Greyhound Canada Transportation Corp.

Transcription

1 Greyhound Canada Transportation Corp. Plan Document Numbers: G and G Group Policy Number: G Class: 34 - Union Employees (ATU Local 1374) of Greyhound Canada Transportation Corp. Employee Name: Certificate Number: Welcome to Your Group Benefit Program Plan Document Effective Date: March 1, 1983 Group Policy Effective Date: March 1, 1983 This Benefit Booklet has been specifically designed with your needs in mind, providing easy access to the information you need about the benefits to which you are entitled. Group Benefits are important, not only for the financial assistance they provide, but for the security they provide for you and your family, especially in case of unforeseen needs. Your employer can answer any questions you may have about your benefits, or how to submit a claim. This booklet produced: March 29,

2 Ta ble of Con tents Ben e fit Sum mary....3 How to Use Your Ben e fit Book let Explanation of Commonly Used Terms...12 Why Group Ben e fits? Your Em ployer s Rep re sen ta tive...17 Ap ply ing for Group Ben e fits Mak ing Changes The Claims Pro cess...18 Nam ing a Ben e fi ciary How to Sub mit a Claim...18 Co-or di na tion of Ex tended Health Care and Den tal Care Ben e fits Who Qualifies for Coverage? El i gi bil ity Med i cal Ev i dence Late Ap pli ca tion...21 Late Den tal Ap pli ca tion Ef fec tive Date of Cov er age Ter mi na tion of Cov er age...22 Your Group Ben e fits...23 Em ployee Life In sur ance...23 Em ployee Op tional Life In sur ance Spousal Op tional Life In sur ance Ac ci den tal Death and Dis mem ber ment...29 Em ployee Vol un tary Ac ci den tal Death and Dis mem ber ment...33 De pend ent Vol un tary Ac ci den tal Death and Dis mem ber ment Ex tended Health Care Den tal Care Sur vi vor Ex tended Ben e fit...68 Weekly In come (Short Term Dis abil ity) Long Term Dis abil ity...73 Notes Greyhound Canada Transportation Corp.

3 Ben e fit Sum mary This Benefit Summary provides information about the specific benefits supplied by Manulife Financial that are part of your Group Plan. This version of the Benefit Summary produced: March 29, 2016 Employee Life Insurance The Employee Life Insurance Benefit is insured under Manulife Financial s Policy G Employee Life Insurance Benefit Amount for single employees under age 65 - $25,000 for employees under age 65 with dependents - $50,000 for employees age 65 and over - $12,500 Termination Age - your benefit amount terminates at retirement. On retirement, your coverage may continue under the appropriate retiree Class. Employee Optional Life Insurance The Employee Optional Life Insurance Benefit is insured under Manulife Financial s Policy G Employee Optional Life Insurance Benefit Amount - increments of $10,000 to a maximum of $200,000 Termination Age - age 65 or retirement, whichever is earlier Spousal Optional Life Insurance The Spousal Optional Life Insurance Benefit is insured under Manulife Financial s Policy G Spousal Optional Life Insurance Benefit Amount - Spouse - increments of $10,000 to a maximum of $200,000 Termination Age - employee s age 65, spouse s age 70 or employee s retirement, whichever is earlier Greyhound Canada Transportation Corp. 3

4 Ben e fit Sum mary Accidental Death and Dismemberment Accidental Death and Dismemberment The Accidental Death and Dismemberment Benefit is insured under Manulife Financial s Policy G Benefit Amount for single employees - $25,000 for employees with dependents - $50,000 Termination Age - your benefit amount terminates at age 70 or retirement, whichever is earlier. Employee Voluntary Accidental Death and Dismemberment Employee Voluntary Accidental Death and Dismemberment The Employee Voluntary Accidental Death and Dismemberment Benefit is insured under Manulife Financial s Policy G Benefit Amount - increments of $10,000 to a maximum of $250,000 Termination Age - age 70 or retirement, whichever is earlier Dependent Voluntary Accidental Death and Dismemberment Dependent Voluntary Accidental Death and Dismemberment The Dependent Voluntary Accidental Death and Dismemberment Benefit is insured under Manulife Financial s Policy G Benefit Amount - Spouse of the amount of the Employee s Voluntary Accidental Death and Dismemberment Benefit to a maximum benefit of $125,000 if there are no children; 0.4 of the amount of the Employee s Voluntary Accidental Death and Dismemberment Benefit to a maximum benefit of $100,000 if there are children. - Child of the amount of the Employee s Voluntary Accidental Death and Dismemberment Benefit to a maximum benefit of $37,500 if there is no spouse; 0.1 of the amount of the Employee s Voluntary Accidental Death and Dismemberment Benefit to a maximum benefit of $25,000 if there is a spouse. Termination Age - employee s age 70 or retirement, whichever is earlier 4 Greyhound Canada Transportation Corp.

