SUPPLEMENTARY HEALTH AND HOSPITAL INSURANCE. The employer will continue to pay for employee benefits as they have in the past using up to date riders and fee schedules 55.1 The Employer shall pay one hundred percent (100%) of the monthly premium of the Supplementary Health and Hospital Plan. (a) A dispensing fee cap of $9.00 per prescription will be placed on all prescriptions for the life of the contract. 55.2 Effective January 1, 1998, the Supplementary Health and Hospital Plan shall provide for the reimbursement of ninety percent (90%) [effective November 1, 2001, ninety-five percent (95%)] of the cost of prescribed drugs and medicines, one hundred percent (100%) of the cost of semi-private or private hospital accommodation to a maximum of one hundred and fifty dollars ($150.00) per day over and above the cost of standard xxxx care, and one hundred percent (100%) of the cost for the following services: (a) charges for accommodation, for employees sixty-five (65) and over, in a licensed chronic or convalescent hospital up to twenty-five dollars ($25.00) per day and limited to one hundred and twenty (120) days per calendar year for semi-private or private accommodation; (b) charges made by a licensed hospital for out-patient treatment not paid for under a provincial plan; (c) charges for private-duty nursing in the employee's home, by a registered nurse or a registered nursing assistant who is not ordinarily resident in the employee's home, and who is not related to either the employee or his/her dependants, provided such registered nursing service is approved by a licensed physician or surgeon as being necessary to the employee's health care; (d) charges for the services of a Chiropractor, Osteopath, Naturopath, Podiatrist, Physiotherapist, Speech Therapist, and Masseur (if licensed and practising within the scope of their licence), to a maximum of twelve dollars ($12.00) per visit for each visit not subsidized by the Ontario Health Tax; (e) charges for the services of a Psychologist up to sixteen dollars ($16.00) per half-hour for individual psychotherapy and/or testing and twelve dollars ($12.00) per visit for all other visits; (f) artificial limbs and eyes, crutches, splints, casts, trusses and braces; seventy-five percent (75%) of the cost of specially modified shoes (factory custom) ready made, off-the-shelf with a limit of three (3) pairs per calendar year, if medically necessary and prescribed by a licenced physician; and seventy-five percent (75%) of the cost of corrective shoe inserts, if medically prescribed, up to a limit of three (3) pairs per calendar year; (g) rentals of wheel chairs, hospital beds or iron lungs required for temporary therapeutic use. A wheel chair may be purchased if recommended by the attending physician and if rental cost would exceed the purchase cost. Fifty percent (50%) of the cost of repair (including batteries) and modifications to purchased wheel chairs provided that the reimbursement for any one repair, battery or modification shall in no event exceed five hundred dollars ($500.); (h) ambulance services to and from a local hospital qualified to provide treatment, excluding benefits allowed under a provincial hospital plan; (i) oxygen and its administration; (j) blood transfusions outside the hospital; (k) dental services and supplies, provided by a dental surgeon within a period of twenty-four (24) months following an accident, for the treatment of accidental injury to natural teeth, including replacement of such teeth or for the setting of a jaw fractured or dislocated in an accident, excluding any benefits payable under any provincial medicare plan; (l) hearing aids and eye glasses, if required as a result of accidental injury; (m) charges for services of physicians, surgeons and specialists legally licensed to practise medicine which, when provided outside the Province of Ontario, exceed the Ontario Health Tax fee schedule, the allowance under this benefit being up to one hundred percent (100%) of the O.M.A. fee schedule when added to government payments under the Ontario Health Tax fee schedule. (n) charges for surgery by a Podiatrist, performed in a Podiatrist's office, to a maximum of one hundred dollars ($100.00). 55.3 Effective April 1, 1999, the Employer agrees to pay sixty percent (60%) of the monthly premiums for vision care and hearing aid coverage, under the Supplementary Health and Hospital Plan, with the balance of the monthly premiums being paid by the employee through payroll deduction. This coverage includes a ten dollar ($10.00) (single) and twenty dollar ($20.00) (family) deductible in any calendar year and provides for vision care (maximum two hundred and fifty dollars ($250.00) per person in any twenty-four (24) month period) and the purchase of hearing aids (maximum two hundred and fifty dollars ($250.00) per person once only) equivalent to the vision and hearing component of the Blue Cross Extended Health Care Plan. 55.4 It is not necessary for an employee or dependants to be confined to hospital to be eligible for benefits under this plan. If an employee is totally disabled or his or her dependent is confined to hospital on the date his or her Supplementary Health and Hospital Insurance terminates, benefits shall be payable until the earliest of the date the total disability ceases, the date his or her dependent is discharged from hospital, or the expiration of six (6) months from the date of termination of insurance. 55.5 Where an employee is totally disabled, coverage for Supplementary Health and Hospital Insurance will cease at the end of the month in which the employee receives his or her last pay from the Employer, except as provided in Clause 54.3 of Article 54 (
Appears in 1 contract
Samples: Collective Agreement
SUPPLEMENTARY HEALTH AND HOSPITAL INSURANCE. The employer will continue to pay for employee benefits as they have in the past using up to date riders and fee schedules
55.1 The Employer shall pay one hundred percent (100%) of the monthly premium of the Supplementary Health and Hospital Plan.
