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Group Health Insurance

Extended Health Care Benefits

This benefit provides additional medical coverage for the treatment of illness or injury which are not assumed under a province’s basic medical plan. Coverage is provided to both you and your eligible dependents, with no deductible.


Coverage Maximum:

The maximum reimbursement per insured person per calendar year will be unlimited, except as defined for each specific service.


Some available features include:

Medical Services and Supplies (100% coverage)


Paramedicals

The CHF Canada health plan charges by the following licensed and qualified practitioners for treatment of injury or sickness in excess of amounts allowed under the covered employee’s provincial health care benefits, to a maximum of $700 per practitioner per covered person:


Prescription Drugs

The CHF Canada prescription drug plan covers charges for drugs or medicines required for medical treatment of injury or sickness, prescribed by a licensed physician or dentist. The plan also features a pay-direct drug card administered by The Co-operators. The co-payment amount is equal to the pharmacy dispensing fee.


Vision Care

The Vision Care benefit covers charges for lenses, frames or contact lenses when prescribed by a licensed Optometrist or Ophthalmologist. The maximum reimbursement will be $200 in any 24 consecutive months per covered person, with a $50 maximum reimbursement for frames.

Note: This benefit is only available if your co-op has selected this option.


Out-of-Country/Province Coverage (100% coverage)

This benefit is limited to the first thirty (30) days of travel by the covered person outside his/her province of residence. These charges are not subject to any deductible or co-insurance amounts.

Note that your provincial health care plan covers emergency care while temporarily absent from your home province, but often will not pay the full cost of these services. This supplementary health plan covers these additional hospital and medical costs up to the reasonable and customary charges.

Covered charges include those listed below for emergency medical care or emergency hospitalization incurred by a covered person while travelling outside their province of residence.

The plan covers emergency medical expenses required as the result of a sudden and unexpected illness or injury which occurs while temporarily outside your home province.


Emergency Medical Travel Assistance Service

The emergency medical travel assistance service provides you and your eligible dependents with 24 hour access to medical assistance in the event of an emergency covered by your Extended Health Care benefit.

If a medical emergency arises while traveling, notify the emergency travel medical assistance service within 48 hours following your emergency: Canada and U.S.A. 1-888-440-2667 From other Countries 1-416-340-1316 (call collect)

For more information on your Emergency Medical Travel Assistance service, please refer to your handbook.


Termination Age

Your Extended Health Care benefits terminate at age 75.

Note: The Employee Family Assistance Program benefit will be available to all employees and their dependents, regardless of option selected.

This summary is intended to provide a brief description of the benefits available under the CHF Canada group insurance program. This material does not create or confer any rights. The exact terms and conditions of your benefits are outlined in the applicable group benefits agreements or policies. Some restrictions and/or limitations may apply to all benefits mentioned above.

Please contact Morneau Shepell for full details.

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