GROUP INSURANCE PLANS ELIGIBILITY

Transcription

1 GROUP INSURANCE PLANS ELIGIBILITY You must be a member of RTO/ERO, permanently residing in Canada and covered by your Government Health Insurance Plan (GHIP), to be eligible to participate in our insurance plans. The following charts outline who may be eligible for coverage: RTO/ERO Health Plans Member 1 Spouse 2 Children 3 Parents Friends Semi-Private Hospital and Convalescent Care Plan Extended Health Care Plan Dental Plan Supplemental Travel Plan When to Enroll in the RTO/ERO Group Insurance Plans You may enroll without medical evidence of insurability, regardless of your age, provided we receive your application within 60 days of the termination date of your most recent group insurance plan. Coverage for you, your spouse and your dependent children will begin on the date following the termination of your coverage under the following: Your school board plan; Your spouse s group plan; or Any other group plan. Extended Health Care, Dental, Semi-Private Hospital and Convalescent Care are insured by Sun Life Assurance Company of Canada, a member of the Sun Life Financial group of companies, under a group insurance policy bearing contract numbers , , , Trip Cancellation, Interruption/Delay Benefits are underwritten by CUMIS General Insurance Company and administered by Allianz Global Assistance, under a group policy bearing contract number FC Allianz Global Assistance is a registered business name of AZGA Service Canada Inc. and AZGA Insurance Agency Canada Ltd.

2 If you apply after the 60 day eligibility period, you will be considered a late applicant and will be required to submit medical evidence of insurability to participate in the Semi-Private Hospital and Convalescent Care and Extended Health Care Plans. Under the Dental Plan, acceptance is guaranteed, but the maximum benefit payable during the first twelve months will be limited to $500 per insured person. This same requirement applies if you transfer from an individual policy. For the purpose of the RTO/ERO Group Insurance Plans: 1 A member is defined as a full or associate member in good standing of RTO/ERO. 2 A spouse is defined as your legal or common-law spouse, or same-sex partner. 3 A dependent child is defined as unmarried children: under 21 years of age, or under age 30 if in full-time attendance at a post-secondary institution, or any functionally impaired child who was insured as a dependent shall remain insured beyond any limiting age.

3 Individual Insurance Benefits Member 1 Spouse 2 Children 3 Parents Friends Accidental Death & Dismemberment Home and Auto Insurance Hospital Money Long Term Care Life Insurance For the purpose of the RTO/ERO Individual Benefits: 1 A member is defined as a full or associate member in good standing of RTO/ERO. 2 A spouse is defined as your legal or common-law spouse, or same-sex partner. 3 A child is defined as a child of any age.

4 WHO IS ELIGIBLE FOR COVERAGE? As a regular or associate member of RTO/ERO permanently residing in Canada, you are eligible to participate in the plans offered. Coverage is also available for your spouse and/or dependent children residing in Canada, including: Your legal or common-law spouse, including same sex partner; Unmarried children (including adopted, foster, step-children and legal wards) under 21 years of age; Unmarried children under age 30 provided they are enrolled at an accredited post-secondary institution as a full-time student and dependent upon you for support. Coverage will be extended to the earlier of August 31 st of the school year, age 30, or until coverage is terminated. Confirmation of full-time student status is requested each year by Johnson Inc. Any functionally impaired child who was insured as a dependent shall remain insured beyond any limiting age for dependents. For the purposes of insurance, functionally impaired includes an unmarried person who was insured as a dependent prior to becoming functionally impaired and who is wholly dependent upon the participant for support and maintenance within the terms of the Income Tax Act. (Note: A letter of diagnosis/prognosis is required from a physician.) Eligible expenses for covered dependent children studying outside their normal province of residence will be considered under the Extended Health Care Plan on the same basis as if expenses were incurred in their province of residence. Eligible expenses incurred due to a medical emergency by students travelling 500 kilometers or more away from their student residence and outside their normal province of residence will be considered under the Out-of-Province/Canada Travel Benefit.

5 SUPPLEMENTAL TRAVEL PLAN TRIP OPTIONS & PREMIUM RATES Coverage for the first 93 days of travel is included under your Extended Health Care Plan. Supplemental Travel Plan coverage starts on the 94 th day of travel. Rates Effective: September 1, 2016 to August 31, 2017 Single Premium** Couple Premium** EHC Base Plan Supplemental Travel Plan Total Trip Duration Under 55 Age and Over , ,513 2, ,402 2,268 3, ,050 1,778 2,901 3, ,014 1,321 2,245 3,529 4, * 197* ,221 1,589 2,673 4,192 5, * 212* ,074 1,434 1,882 3,134 4,908 6,548 EHC Base Plan Supplemental Travel Plan Total Trip Duration Under 55 Age and Over , ,142 1,942 2, ,064 1,860 3,026 4, ,248 1,644 2,804 4,536 6, ,264 1,628 2,100 3,556 5,802 7, ,548 2,028 2,642 4,490 7,058 9, * 197* 784 1,074 1,856 2,442 3,178 5,346 8,384 11, * 212* 918 1,254 2,148 2,868 3,764 6,268 9,816 13,096 * The availability of the Supplemental Travel Trip Options is subject to provincial residency requirements; currently these options are available only to Ontario, British Columbia, Alberta, Manitoba, New Brunswick, and Newfoundland and Labrador residents. For all other provinces the maximum duration is 182 days. ** Retail Sales Tax will be added to these premium rates, where required by law; 8% for Ontario residents and 9% for Quebec residents.

6 The Supplemental Travel Plan Premium will be deducted in equal monthly deductions from your pension or your bank account from the first deduction date following receipt of your signed and completed application to the last deduction date in the policy year which is July. Please contact Johnson Inc. Plan Benefits Service to obtain premium rates or for any other information. Johnson Inc. Plan Benefits Service Spadina Road Toronto ON M5R 2S (Toronto area) (toll free) (fax) ( ) Rev Jan 2017