Common use of Health/Dental Benefits Clause in Contracts

Health/Dental Benefits. (a) The Board will contribute one hundred percent (100%) of the cost of the monthly premium of an extended health benefit plan, as detailed in Schedule B attached hereto, for all members who are subscribers, their spouses, and all eligible dependants. This is also to include all future retirees and their spouses and eligible dependants until the retiree reaches the age of 65, with one hundred percent (100%) of the premium paid by the Board, provided that the retiree is in receipt of a pension under the Ontario Municipal Employees Retirement System (OMERS). For the purposes of prescription drugs, generic drugs are to be dispensed if available, unless stipulated otherwise by the physician. (2012) (b) The Board shall provide the Blue Cross Dental Plan 9 or its equivalent, with a nine-month recall for those insured who are eighteen (18) years of age and over. The Board shall pay one hundred percent (100%) of the premium cost for both single and dependant coverage based on the Ontario Dental Association Schedule of Fees of current year less one. This is also to include all future retirees and their spouses and eligible dependants until the retiree reaches the age of 65, with one hundred percent (100%) of the premium paid by the Board, provided that the retiree is in receipt of an OMERS pension. (2014) (c) For orthodontic care, the Board will pay the premiums necessary to provide coverage on a 50/50 co-payment basis, $3,000 lifetime maximum, for each member or dependant. (2009) (d) The Board shall pay one hundred percent (100%) of the premium to provide members and eligible dependants with major restorative services (crowns, dentures, bridges, implants) on the basis of 50/50 co-insurance, to a maximum of $3,000 per insured per year. (2009) (e) Effective January 1, 2018, members shall have access to a health care spending account (HCSA) through the health care benefits insurer in the amount of $250 per calendar year as follows, subject to the provisions for HCSAs under the Income Tax Act. Effective January 1, 2019, this amount shall increase to $300. (1) The annual amount shall be provided on a “per member” basis regardless of the member’s family status. (2) Unused HCSA credits at the end of the year will be added to the next year’s HCSA balance. HCSA credits can be carried over for one year but are forfeited if not used by the end of the second calendar year. (3) Subject to article 11.3(e)(4), members may submit a claim up to 180 days following the end of the plan year in which the expense occurred. (4) A grace period of 180 days applies to expenses from the previous calendar year being eligible for reimbursement from HCSA credits carried over from the previous calendar year. Unused HCSA allocations cannot be reimbursed to members. (5) Eligible expenses will be defined by the Income Tax Act, including a carryover of expenses from the previous year as permitted by the Income Tax Act. (6) Full HCSA allocation will be available for members at the start of each calendar year, but the annual amount shall be prorated on a calendar year basis in the first and final years of entitlement. (7) For members with coverage under a spousal plan, coordination of benefits must be applied prior to HCSA usage. (8) The annual amount is not transferable to a spouse upon the death of the member. (2017)

Health/Dental Benefits. (a) The Board will contribute one hundred percent (100%) of the cost of the monthly premium of an extended health benefit plan, as detailed in Schedule B attached hereto, for all members who are subscribers, their spouses, and all eligible dependants. This is also to include all future retirees and their spouses and eligible dependants until the retiree reaches the age of 65, with one hundred percent (100%) of the premium paid by the Board, provided that the retiree is in receipt of a pension under the Ontario Municipal Employees Retirement System (OMERS). For the purposes of prescription drugs, generic drugs are to be dispensed if available, unless stipulated otherwise by the physician. (2012) (b) The Board shall provide the Blue Cross Dental Plan 9 or its equivalent, with a nine-month recall for those insured who are eighteen (18) years of age and over. The Board shall pay one hundred percent (100%) of the premium cost for both single and dependant coverage based on the Ontario Dental Association Schedule of Fees of current year less one. This is also to include all future retirees and their spouses and eligible dependants until the retiree reaches the age of 65, with one hundred percent (100%) of the premium paid by the Board, provided that the retiree is in receipt of an OMERS pension. (2014) (c) For orthodontic care, the Board will pay the premiums necessary to provide coverage on a 50/50 co-payment basis, $3,000 lifetime maximum, for each member or dependant. (2009) (d) The Board shall pay one hundred percent (100%) of the premium to provide members and eligible dependants with major restorative services (crowns, dentures, bridges, implants) on the basis of 50/50 co-insurance, to a maximum of $3,000 per insured per year. (2009) (e) Effective January 1, 2018, members shall have access to a health care spending account (HCSA) through the health care benefits insurer in the amount of $250 per calendar year as follows, subject to the provisions for HCSAs under the Income Tax Act. Effective January 1, 2019, this amount shall increase to $300. (1) The annual amount shall be provided on a “per member” basis regardless of the member’s family status. (2) Unused HCSA credits at the end of the year will be added to the next year’s HCSA balance. HCSA credits can be carried over for one year but are forfeited if not used by the end of the second calendar year. (3) Subject to article 11.3(e)(4), members may submit a claim up to 180 days following the end of the plan year in which the expense occurred. (4) A grace period of 180 days applies to expenses from the previous calendar year being eligible for reimbursement from HCSA credits carried over from the previous calendar year. Unused HCSA allocations cannot be reimbursed to members. (5) Eligible expenses will be defined by the Income Tax Act, including a carryover of expenses from the previous year as permitted by the Income Tax Act. (6) Full HCSA allocation will be available for members at the start of each calendar year, but the annual amount shall be prorated on a calendar year basis in the first and final years of entitlement. (7) For members with coverage under a spousal plan, coordination of benefits must be applied prior to HCSA usage. (8) The annual amount is not transferable to a spouse upon the death of the member. (2017)

