Summary of Health Benefits for Active Members

As at January 1, 2019 Print This Page

All benefits are subject to the terms of the insurance policies and the Official Plan Documents. This is a summary for your convenience.

Life Insurance

Benefit Amount $75,000 (Member only)

AD & D

Principal Amount $100,000 (Member only)

* Long Term Disability Income

Maximum Benefit Amount $2,400 per month.
Taxes Benefit is taxable.
Qualifying Period 26 continuous weeks of total disability. Where applicable LTD benefits will commence after the expiry of the WI benefit.
Benefit Duration Maximum to age 65.

* Weekly Disability Income (WI)

Maximum Benefit Amount $562 per week for disabilities occurring on/after January 1, 2019. WI disability benefit amounts mirror the current EI maximum benefit each year.
Taxes Benefit is taxable.
Qualifying Period 1st day of accident, after 24 hours of hospitalization/accident or 8th day of illness.
Benefit Duration Maximum of 26 weeks. Benefit is integrated with EI.

Special Disability Benefit

Maximum Benefit Amount $1,000 per month.
Eligibility Criteria Under age 65, ready to retire from the Boilermakers' trade due to a permanent disability. Member must be in good standing with the IBB throughout duration of the special disability benefit. Recipients must enroll in the Early Retiree Health Benefit Plan.

Dental

Deductible Nil.
Reimbursement 100% for Basic and Major expenses, 60% for orthodontics.
Fee Guide Current.
Maximums $2,500 per person each calendar year for Basic and Major expenses. $2,000 lifetime maximum for orthodontics.
Coverage Notes Dental implant coverage may be reimbursed at the equivalent cost of a bridge or partial denture. Orthodontic coverage is for dependant children 19 years of age or younger. Members should submit a pre-determination of benefits form to the Plan for services over $500 and orthodontics.

** Medical Benefit Enrollment in Provincial Health Care Plan is mandatory. Provincial Plan is the first payer.

Lifetime Maximum Unlimited.
Reimbursement 100% of most eligible expenses subject to maximums and limits; prescription drugs are reimbursed at the lower of the brand name or generic drug ingredient cost. If no generic drug is available, the Plan will pay 100% of the brand name drug ingredient cost.
Practitioners

Chiropractor, Speech Therapist, Osteopath, Naturopath, Homeopath, and Podiatrist – Expenses are reimbursed at 100%, up to a maximum of $300 annually, per practitioner.

Acupuncture and Massage Therapy – Expenses are reimbursed at 50%, up to a maximum of $300 annually.

Certified Athletic Therapist, Physiotherapist and Occupational Therapist – Expenses are reimbursed at 100%, up to a maximum of $75 per treatment and $5,000 annually.

Psychologist – Expenses are reimbursed up to a maximum of $2,000 annually, and up to a maximum of $200 per hour. Please consider using the Plan's member assistance program for free private counselling.

Prescription Drugs Reimbursement (as described above) for drugs which by law require the written prescription of a physician. Includes oral contraceptives, fertility drugs ($2,500 per family), diabetic supplies, smoking cessation (100% for 1st course of treatment up to $400, 50% for 2nd course of treatment up to $200), erectile dysfunction ($400 per calendar year), anaesthesia, vaccinations and immunizations (subject to individual maximums). Over the counter drugs, vitamins or minerals are not covered. Medical cannabis including derivates is not covered.
Deductible Nil. Maximum dispensing fee of $9.50 per prescription.
Vision Care

Member Benefit Amount: Lenses – $800 per 24 months; Frames – $150 per 24 months.

Laser Eye Surgery – $1,750 lifetime maximum (member only).

Industrial Safety Glasses – $400 per 12 months with a prescription (member only).

Dependant Benefit Amount: Lenses – $550 per 24 months; Frames – $150 per 24 months.

Contact Lenses – $250 per 24 months per person.

Basic or Retina Eye Exam – One exam per calendar year (when not covered by the provincial government plan).

Ambulance Reimbursement for land ambulance services when used to transport to the nearest hospital. If ambulance services provided by air or rail, there is a $500 maximum per individual, per calendar year.
Accidental Dental $5,000 per dental accident – work must commence within 12 months.
Hospital The difference between ward room and semi-private hospital room. Rehabilitation hospital room allowance is $10 per day up to a maximum of 100 days of confinement per disability prior to age 65.
Medical Services and Supplies Medical equipment and supplies, custom foot orthotics (maximum $400 per year) and orthopedic shoes (at 50%, maximum $400 per year), PSA tests, oxygen and oxygen supplies.
Hearing Aids $1,500 per 48 month period.
Private Duty Nursing Up to $10,000 per year.
Mobility Assistance Equipment Benefit Member only reimbursement of 75% of the expenses associated with specific mobility equipment and its installation, subject to a lifetime maximum benefit of $5,000.
Age 65 Provincial Plan Benefit $200 annual maximum benefit to reimburse the actual cost incurred to enroll in the individual's provincially sponsored health care/medical plan. Covers premium, deductibles and co-payments.
Travel Costs related to Medical Treatment Reasonable expenses associated with travelling at least 100km to receive medically necessary treatment otherwise unavailable. 80% of such expenses are reimbursed for members or eligible dependants, subject to a lifetime family maximum benefit of $1,000. Includes accommodation, meal and gas/travel expenses.

Emergency Travel Assistance (ETA) Effective March 1st, 2019 this coverage is not available for members who are on Pay Direct Option.

Lifetime Maximum $1,000,000
Coverage Emergency medical coverage and travel assistance services for Members and eligible dependants while travelling for periods of up to 90 days per trip. Must be in a condition of stable health prior to departure.

Member Assistance Program

Coverage Confidential counselling services providing crisis support, advice and information by telephone, face-to-face, or online. Tel# 1.866.990.1113, TTY: 1.888.234.0414, Website: myfseap.com. Please contact the Plan Administration Office for group name and password.

Current Benefit Contribution

Contribution Amount Effective with the May 2019 benefit month, the dollar bank drawdown is $370 per month. Maximum dollar bank is $5,550. There are several options for pay direct and partial benefits. Drawdown and pay direct amounts are subject to change. Retail Sales Tax (RST) is added where applicable.

* Not covered for members who have commenced receipt of a pension from the Boilermakers' National Pension Plan (Canada)
** Medical expenses must be medically necessary, reasonable and customary in the circumstances.