(a) A dispensing fee cap of $9.00 per prescription will be placed on all prescriptions for the life of the contract.
55.2 . Effective January 1, 1998, the Supplementary Health and Hospital Plan shall provide for the reimbursement of ninety percent (90%) [effective November 1, 2001, ninety-five percent (95%)] of the cost of prescribed drugs and medicines, and one hundred percent (100%) of the cost of semi-private or private hospital accommodation to a maximum of one hundred and fifty five dollars ($150.0075) per day over and above the cost of standard xxxx care, care and one hundred percent (100%) of the cost for the following services:
(a) : charges for accommodation, for employees sixty-five (65) and over, in a licensed chronic or convalescent hospital up to twenty-five dollars ($25.0025) per day and limited to one hundred and twenty (120) days per calendar year for semi-private or private accommodation;
(b) accommodation charges made by a licensed hospital for out-patient treatment not paid for under a provincial plan;
(c) plan charges for private-duty nursing in the employee's home, home by a registered nurse or a registered nursing assistant who is not ordinarily normally resident in the employee's home, home and who is not related to either the employee or his/her dependantsdependents, provided such registered nursing service is approved by a licensed physician or surgeon as being necessary to the employee's health care;
(d) care charges for the services of a Chiropractorchiropractor, Osteopathosteopath, Naturopathnaturopath, Podiatristpodiatrist, Physiotherapistphysiotherapist, Speech Therapist, speech therapist and Masseur masseur (if licensed and practising within the scope of their licence), ) to a maximum of twelve dollars ($12.0012) per visit for each visit not subsidized by the Ontario Health Tax;
(e) provincial health plan charges for the services of a Psychologist psychologist up to sixteen dollars ($16.0016) per half-hour for individual psychotherapy and/or testing and twelve dollars ($12.0012) per visit for all other visits;
(f) visits artificial limbs and eyes, crutches, splints, casts, trusses and braces; seventy-five percent (75%) reimbursement of of the cost of specially modified shoes (factory custom) ready made, off-the-off the shelf with a limit of three (3) pairs per calendar year, year if medically necessary and prescribed by a licenced licensed physician; and seventy-five percent (75%) of the cost of corrective shoe inserts, if medically necessary and prescribed, up to a limit of three (3) pairs per calendar year;
(g) year rentals of wheel chairs, hospital beds or iron lungs required for temporary therapeutic use. A wheel chair may be purchased if recommended by the attending physician and if rental cost would exceed the purchase cost. Fifty percent (50%) of the cost of repair (including batteries) and modifications to purchased wheel chairs provided that the reimbursement for any one repair, battery or modification shall in no event exceed five hundred dollars ($500.);
(h) ambulance services to and from a local hospital qualified to provide treatment, excluding benefits allowed under a provincial hospital plan;
(i) plan oxygen and its administration;
(j) administration blood transfusions outside the hospital;
(k) hospital dental services and supplies, provided by a dental surgeon within a period of twenty-four (24) months following an accident, for the treatment of accidental injury to natural teeth, including replacement of such teeth or for the setting of a jaw fractured or dislocated in an accident, excluding any benefits payable under any provincial medicare plan;
(l) plan hearing aids and eye glasseseyeglasses, if required required, as a result of accidental injury;
(m) injury charges for services of physicians, surgeons and specialists legally licensed to practise medicine which, when provided outside the Province of Ontario, exceed the Ontario Health Tax health plan fee schedule, the allowance under this benefit being up to one hundred percent (100%) of the O.M.A. fee schedule when added to government payments under the Ontario Health Tax fee schedule.
(n) provincial health plan charges for surgery by a Podiatristpodiatrist, performed in a Podiatristpodiatrist's office, to a maximum of one hundred dollars ($100.00).