5 Ben e fit Sum mary Extended Health Care The Benefit Overall Benefit Maximum - $1,000,000 per lifetime (Maximum does not apply to Vision - Prescription Glasses) Extended Health Care Extended Health Care - The Benefit Deductible - Nil Benefit Percentage (Co-insurance) 100% for - Hospital Care - Medical Services & Supplies - Professional Services - Vision 90% for - Drugs Note: The Benefit Percentage for Out-of-Province/Canada Emergency Medical Treatment is 100%. Out-of-Province/Canada Emergency Medical Treatment coverage is in place for business and vacation travel only and subject to a maximum trip duration of 60 days. No Out-of-Province/Canada Emergency Medical Treatment benefits are payable for dependent students going to school outside Canada. The Benefit Percentage for Emergency Travel Assistance is 100%. Termination Age - employee s retirement Manu Script Ge neric Drug Plan 2 - Pre scrip tion Drugs Charges incurred for the following expenses are payable when prescribed in writing by a physician or dentist and dispensed by a licensed pharmacist. drugs for the treatment of a sickness or injury, which by law or convention require the written prescription of a physician or dentist Extended Health Care - ManuScript Generic Drug Plan 2 - Prescription Drugs oral contraceptives injectable medications standard syringes, needles, automatic jet injectors, manual or automatic insulin guns, and diagnostic aids, required for the treatment of diabetes (charges for cotton swabs, rubbing alcohol and similar equipment are not covered) allergy serums ileostomy and colostomy supplies Greyhound Canada Transportation Corp. 5

6 Ben e fit Sum mary Charges for the following expenses are not covered: - Drug Maximums preventive vaccines and medicines (oral or injected) the administration of serums, vaccines, or injectable drugs drugs, biologicals and related preparations which are administered in hospital on an in-patient or out-patient basis drugs determined to be ineligible as a result of due diligence intrauterine devices and diaphragms - Drug Maximums Covered drug expenses are subject to the Overall Benefit Maximum. Additional limitations also apply to the following expenses: Fertility drugs - $15,000 per lifetime Anti-smoking drugs - $350 per lifetime Drugs used in the treatment of a sexual dysfunction - Unlimited - Payment of Covered Expenses - Payment of Covered Expenses Payment of your covered drug expenses will be subject to any Drug Deductible, any Drug Dispensing Fee Maximum, the Benefit Percentage for drugs and any maximum. Covered expenses for any prescribed drug will not exceed the price of the lower cost alternative drug that can legally be used to fill the prescription, as listed in the Provincial Drug Benefit Formulary or a lower cost alternative that provides therapeutically similar results as identified by Manulife Financial. Manulife Financial can limit the Covered Expense for any drug to that of a lower cost interchangeable drug at the time the drug is purchased. If there is no lower cost alternative drug for the prescribed drug, the amount payable is based on the cost of the prescribed drug. - No Substitution Prescriptions - No Substitution Prescriptions If your prescription contains a written direction from your physician or dentist that the prescribed drug is not to be substituted with another product, the maximum amount covered is the price of the lower cost alternative drug that can legally be used to fill the prescription, as listed in the Provincial Drug Benefit Formulary or a lower cost alternative that provides therapeutically similar results as identified by Manulife Financial. If there is no lower cost alternative drug for the prescribed drug, the amount payable is based on the cost of the prescribed drug. 6 Greyhound Canada Transportation Corp.

