MAJOR MEDICAL EXPENSE BENEFIT. Basic medical benefits are provided for you and your family under your provincial health plan (OHIP). The major medical expense benefit under the Company's group insurance plan provides benefits for you and your covered dependents for certain expenses not covered by the provincial hospital and medical plans. Expenses allowed under the major medical expense benefit are listed below. Benefits are payable only if the services are recommended by a physician and if provincial legislation does not prohibit insurance of any such expense. π drugs and medicines (except over-the-counter drugs) dispensed on the written prescription of a physician. Reimbursement will be based on the cost of the generic equivalent of a prescription drug, if such an equivalent exists. You will receive full reimbursement of a brand name drug only if a generic equivalent does not exist, or if your physician provides specific instructions prohibiting substitution. π private duty nursing by registered graduate nurses who are not ordinarily resident in your home and are not related to you or your dependents π hospital charges for other than room and board not paid by the provincial plan π oxygen and its administration π blood and blood plasma π rental of wheel chair, hospital bed or respirator/ventilator π splints, trusses, braces, crutches, casts π artificial limbs and eyes provided the loss of the natural limb or eye occurred while insured under this plan π services of duly qualified and licensed physiotherapists other than members of the insured's family π local ambulance services π emergency transportation by a licensed ground ambulance, including air ambulance, to and from the nearest hospital in which treatment can be provided (subject to one round trip per calendar year). π services of a licensed chiropractor or osteopath when operating in their recognized field of expertise (eligible only after provincial plan maximum has been reached). π services provided by the following: Acupuncturist, Podiatrist, Homeopath, Massage Therapist, Naturopath, Psychologist, Speech Therapist. All practitioner services are reimbursable only after any applicable provincial plan maximum has been reached and subject to a total annual maximum benefit of $500 for such services. π frames, lenses and the fitting of any type of prescription glasses (including contact lenses), when prescribed by a physician or optometrist up to a total payment of $250.00 every twenty-four (24) months for each eligible insured per...
MAJOR MEDICAL EXPENSE BENEFIT. Claim must be submitted no later than the end of the calendar year following the year in which the expense was incurred except that, when your insurance is cancelled for any reason, proof of claim must be submitted within (90) days of the date of termination of your insurance. Itemized bills and statements showing the patient's name, dates of service, prescription numbers for drug expenses and amount of the charges, must accompany the claim form verifying all such expenses including those which you have paid to satisfy the deductible. It is suggested that such claims not be submitted until the total bills exceed the deductible by at least $10.
MAJOR MEDICAL EXPENSE BENEFIT. Basic medical benefits are provided for you and your family under the Provincial Medical Plan in your province of residence. The Major Medical benefit under the company's Group Insurance Plan provides benefits for certain expenses not covered by the basic medical and hospital plans. Expenses allowed under the Major Medical Expense Benefit are listed below. Benefits are payable only if the services are ordered by a physician and if provincial legislation does not prohibit insurance of any such expense. The plan provides for 80% reimbursement of allowable expenses up to a lifetime maximum of $300,000 per person including prescription drug benefits. However, chiropractic and psychological coverage will be reimbursed at 80% of allowable expenses. The plan does provide 80% reimbursement of physiotherapy up to an annual maximum of $1500 per person. - Private duty nursing by registered graduate nurses or members of the Victorian Order of Nurses, who are not members of your family and are not normally resident in your home. The maximum eligible expense is $5000 in any period of 3 consecutive years. - Charges for treatment by a licensed or registered physiotherapist if not related to you by blood or marriage. - Oxygen and its administration. - Charges for artificial limbs, eyes or other prosthetic appliances, charges for artificial limbs, eyes or other prosthetic appliances, crutches, splints, casts, braces and trusses when required as a result of bodily injury occurring or disease commencing while insured under the plan. Replacement charges are applicable only in cases of pathologic change. Maximum charges for maintenance are $50.00 in any 12 consecutive month period. - Charges for orthopedic shoes and shoe modification supplies (maximum charge $50.00 in any 12 consecutive month period). - Charges for rental of wheelchair, respirator/ventilator, hospital bed or other durable equipment for therapeutic use, or at the insurer's option the purchase cost of such equipment. (Lifetime maximum of $5000 for each insured person). - Charges for emergency transportation by air, rail or water to the nearest hospital able to provide the required care, including return expenses, if certified by the attending physician as medically necessary. (Maximum benefit is $500.00 per person during any 12 consecutive month period). - Charges for blood and blood plasma. - Charges for the services of a duly licensed dental practitioner for necessary dental treatment, required as the result of...
