Summary of Health Benefits for Enhanced Pensioners

As at December 1, 2016. No new entries after December 1, 2016. Print This Page

GRANDFATHERED MEMBERS ONLY – 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 $30,000 (Member only)

AD & D

Principal Amount $5,000 (Member only)

Dental

Deductible Nil.
Reimbursement 100% for Basic and Major expenses.
Fee Guide Current or equivalent (Alberta).
Annual Maximum $2,500 per person each calendar year for Basic and Major expenses.
Coverage Note Dental implant coverage will be reimbursed at the equivalent cost of a bridge or partial denture. No orthodontic coverage.

Vision Care

Member/Dependant Benefit Amount Lenses – $250 per 24 months; Frames – $150 per 24 months.
Contact Lenses $250 per 24 months.
Eye Exam or Retina Exam One exam per calendar year (when not covered by the provincial government plan).

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

Lifetime Maximum $50,000 per covered person.
Calendar Year Maximum After the lifetime maximum is reached, there is a maximum calendar year benefit of $5,000.
Reimbursement 100% of most eligible expenses subject to maximums and limits below. 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

Massage Therapist – Expenses are reimbursed at 50%, up to a maximum of $200 per person per year.

Podiatrist – Expenses are reimbursed at 100%, up to a maximum of $200 per person per year.

Certified Athletic Therapist / Physiotherapist – Expenses are reimbursed at 100%, up to a maximum of $250 per person per year. Maximum per treatment is $75.

Prescription Drugs Reimbursement (as described above) for drugs which by law require the written prescription of a physician. Includes oral contraceptives, diabetic supplies, smoking cessation(1st treatment maximum of $400 at 100%, 2nd treatment maximum of $400 at 50%; lifetime maximum of $600), erectile dysfunction ($400 per calendar year maximum), anesthetics, 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 No deductible but there is a maximum dispensing fee payable of $9.50 per prescription.
Hospital $5,000 semi-private hospital room per year.
Ambulance Land/air/rail up to $200 per calendar year.
Medical Services and Supplies Oxygen and supplies, PSA tests.
Private Duty Nursing $10,000 per calendar year.
Hearing Aids $1,500 for each 48 month period.
Mobility Assistance Equipment Benefit Member only reimbursement of expenses associated with mobility equipment and installation. Wheelchair lift, stair lift, ramp, ceiling hoist, elevator. Subject to a lifetime maximum 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 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 Maximum benefit per family of $1,000. Includes accommodation, meal and gas/travel expenses.

Emergency Travel Assistance (ETA)

Lifetime Maximum $250,000
Coverage Emergency/medical and travel assistance services for pensioners and eligible dependants. Must be in a condition of stable health prior to departure. Coverage is limited to a period of 30 days per trip. Top-up coverage is available.

Employee 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 Depends upon amount of pension in normal form. Pay direct amounts are subject to change. Retail Sales Tax (R.S.T.) is added for Ontario and Manitoba members.

* Medical expenses must be medically necessary, reasonable and customary in the circumstances.