7 Ben e fit Sum mary Reimbursement at the cost of a prescribed drug, where a lower cost alternative drug is available, will only be considered if medical evidence is provided by the treating physician to support why the lower cost alternative drug cannot be tolerated or is ineffective. Payment of your covered drug expenses will be subject to any Drug Deductible, any Drug Dispensing Fee Maximum, the Benefit Percentage for drugs and any maximum. Payment of Drug Claims Your Pay Direct Drug Card provides your pharmacist with immediate confirmation of covered drug expenses. This means that when you present your Pay Direct Drug Card to your pharmacist at the time of purchase, you and your eligible dependents will not incur out-of-pocket expenses for the full cost of the prescription. The Pay Direct Drug Card is honoured by participating pharmacists displaying the appropriate Pay Direct Drug decal. To fill a prescription for covered drug expenses: a) present your Pay Direct Drug Card to the pharmacist at the time of purchase, and b) pay any amounts that are not covered under this benefit. You will be required to pay the full cost of the prescription at time of purchase if: you cannot locate a participating Pay Direct Drug pharmacy you do not have your Pay Direct Drug Card with you at that time the prescription is not payable through the Pay Direct Drug Card system For details on how to receive reimbursement after paying the full cost of the prescription, please see your Plan Administrator. Vision Care eye exams, $31.75 per 24 months purchase and fitting of prescription glasses or elective contact lenses, as well as repairs, or elective laser vision correction procedures, to a maximum of $200 per 12 months for persons under age 14 and $200 per 24 months for persons age 14 and over Extended Health Care - Vision Care contact lenses or glasses following cataract surgery, once per lifetime Pro fes sional Ser vices Services provided by the following licensed practitioners: Chiropractor - $35 per visit to a maximum of 20 visits per calendar year Osteopath - $35 per visit to a maximum of 20 visits per calendar year Podiatrist/Chiropodist - $35 per visit to a maximum of 20 visits per calendar year Extended Health Care - Professional Services Greyhound Canada Transportation Corp. 7

8 Ben e fit Sum mary Chiropodist - $35 per visit to a maximum of 20 visits per calendar year Massage Therapist - $35 per visit to a maximum of 20 visits per calendar year Speech Therapist - $35 per visit to a maximum of 20 visits per calendar year Physiotherapist - $35 per visit to a maximum of 20 visits per calendar year Psychologist - $50 per visit to a maximum of $500 per calendar year Naturopath - $200 per calendar year Acupuncturist - $100 per calendar year Nutritional Counsellor - $100 per calendar year. Dietitians are eligible for reimbursement for residents of Alberta, Quebec, New Brunswick and Nova Scotia only. Dental Care Dental Care - The Benefit Dental Care The Benefit Deductible for Dental Accident - Nil for all other expenses - $30 Individual, $50 Family, per calendar year Dental Fee Guide - Current Fee Guide for General Practitioners and Specialists for your Province of Residence If you reside in Alberta, the current Fee Guide is considered to be the 1997 Alberta Dental Association Fee Guide for General Practitioners and Specialists plus inflationary adjustment as determined by Manulife Financial. Benefit Percentage (Co-insurance) - 90% for Type 1 - Diagnostic and Preventative - 90% for Type 2 - Minor Restorative Services - 90% for Dental Accidents - 80% for Type 3 - Major Restorative: Crowns, Onlays and Inlays - 50% for Type 3 - Major Restorative: all eligible expense excluding Crowns, Onlays and Inlays - 50% for Type 4 - Orthodontics 8 Greyhound Canada Transportation Corp.

9 Ben e fit Sum mary Benefit Maximums - unlimited for Dental Accidents - $1,500 per calendar year combined for Type 1, Type 2 and Type 3, excluding Dentures and Bridges - $2,000 per year for Type 3: Dentures and Bridges - $1,500 per lifetime for Type 4 Termination Age - employee s retirement Weekly Income (Short Term Disability) Weekly Income The Weekly Income Benefit is insured under Manulife Financial s Policy G Benefit Amount - 60% of weekly earnings, to a maximum benefit of $550 Minimum benefit of $408 for senior shop and store clerks, operators, mechanics, service employees and ticket, baggage, express agents and $342 for all other Employees. Qualifying Period - none, if the disability is due to an accident; 2 calendar days, if the disability is due to a sickness If hospitalized due to sickness prior to the end of the Qualifying Period, benefits are payable from the first day of hospitalization. Maximum Benefit Period - 26 weeks Termination Age - retirement Long Term Disability Long Term Disability The Long Term Disability Benefit is insured under Manulife Financial s Policy G Benefit Amount - 50% of monthly earnings, to a maximum of $1,800 Qualifying Period - 26 weeks Maximum Benefit Period - to age 60. However, should you complete the qualifying period after your 59th birthday but prior to your 60th birthday, the monthly income payments will continue beyond age 60 as long as you are totally disabled, subject to a maximum of 12 monthly payments. Termination Age - age 60 or retirement, whichever is earlier Greyhound Canada Transportation Corp. 9