55.3 100) the Employer shall make available to employees an information booklet with periodic updates, when necessary, within a reasonable period of time following the signing of a new collective agreement or following major alterationsto the Plan. Effective April 1, 1999, January the Employer agrees to pay sixty percent (60%) of the monthly premiums for vision care and hearing aid coverage, coverage under the Supplementary Health and Hospital Planplan, with the balance of the monthly premiums being paid by the employee through payroll deduction. This coverage includes a ten dollar ($10.00) (single) and twenty dollar ($20.00) (family) deductible in any calendar year and provides for vision care (maximum two hundred and fifty dollars ($250.00200.00) per person in any twenty24-four (24) month period) and the purchase of hearing aids (maximum two hundred and fifty dollars ($250.00200) per person once only) equivalent to the vision and hearing aid component of the Blue Cross Extended Health Care Plan.
55.4 . It is not necessary for an employee or dependants dependents to be confined to hospital to be eligible for benefits under this plan. If an employee is totally disabled or his or her dependent is confined to hospital on the date his or her Supplementary Health and Hospital Insurance terminates, benefits shall be payable until the earliest of the date the total disability ceases, the date his or her dependent is discharged from hospital, hospital or the expiration of six (6) months from the date of termination of insurance.
55.5 . Where an employee is totally disabled, coverage for Supplementary Health and Hospital Insurance will cease at the end of the month in which the employee receives his or her last pay from the Employer, Employer except as provided in Clause 54.3 section of Article 54 (Long Term Income Protection). If an employee wishes to have Supplementary Health and Hospital Insurance continue, arrangement may be made through the Human Resources Department. The employee shall pay the full premium.
Appears in 1 contract
Samples: Collective Agreement
SUPPLEMENTARY HEALTH AND HOSPITAL INSURANCE. The employer Employer will continue to pay for employee benefits as they have in the past using up to date riders and fee schedules.
55.1 54.1 The Employer shall pay one hundred percent (100%) of the monthly premium of the Supplementary Health and Hospital Plan.
(a) A dispensing fee cap Effective May 1, 2010 reimbursement of prescription drugs will include a three dollar ($9.00 3.00) deductible per prescription will to be placed on all prescriptions for the life of the contractapplied before reimbursement is made.
55.2 (b) Not later than May 1, 2010 the Employer agrees to provide employees with a Drug Card, which shall provide for direct payment of drug costs at the point of purchase. The Employer will provide drug card information with card.
54.2 Effective January 1, 1998, the Supplementary Health and Hospital Plan shall provide for the reimbursement of ninety percent (90%) [effective November 1, 2001, ninety-five percent (95%)] of the cost of prescribed drugs and medicines, one hundred percent (100%) of the cost of semi-private or private hospital accommodation to a maximum of one hundred and fifty dollars ($150.00) per day over and above the cost of standard xxxx care, and one hundred percent (100%) of the cost for the following services:
(a) charges for accommodation, for employees sixty-five (65) and over, in a licensed chronic or convalescent hospital up to twenty-five dollars ($25.00) per day and limited to one hundred and twenty (120) days per calendar year for semi-private or private accommodation;
(b) charges made by a licensed hospital for out-patient treatment not paid for under a provincial plan;
(c) charges for private-duty nursing in the employee's home, by a registered nurse or a registered nursing assistant who is not ordinarily resident in the employee's home, and who is not related to either the employee or his/her dependants, provided such registered nursing service is approved by a licensed physician or surgeon as being necessary to the employee's health care;
(d) charges for the effective May 1, 2010, out-of-hospital services of a Chiropractor, Osteopath, Chiropodist/Podiatrist, Naturopath, Podiatrist, Physiotherapist, Speech Therapist, and Masseur Massage Therapist (if licensed and practising within the scope of their licence), to a maximum of twelve twenty-five dollars ($12.0025.00) per visit for each visit not subsidized by the Ontario Health Taxto a five hundred dollar ($500.00) calendar year maximum per practitioner;
(e) charges for the services of a Psychologist up to sixteen dollars ($16.00) per half-hour for individual psychotherapy and/or testing and twelve dollars ($12.00) per visit for all other visits;
