses months for medically necessary contact lenses Audio Plan Plan years Out-Of-Province Plan Dental Plan of Fee Guide effective April to March of Fee Guide effective April to March of Fee Guide effective to March of Fee Guide effective April to March of Fee Guide April to March single or family deductible per year for the life of the contract The Company shall pay the premium costs covering the following items for seniority employees only. The Company reserves the right to the carrier of each plan.