Health/Dental Benefits. (a) The Board will contribute one hundred percent (100%) of the cost of the monthly premium of an extended health benefit plan, as detailed in Schedule B attached hereto, for all members who are subscribers, their spouses, and all eligible dependants. This is also to include all future retirees and their spouses and eligible dependants until the retiree reaches the age of 65, with one hundred percent (100%) of the premium paid by the Board, provided that the retiree is in receipt of a pension under the Ontario Municipal Employees Retirement System (OMERS). For the purposes of prescription drugs, generic drugs are to be dispensed if available, unless stipulated otherwise by the physician. (2012) (b) The Board shall provide the Blue Cross Dental Plan 9 or its equivalent, with a nine-month recall for those insured who are eighteen (18) years of age and over. The Board shall pay one hundred percent (100%) of the premium cost for both single and dependant coverage based on the Ontario Dental Association Schedule of Fees of current year less one. This Effective January 1, 1993, this is also to include all future retirees and their spouses and eligible dependants until the retiree reaches the age of 65, with one hundred percent (100%) of the premium paid by the Board, provided that the retiree is in receipt of an OMERS pension. (20142012) (c) For orthodontic care, the Board will pay the premiums necessary to provide coverage on a 50/50 co-payment basis, $3,000 lifetime maximum, for each member or dependant. (2009) (d) The Board shall pay one hundred percent (100%) of the premium to provide members and eligible dependants with major restorative services (crowns, dentures, bridges, implants) on the basis of 50/50 co-insurance, to a maximum of $3,000 per insured per year. (2009) (e) Effective January 1, 2018, members shall have access to a health care spending account (HCSA) through the health care benefits insurer in the amount of $250 per calendar year as follows, subject to the provisions for HCSAs under the Income Tax Act. Effective January 1, 2019, this amount shall increase to $300. (1) The annual amount shall be provided on a “per member” basis regardless of the member’s family status. (2) Unused HCSA credits at the end of the year will be added to the next year’s HCSA balance. HCSA credits can be carried over for one year but are forfeited if not used by the end of the second calendar year. (3) Subject to article 11.3(e)(4), members may submit a claim up to 180 days following the end of the plan year in which the expense occurred. (4) A grace period of 180 days applies to expenses from the previous calendar year being eligible for reimbursement from HCSA credits carried over from the previous calendar year. Unused HCSA allocations cannot be reimbursed to members. (5) Eligible expenses will be defined by the Income Tax Act, including a carryover of expenses from the previous year as permitted by the Income Tax Act. (6) Full HCSA allocation will be available for members at the start of each calendar year, but the annual amount shall be prorated on a calendar year basis in the first and final years of entitlement. (7) For members with coverage under a spousal plan, coordination of benefits must be applied prior to HCSA usage. (8) The annual amount is not transferable to a spouse upon the death of the member. (2017)

Health/Dental Benefits. (a) The Board will contribute one hundred percent (100%) of the cost of the monthly premium of an extended health benefit plan, as detailed in Schedule B attached hereto, for all members who are subscribers, their spouses, and all eligible dependants. This is also to include all future retirees and their spouses and eligible dependants until the retiree reaches the age of 65, with one hundred percent (100%) of the premium paid by the Board, provided that the retiree is in receipt of a pension under the Ontario Municipal Employees Retirement System (OMERS). For the purposes of prescription drugs, generic drugs are to be dispensed if available, unless stipulated otherwise by the physician. (2012) (b) The Board shall provide the Blue Cross Dental Plan 9 or its equivalent, with a nine-month recall for those insured who are eighteen (18) years of age and over. The Board shall pay one hundred percent (100%) of the premium cost for both single and dependant coverage based on the Ontario Dental Association Schedule of Fees of current year less one. This is also to include all future retirees and their spouses and eligible dependants until the retiree reaches the age of 65, with one hundred percent (100%) of the premium paid by the Board, provided that the retiree is in receipt of an OMERS pension. (2014) (c) For orthodontic care, the Board will pay the premiums necessary to provide coverage on a 50/50 co-payment basis, $3,000 lifetime maximum, for each member or dependant. (2009) (d) The Board shall pay one hundred percent (100%) of the premium to provide members and eligible dependants with major restorative services (crowns, dentures, bridges, implants) on the basis of 50/50 co-insurance, to a maximum of $3,000 per insured per year. (2009) (e) Effective January 1, 2018, members Members shall have access to a health care spending account (HCSA) through the health care benefits insurer in the amount of $250 300 per calendar year as follows, subject to the provisions for HCSAs under the Income Tax Act. Effective January 1, 20192021, this amount shall increase to $300500. Effective January 1, 2022, this amount shall increase to $700. (1) The annual amount shall be provided on a “per member” basis regardless of the member’s family status. (2) Unused HCSA credits at the end of the year will be added to the next year’s HCSA balance. HCSA credits can be carried over for one year but are forfeited if not used by the end of the second calendar year. (3) Subject to article 11.3(e)(411.4(e)(4), members may submit a claim up to 180 days following the end of the plan year in which the expense occurred. (4) A grace period of 180 days applies to expenses from the previous calendar year being eligible for reimbursement from HCSA credits carried over from the previous calendar year. Unused HCSA allocations cannot be reimbursed to members. (5) Eligible expenses will be defined by the Income Tax Act, including a carryover of expenses from the previous year as permitted by the Income Tax Act. (6) Full HCSA allocation will be available for members at the start of each calendar year, but the annual amount shall be prorated on a calendar year basis in the first and final years of entitlement. (7) For members with coverage under a spousal plan, coordination of benefits must be applied prior to HCSA usage. (8) The annual amount is not transferable to a spouse upon the death of the member. (20172020)