Overall Benefits Plan New Plan Current Plan Who is eligible - - PowerPoint PPT Presentation
Overall Benefits Plan New Plan Current Plan Who is eligible Mandatory Health and Dental for Available to all teachers. 1.0 FTE members Mandatory basic life insurance. Voluntary Health and Dental for permanent members and eligible
New Plan Current Plan Who is eligible Mandatory Health and Dental for 1.0 FTE members Voluntary Health and Dental for permanent members and eligible LTOs working less than 1.0 and for members on non-status leaves Mandatory Basic Life and AD&D for all active permanent members and eligible LTOs. Available to all teachers. Mandatory basic life insurance. Accidental Death and Dismemberment was available, at the teacher’s expense.
New Plan Current Plan Ambulance Transport to/from nearest facility Includes air ambulance same Glucometers $150/benefit year No limit Hearing Aids $1000/ 5 benefit years $1500/ 5 benefit years Orthotics $350/ benefit year One pair per calendar year Orthopaedic Shoes (custom) Two pairs/benefit year $500 max/pair Orthopaedic Shoes (stock) $500/benefit year for modifications and adjustments
New Plan Current Plan Private Duty Nursing $50 000/benefit year No limit Surgical stockings 6 pairs /benefit year $250 Wigs $500 lifetime max same
New Plan No per visit fee cap No deductible Current Plan $50/visit max $10/individual, $20/family ded. Chiropractor/ Osteopath $1000 combined/benefit year $450 each Dietician/Nutritionist $500 combined/benefit year No coverage Massage Therapist $1000/ benefit year (doctor’s referral required) $450/ benefit year (no referral required) Naturopath $1000/ benefit year $450 Physiotherapist/ Athletic Therapist/
Occupational Therapist
$1000 combined Physiotherapist - $450 Athletic Therapist, Occupational Therapist - no coverage
New Plan No per visit fee cap No deductible Current Plan $50/visit max $10/individual, $20/family ded. Podiatrist/ Chiropodist $450 combined/benefit year same Psychologist, Marriage and Family Therapist, Registered Social Worker $1500 combined/benefit year $450 Speech-Language Pathologist, Communicative Disorders Assistants, Audiologist $1000/ combined/ benefit year Speech therapy - $450/ benefit year Audiologist - no coverage
New Plan Current Plan Hospital room semi-private Private room Semi-private room in private OHIP-funded facilities (for example, the Shouldice Hospital, Homewood covered Covered
New Plan Current Plan Glasses, contact lenses, laser eye surgery $500 max/2 benefit years (1 benefit year for children under 18) Laser eye surgery is included in this. $500 max /2 benefit years ($250 /year for children under 18) Laser eye surgery - one time payment of $725 Eye exams Once every 2 years, cost is included in the above $500 max Once every 24 months Visual Training $200 lifetime Visual therapy and remediation exercises under care of
New Plan Current Plan Emergency medical services 100% Up to 60 days/trip $5 million lifetime max 100% with some limitations Up to 180 days/trip $5 million lifetime max
New Plan Current Plan Basic Life 1x annual salary to $400 000 max combined 50% reduction at age 65 Ends at retirement $25 000 or 1,2,3,4x salary as selected by teacher Upon retirement, until age 65 members could remain in plan Supplemental Life Option of 1 or 2x annual salary to $400 000 max comb. 50% reduction from age 65 Maximum combined with Basic Life Ends at retirement Member paid Additional coverage to max of $500 000 available. Combined max $525 000 Accidental Death and Dismemberment Coverage matches Life 50% reduction from age 65 Ends at retirement or age 70 (whichever comes first) Max $350 000 Member paid Medical evidence required
New Plan Current Plan Spousal/ Partner Optional Life and AD&D Child Optional Life
coverage up to $400 000
retirement or when spouse reaches age 65, whichever comes first
member retires or reaches age 70, or spouse reaches 65, whichever comes first
000, member-paid
teachers, to a max of $350 000, member paid
insurance available up to $100 000
coverage available up to $50 000
retirement, until age 65. Member paid
New Plan Current Plan Pay direct benefits card Yes Yes Deductible $2 deductible/prescription $10/year per person $20/year per family Dispensing fee max $11 Not specified Limits Maintenance medications limited to 7 dispensing fees/prescription/12 months Also included Diabetic supplies, preventative vaccines, Fertility drugs up to $12 000 lifetime max. Diabetic supplies, vaccines, fertility drugs (no limit), anti-obesity drugs
New Plan Current Plan Basic dental 100% of check ups, x-rays, fillings, other Recall exams: every 9 months - adults Every 6 months - children under 19 Full exams and xrays once every 24 months Same Full xrays, exams every 3 years Periodontic/ Endodontic services 100% of root canals and related 100% of scaling, root planing, gum treatments, etc. 14 units of scaling and root planing combined/benefit year Same 8 units every 12 months
New Plan Current Plan Major restorative services 60% of crowns, bridges, dentures, implants, inlays, onlays $2000 max/benefit year Crown, onlays or denture replacement
Dental implant max: lowest cost alternative treatment option 50% of costs No maximum Orthodontics 50% coverage for adults and children $3500 lifetime max 50% $3000 lifetime max