(f) artificial limbs and eyes, crutches, splints, casts, trusses and braces; effective May 1, 2010, seventy-five percent (75%) of the cost costs and repairs to one (1) pair of specially orthopaedic shoes or winter footwear specifically designed and constructed for the patient and specifically modified shoes (factory custom) ready madeshoes, off-the-off the shelf with a limit of three (3) pairs and their corrective inserts, per calendar year, to a maximum of six hundred dollars ($600.00) per pair and one hundred percent (100%) of the cost of one (1) orthotic appliance per calendar year to a maximum of four hundred dollars ($400.00) per pair, if medically necessary and prescribed by a licenced physician; and seventy-five percent (75%) of the cost of corrective shoe inserts, if medically prescribed, up to a limit of three (3) pairs per calendar year;
(g) rentals of wheel chairs, hospital beds or iron lungs required for temporary therapeutic use. A wheel chair may be purchased if recommended by the attending physician and if rental cost would exceed the purchase cost. Fifty percent (50%) of the cost of repair (including batteries) and modifications to purchased wheel chairs provided that the reimbursement for any one repair, battery or modification shall in no event exceed five hundred dollars ($500.);Fifty
(h) ambulance services to and from a local hospital qualified to provide treatment, excluding benefits allowed under a provincial hospital plan;
(i) oxygen and its administration;
(j) blood transfusions outside the hospital;
(k) dental services and supplies, provided by a dental surgeon within a period of twenty-four (24) months following an accident, for the treatment of accidental injury to natural teeth, including replacement of such teeth or for the setting of a jaw fractured or dislocated in an accident, excluding any benefits payable under any provincial medicare plan;
(l) hearing aids and eye glasses, if required as a result of accidental injury;
(m) charges for services of physicians, surgeons and specialists legally licensed to practise medicine which, when provided outside the Province of Ontario, exceed the Ontario Health Tax fee schedule, the allowance under this benefit being up to one hundred percent (100%) of the O.M.A. fee schedule when added to government payments under the Ontario Health Tax fee schedule.
(n) charges for surgery by a Podiatrist, performed in a Podiatrist's office, to a maximum of one hundred dollars ($100.00).
55.3 Effective April 1, 1999, the Employer agrees to pay sixty percent (60%) of the monthly premiums for vision care and hearing aid coverage, under the Supplementary Health and Hospital Plan, with the balance of the monthly premiums being paid by the employee through payroll deduction. This coverage includes a ten dollar ($10.00) (single) and twenty dollar ($20.00) (family) deductible in any calendar year and provides for vision care (maximum two hundred and fifty dollars ($250.00) per person in any twenty-four (24) month period) and the purchase of hearing aids (maximum two hundred and fifty dollars ($250.00) per person once only) equivalent to the vision and hearing component of the Blue Cross Extended Health Care Plan.
55.4 It is not necessary for an employee or dependants to be confined to hospital to be eligible for benefits under this plan. If an employee is totally disabled or his or her dependent is confined to hospital on the date his or her Supplementary Health and Hospital Insurance terminates, benefits shall be payable until the earliest of the date the total disability ceases, the date his or her dependent is discharged from hospital, or the expiration of six (6) months from the date of termination of insurance.
55.5 Where an employee is totally disabled, coverage for Supplementary Health and Hospital Insurance will cease at the end of the month in which the employee receives his or her last pay from the Employer, except as provided in Clause 54.3 of Article 54 (
Appears in 1 contract
Samples: Collective Agreement
SUPPLEMENTARY HEALTH AND HOSPITAL INSURANCE. The employer Employer will continue to pay for employee benefits as they have in the past using up to date riders and fee schedulesschedules and in accordance with Canada Life Policy #139188.
55.1 56.1 The Employer shall pay one hundred percent (100%) of the monthly premium of the Supplementary Health and Hospital Plan.
(a) A dispensing fee cap Effective May 1, 2010, reimbursement of prescription drugs will include a three dollar ($9.00 3.00) deductible per prescription will to be placed on all prescriptions for the life of the contractapplied before reimbursement is made.