10 How to Use Your Ben e fit Book let De signed with Your Needs in Mind The Benefit Booklet provides the information you need about your Group Benefits and has been specifically designed with YOUR needs in mind. It includes: Your Benefit Booklet includes... a detailed Table of Contents, allowing quick access to the information you are searching for, Explanation of Commonly Used Terms, which provides a brief explanation of the terms used throughout this Benefit Booklet, a clear, concise explanation of your Group Benefits, and information you need, and simple instructions, on how to submit a claim. Important Note Important Note The purpose of this booklet is to outline the benefits for which you are eligible as an employee of Greyhound Canada Transportation Corp. The information in this booklet is a summary of the provisions of the Group Policy for the Employee Life Insurance, Employee Optional Life Insurance, Spousal Optional Life Insurance, Accidental Death and Dismemberment, Employee Voluntary Accidental Death and Dismemberment, Dependent Voluntary Accidental Death and Dismemberment, Weekly Income and Long Term Disability Benefits, and the Plan Document for the Extended Health Care and Dental Care Benefits. In the event of a discrepancy between this booklet and the Policy or Plan Document (both available from your employer), the terms of the Policy or Plan Document will apply. The booklet in either its paper or electronic form is provided for information purposes only and does not create or confer any contractual rights or obligations. Possession of this booklet alone does not mean that you or your dependents are covered. The Group Policy and Plan Document must be in effect and you must satisfy all the requirements of the Plan. Greyhound Canada Transportation Corp. expects to continue the Group Benefits program indefinitely, however the company reserves the right to modify, suspend or terminate, entirely or partially, any of the benefits summarized herein. Where required by law, you or any claimant under the Group Policy and/or Plan Document has the right to request a copy of any or all of the following items: the Group Policy and/or Plan Document, your application for group benefits, and any Evidence of Insurability you submitted as part of your application for benefits. In the case of a claimant, access to these documents is limited to that which is relevant to the filing of a claim, or the denial of a claim under the Group Policy and/or Plan Document. Manulife Financial reserves the right to charge you for such documentation after your first request. 10 Greyhound Canada Transportation Corp.

11 How to Use Your Ben e fit Book let We suggest you read this Benefit Booklet carefully, then file it in a safe place with your other important documents. Your Group Ben e fit Card Your Group Benefit Card is the most important document issued to you as part of your Group Benefit Program. It is the only document that identifies you as a Plan Member. The Group Policy Number, Plan Document Number and your personal Certificate Number may be required before you are admitted to a hospital, or before you receive dental or medical treatment. Your Group Benefit Card The Group Policy Number, Plan Document Number and your Certificate Number are also necessary for ALL correspondence with Manulife Financial. Please note that you can print your Certificate Number on the front of this booklet for easy reference. Your Group Benefit Card is an important document. Please be sure to carry it with you at all times. Greyhound Canada Transportation Corp. 11

12 Explanation of Commonly Used Terms The following is an explanation of the terms used in this Benefit Booklet. Adherence Adherence use drug, service or supply in accordance with the terms for which it was prescribed. Advisory Body Advisory Body Manulife Financial approved external experts that may provide Manulife Financial with recommendations, applying a pharmacoeconomic or cost effectiveness evaluation. Ben e fit Per cent age (Co-in sur ance) Benefit Percentage (Co-insurance) the percentage of Covered Expenses which is payable by your employer Common Accident Common Accident the same covered accident or separate covered accident occurring within a 24 hour period Covered Expenses Cov ered Ex penses expenses that will be considered in the calculation of payment due under your Extended Health Care or Dental Care benefit Deductible Deductible the amount of Covered Expenses that must be incurred and paid by you or your dependents before benefits are payable by your employer Dependent Dependent your spouse or child who resides in the same country as you, and, for Extended Health Care, is covered under the provincial medical plan - Spouse your legal spouse, or a person continuously living with you in a role like that of a marriage partner for at least one year Only one spouse will be eligible for benefits under this Plan, and will be as indicated by you on your application for benefits under this Plan. Where this information is not contained on your application, the person who qualifies last under this Plan s definition of spouse will be the eligible spouse. 12 Greyhound Canada Transportation Corp.

