Active Member Health Benefits

Summary of Health Benefits for Active Members

As at September 1, 2024 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	$668 per week effective January 1, 2024. WI disability benefit amounts mirror the current EI maximum benefit. WI benefit payments are integrated with EI Sickness benefit payments.
Taxes	Benefit is taxable.
Qualifying Period	1st day of accident, 1st day of hospitalization (after 24 hour stay / outpatient surgery), 8th day of illness.
Benefit Duration	Maximum to the earlier of 26 weeks or age 65.

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. Automatic biologic/biosimilar switching program.
Practitioners	Chiropractor, Speech Therapist, Osteopath, Naturopath, Homeopath, and Podiatrist - Expenses are reimbursed at 100%, up to a maximum of $400 annually, per practitioner. Acupuncture and Massage Therapy - Expenses are reimbursed at 50%, up to a maximum of $500 annually. Certified Athletic Therapist, Physiotherapist and Occupational Therapist - Expenses are reimbursed at 100%, up to a maximum of $100 per treatment and $5,000 annually. Psychologist - Expenses are reimbursed up to a maximum of $10,000 annually per person, 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. Automatic biologic/biosimilar switching program.
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.
Annual Medical Exam	$50 reimbursement to physicians for providing the Plan's "Physician's Confirmation of Annual Medical Exam.
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 except for Members on Disability who are covered effective July 1, 2019.

Coverage	Unlimited Trips. 90 Day Trip Duration Maximum per trip. $5,000,000 Maximum per covered person, per trip. Must be in “Stable” Medical Condition prior to departure. Under age 70 "stable" definition: Medical emergency must be “Sudden and Unforeseen” Age 70 and older "stable" definition: 180 Day “Pre-Existing Medical Condition Stability Period” exclusion applies Please consult Manulife Policy documents on the Plan's ETA page

Member Assistance Program

Coverage	Confidential counselling services by telephone, face-to-face, or online. Tel# 1.866.990.1113, TTY: 1.888.234.0414, Website: myfseap.com. Please visit this page for the group name and password.

Home and Auto Insurance

Coverage	Available to all Plan members - offers discounted premiums for members coast to coast. Please visit here for more information.

National Substance Abuse Program

Coverage	Treatment provided through Renascent (Toronto) available to all Construction Sector Operations (CSO) members.

Virtual Health Care

Coverage	Live interactive health care services that allows members and their dependants to connect directly with a doctor or nurse practitioner 24/7/365, for consultation or other services such as; healthcare advise, prescription renewal, diagnostic and specialist referrals, lab requisitions, help to navigate the health care system, and more. Click here to learn more.

Current Benefit Contribution

Contribution Amount	$430 per month dollar bank drawdown. Maximum dollar bank is $6,450. 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.