MAJOR MEDICAL EXPENSE BENEFIT. No deductible No Co-insurance Hospital Charges Out-Patient Only Basic Preventative Dental Plan (Delta Basic Plan or Blue Cross or equivalent) with the Company paying of the cost and the employee paying of the cost. Effective September the Schedule shall be instituted. Effective February the Schedule shall be instituted. February the Schedule shall be instituted Effective February the Schedule shall be instituted. Safety Shoes: The Company to pay towards the cost of safety shoes for employees with one year or more service up to one pair per contract year. Safety Glasses: The Company agrees to supply and pay for approved industrial prescription safety lens- es and frames once during the life of the Agreement maxi- mum with an additional allowance of maximum for bifocals). Family Eye Care: Third Year The Company agrees to pay up to per family member once in a two year period toward the cost of glasses and frames. Dear Sirs: DRAFT LETTER Waterloo Furniture Components Ltd. and United Steelworkers of America We wish to confirm the following understandings which will apply during the term of the Collective Agreement currently in effect:
MAJOR MEDICAL EXPENSE BENEFIT. No deductible No Coinsurance Hospital Charges Out-Patient Only Basic Preventative Dental Plan (Delta Basic Plan or Blue Cross or equivalent) with the Company paying of the cost and the employee paying of the cost. Effective April the Schedule shall be instituted. Effective February the Schedule shall be instituted. Safety Shoes: Safety Glasses: The Company to pay towards the cost of safety shoes for employees with one year or more service up to one pair per contract year. In the second year of the Agreement increase the to The Company agrees to supply and pay for approved industrial prescription safety lens and frames once during the life of the Agreement maximum with an additional allowance of maximum for bifocals). DRAFT LETTER United of America Dear Sirs: Waterloo Metal Ltd. and United Steelworkers of America We wish to confirm the following understandings which will apply during the term of the Collective Agreement currently in effect:
MAJOR MEDICAL EXPENSE BENEFIT. Basic medical benefits are provided for you and your family under your provincial health plan (OHIP). The major medical expense benefit under the Company’s group insurance plan provides benefits for you and your covered dependents for certain expenses not covered by the provincial hospital and medical plans. Expenses allowed under the major medical expense benefit are listed below. Effective January 1, 2009 there is a lifetime maximum of $750,000 for all major medical expenses per person. Benefits are payable only if the services are recommended by a physician and if provincial legislation does not prohibit insurance of any such expense. • drugs and medicines dispensed on the written prescription of a physician. Reimbursement will be based on the cost of the generic equivalent of a prescription drug, if such an equivalent exists. You will receive full reimbursement of a brand name drug only if a generic equivalent does not exist, or if your physician provides specific instructions prohibiting substitution. Effective January 1, 2009 a maximum of $10.00 dispensing fee per prescription will be reimbursed. • private duty nursing by registered graduate nurses who are not ordinarily resident in your home and are not related to you or your dependents • hospital charges for other than room and board not paid by the provincial plan • oxygen and its administration • blood and blood plasma • rental of wheel chair, hospital bed or respirator/ ventilator • splints, trusses, braces, crutches, casts • artificial limbs and eyes provided the loss of the natural limb or eye occurred while insured under this plan • services of duly qualified and licensed physiotherapists other than members of the insured’s family • local ambulance services • emergency transportation by a licensed ground ambulance, including air ambulance, to and from the nearest hospital in which treatment can be provided (subject to one round trip per calendar year). • services of a licensed chiropractor or osteopath when operating in their recognized field of expertise (eligible only after provincial plan maximum has been reached). • services of a licensed Acupuncturist, Podiatrist, Homeopath, Massage Therapist, Naturopath, Psychologist or Speech Therapist. These practitioner services are reimbursable only after any applicable provincial plan maximum has been reached and subject to a total annual maximum benefit of $500 for these services. The following items are covered when prescribed by a physician or o...
