ELCIC Group Services Inc - Extended Health Care Modules
Please note that the maximums are applied to the plan member and each dependent based on the blue, green or teal module that you are enrolled in.
| Blue | Green | Teal | |
|---|---|---|---|
| Premiums paid by: | 100% Employer paid | payment of additional cost to be determined at the local level | payment of additional cost to be determined at the local level |
| Eligibility: | |||
| Rostered & Non-Rostered | at least 25% of YMPE* no hours criteria | at least 25% of YMPE* no hours criteria | at least 25% of YMPE* no hours criteria |
| Drugs: | |||
| Deductible | none | none | none |
| Reimbursement | 60% | 70% | 80% |
| Plan | Mandatory Generic Drug Plan | Mandatory Generic Drug Plan | Mandatory Generic Drug Plan |
| Drug card | yes | yes | yes |
| Maximum | $1,000,000 per calendar year | $1,000,000 per calendar year | $1,000,000 per calendar year |
| Health & Vision: | |||
| Deductible | none | none | none |
| Reimbursement - Paramedical Services | 60% | 70% | 80% |
| Paramedical Maximum (excluding counselling bundle below) | $300 per calendar year | $400 per calendar year | $500 per calendar year |
| Psychologist, Clinical Counsellor, Marriage and Family Therapist (MFT), Masters in Social Work (MSW), Registered Social Worker (RSW), Registered Psychotherapist, OR Psychoanalyst | $3,000 per calendar yearcombined counselors | $4,000 per calendar yearcombined counselors | $5,000 per calendar year combined counselors |
| Reimbursement - Medical Services & Supplies excluding insulin pumps | 100% | 100% | 100% |
| Insulin pumps | 50% | 50% | 50% |
| Medical Services & Supplies | various | various | various |
| Hospital coverage: semi or private | none | none | none |
| Reimbursement - Vision | 100% | 100% | 100% |
| Eye Exams | <18 once every 12 months 18+ once every 24 months | <18 once every 12 months 18+ once every 24 months | <18 once every 12 months 18+ once every 24 months |
| Eye Glasses/Contacts | none | $250 per 24 months | $400 per 24 months |
| Out-of-Country-Travel: | |||
| Eligibility | all active plan members | all active plan members | all active plan members |
| Reimbursement | 100% | 100% | 100% |
| $5,000,000 Lifetime maximum | yes | yes | yes |
| Dental: | |||
| Deductible | none | none | none |
| Reimbursement - Basic | 60% | 70% | 80% |
| Reimbursement - Major | 50% | 50% | 50% |
| Reimbursement - Ortho | none | 50% | 50% |
| Annual Maximum Basic & Major | $1,000 | $1,500 | $2,000 |
| Lifetime Maximum for Ortho | $0 | $1,500 | $2,000 |
| Health Care Spending Account: | |||
| Available | yes | yes | yes |
| Credit Amount | single $450 family $900 | single $550 family $1,100 | single $650 family $1,300 |