13 Explanation of Commonly Used Terms - Child your natural or adopted child, stepchild or foster child, who: - is unmarried, - relies on you for support, - is not employed for more than 30 hours per week, - is not eligible for coverage as an employee under this or any other Group Benefit Program, and - is under age 21, or under age 25 if a full-time student. a child who is incapacitated on the date he or she reaches the age when coverage would normally terminate will continue to be an eligible dependent. However, the child must have been covered under this Benefit Program immediately prior to that date. A child is considered incapacitated if he or she is incapable of engaging in any substantially gainful activity and is dependent on the employee for support, maintenance and care, due to a mental or physical handicap. Your employer may require written proof of the child s condition as often as may reasonably be necessary. a stepchild must be living with you to be eligible a newborn child shall become eligible from the moment of birth Dis ease Man age ment Pro grams an approach to healthcare that teaches patients how to manage a chronic disease. A system of coordinated healthcare interventions and communications for patients with conditions in which patient self-care efforts are significant in the management of their condition. Disease Management Programs Drug a medication that has been approved for use by Health Canada and has a Drug Identification Number. Drug Due Diligence a process employed by Manulife Financial to assess new drugs, existing drugs with new indications, services or supplies to determine eligibility under the Plan Document. This process may use pharmacoeconomics, cost effectiveness analysis reference information from existing Federal or Provincial formularies, recognized clinical practice guidelines, or an advisory body. Due Diligence Greyhound Canada Transportation Corp. 13

14 Explanation of Commonly Used Terms Earnings Earn ings for drivers/operators, average earnings (excluding meal allowance, but including vacation pay) during the first 13 or last 13 pay periods of the year; the period to be used is the last completed pay period prior to the date of disability. This amount will be pro-rated by deducting any period of 15 days or longer off the payroll due to leave of absence or lay-off. for all other employees, basic earnings based on the classification and hourly rate as of January 1 of each year. For the purposes of determining the amount of your benefit at the time of claim, your earnings will be the lesser of: the amount reported on your claim form, or the amount reported by your employer to Manulife Financial and for which premiums have been paid. Employer Employer Greyhound Canada Transportation Corp Exclusive Distribution Ex clu sive Dis tri bu tion Manulife Financial approved vendors. Ex per i men tal or In ves ti ga tional Experimental or Investigational not approved as an effective, appropriate and essential treatment of an illness or injury. Immediate Family Member Immediate Family Member you, your spouse or child, your parent or your spouse s parent, your brother or sister, or your spouse s brother or sister Interchangeable Drug In ter change able Drug includes but is not limited to: a generic equivalent to the brand name drug deemed to be interchangeable by law where the drug is dispensed; a drug that contains the same active ingredient that has not been deemed interchangeable in the province where the drug is dispensed; but has been identified as interchangeable by Manulife Financial Li censed, Cer ti fied, Reg is tered Licensed, Certified, Registered the status of a person who legally engages in practice by virtue of a license or certificate issued by the appropriate authority, in the place where the service is provided Life-Sustaining Drugs Life-Sustaining Drugs non-prescription drugs which are necessary to sustain life. 14 Greyhound Canada Transportation Corp.