55.2 56.2 Effective January 1, 1998, the Supplementary Health and Hospital Plan shall provide for the reimbursement of ninety percent (90%) [effective November 1, 2001, ninety-five percent (95%)] of the cost of prescribed drugs and medicines, one hundred percent (100%) of the cost of semi-private or private hospital accommodation to a maximum of one hundred and fifty dollars ($150.00) per day over and above the cost of standard xxxx care, and one hundred percent (100%) of the cost for the following services:
(a) charges for accommodation, for employees sixty-five (65) and over, in a licensed chronic or convalescent hospital up to twenty-five dollars ($25.00) per day and limited to one hundred and twenty (120) days per calendar year for semi-private or private accommodation;
(b) charges made by a licensed hospital for out-patient treatment not paid for under a provincial plan;
(c) charges for private-duty nursing in the employee's home, by a registered nurse or a registered nursing assistant who is not ordinarily resident in the employee's home, and who is not related to either the employee or his/her the empoyee’s dependants, provided such registered nursing service is approved by a licensed physician or surgeon as being necessary to the employee's health care;
(d) charges for the Effective May 1, 2018, out- of-hospital services of a Chiropractor, Osteopath, Chiropodist/Podiatrist, Naturopath, Podiatrist, Physiotherapist, Speech Therapist, Therapist and Masseur Massage Therapist (if licensed licenced and practising within the scope of their licence), to a maximum of twelve dollars eight hundred ($12.00800) per visit for each visit not subsidized by the Ontario Health Taxcalendar year maximum per practitioner;
(e) charges for the services of a Psychologist Psychologist, Psychotherapist, or Social Worker up to sixteen dollars ($16.00) per half-hour for individual psychotherapy and/or testing and twelve dollars ($12.00) per visit for all other visits;
(f) artificial limbs and eyes, crutches, splints, casts, trusses and braces; effective May 1, 2010, seventy-five percent (75%) of the cost costs and repairs to one (1) pair of specially orthopaedic shoes or winter footwear specifically designed and constructed for the patient and specifically modified shoes (factory custom) ready madeshoes, off-the-off the shelf with a limit of three (3) pairs and their corrective inserts, per calendar year, to a maximum of six hundred dollars ($600.00) per pair and one hundred percent (100%) of the cost of one (1) orthotic appliance per calendar year to a maximum of four hundred dollars ($400.00) per pair, if medically necessary and prescribed by a licenced physician; and seventy-five percent (75%) of the cost of corrective shoe inserts, if medically prescribed, up to a limit of three (3) pairs per calendar year;
(g) rentals of wheel chairswheelchairs, automatic hospital beds or iron lungs required for temporary therapeutic use. A wheel chair wheelchair may be purchased if recommended by the attending physician and if rental cost would exceed the purchase cost. Fifty percent (50%) of the cost of repair (including batteries) and modifications to purchased wheel chairs wheelchairs provided that the reimbursement for any one repair, battery or modification shall in no event exceed five hundred dollars ($500.500.00);
(h) ambulance services to and from a local hospital qualified to provide treatment, excluding benefits allowed under a provincial hospital plan;
(i) oxygen and its administration;
(j) blood transfusions outside the hospital;
(k) dental services and supplies, provided by a dental surgeon within a period of twenty-four (24) months following an accident, for the treatment of accidental injury to natural teeth, including replacement of such teeth or for the setting of a jaw fractured or dislocated in an accident, excluding any benefits payable under any provincial medicare plan;
(l) hearing aids and eye glasseseyeglasses, if required as a result of accidental injury;
(m) charges for services of physicians, surgeons and specialists legally licensed to practise medicine which, when provided outside the Province of Ontario, exceed the Ontario Health Tax fee schedule, the allowance under this benefit being up to one hundred percent (100%) of the O.M.A. fee schedule when added to government payments under the Ontario Health Tax fee schedule.
(n) charges for surgery by a Podiatrist, performed in a Podiatrist's office, to a maximum of one hundred dollars ($100.00).
55.3 Effective April 1, 1999, the Employer agrees to pay sixty percent (60%) of the monthly premiums for vision care and hearing aid coverage, under the Supplementary Health and Hospital Plan, with the balance of the monthly premiums being paid by the employee through payroll deduction. This coverage includes a ten dollar ($10.00) (single) and twenty dollar ($20.00) (family) deductible in any calendar year and provides for vision care (maximum two hundred and fifty dollars ($250.00) per person in any twenty-four (24) month period) and the purchase of hearing aids (maximum two hundred and fifty dollars ($250.00) per person once only) equivalent to the vision and hearing component of the Blue Cross Extended Health Care Plan.
55.4 It is not necessary for an employee or dependants to be confined to hospital to be eligible for benefits under this plan. If an employee is totally disabled or his or her dependent is confined to hospital on the date his or her Supplementary Health and Hospital Insurance terminates, benefits shall be payable until the earliest of the date the total disability ceases, the date his or her dependent is discharged from hospital, or the expiration of six (6) months from the date of termination of insurance.
55.5 Where an employee is totally disabled, coverage for Supplementary Health and Hospital Insurance will cease at the end of the month in which the employee receives his or her last pay from the Employer, except as provided in Clause 54.3 of Article 54 (
Appears in 1 contract
Samples: Collective Agreement