15 Explanation of Commonly Used Terms Lower Cost Al ter na tive if two or more drugs, supplies or services result in therapeutically similar results, the lower cost alternative will be considered. Lower Cost Alternative Med i cally Nec es sary accepted and recognized by the Canadian medical profession and Manulife Financial as effective, appropriate and essential treatment of a phase of an illness or injury. Manulife Financial has the right after due diligence has been completed to determine whether the drug, service or supply is eligible under the Plan Document. Medically Necessary Non-Evidence Limit you must submit satisfactory medical evidence to Manulife Financial for Benefit Amounts greater than this amount Non-Evidence Limit Pa tient As sis tance Pro gram a program that provides assistance to you or your dependents who are prescribed select drugs, supplies or services. Manufacturers and distributors may provide patient assistance programs that include financial support, along with education and training. Patient Assistance Program Pharmacoeconomics the scientific discipline that compares the value of one pharmaceutical drug or drug therapy to another. Pharmacoeconomic studies serve to guide optimal healthcare resource allocation, in a standardized and scientifically grounded manner as determined by Manulife Financial. Pharmacoeconomics Plan Spon sor First Canada ULC Employee Benefit Trust Plan Sponsor Prior Authorization a claims management feature applied to a specific list of drugs, supplies or services to determine eligibility based on predefined clinical criteria and a pharmacoeconomic or cost effectiveness evaluation. Prior Authorization Provincial Plan any plan which provides hospital, medical, or dental benefits established by the government in the province where the covered person lives Provincial Plan Qualifying Period a period of continuous total disability, starting with the first day of total disability, which you must complete in order to qualify for disability benefits Qualifying Period Greyhound Canada Transportation Corp. 15

16 Explanation of Commonly Used Terms Rea son able and Cus tom ary Reasonable and Customary the lowest of: the prevailing amount charged for the same or comparable service or supply in the area in which the charge is incurred, as determined by Manulife Financial, the amount shown in the applicable professional association fee guide, or the maximum price established by law. Take Home Pay (Net Earn ings) Take Home Pay (Net Earnings) your earnings, less deductions normally made for federal and provincial income tax Waiting Period Waiting Period the period of continuous employment with your employer which you must complete before you are eligible for Group Benefits Ward Ward a hospital room with 3 or more beds which provides standard accommodation for patients 16 Greyhound Canada Transportation Corp.

17 Why Group Ben e fits? Government health plans can provide coverage for such basic medical expenses as hospital charges and doctors fees. In case of disability, government plans (such as Employment Insurance, Canada/Quebec Pension Plan, Workers Compensation Act, etc.) may provide some financial assistance. Why Group Benefits? But government plans provide only basic coverage. Medical expenses or a disability can create financial hardship for you and your family. Private health care and disability programs supplement government plans and can provide benefits not available through any government plan, providing security for you and your family when you need it most. Your Employer s Representative Your employer is responsible for ensuring that all employees are covered for the Benefits to which they are entitled by reporting all new enrolments, terminations, changes, etc., and keeping all records up to date. Your Employer s Representative As a member of this Group Benefit Program, it is up to you to provide your employer with the necessary information to perform such duties. Your Employer s Representative is Phone Num ber: ( ) - Please record the name of your representative and the contact number in the space provided. Applying for Group Benefits To apply for Group Benefits, you must submit a completed Enrolment or Re-enrolment Application form, available from your employer. Your employer then forwards the application to Manulife Financial. Applying for Group Benefits Making Changes To ensure that coverage is kept up to date for yourself and your dependents, it is vital that you report any changes to your employer. Such changes could include: change in Dependent Coverage change in Beneficiary applying for coverage previously waived change in Name Making Changes Greyhound Canada Transportation Corp. 17

18 The Claims Pro cess Naming a Beneficiary Naming a Beneficiary Manulife Financial does not accept beneficiary designations for any benefits other than Employee Life Insurance, Employee Optional Life Insurance, Accidental Death and Dismemberment and Employee Voluntary Accidental Death and Dismemberment. This Plan contains a provision removing or restricting the right of the covered person to designate persons to whom or for whose benefit money is to be payable. How to Submit a Claim How to Sub mit a Claim All claim forms, available from your employer, must be correctly completed, dated and signed. Remember, always provide your Group Policy Number, Plan Document Number and your Certificate number (found on your Group Benefit Card) to avoid any unnecessary delays in the processing of your claim. Your employer can assist you in properly completing the forms, and answer any questions you may have about the claims process and your Group Benefit Program. You may not commence legal action against the employer or the administrator less than 60 days after proof has been filed as outlined under Submitting a Claim. Every action or proceeding against the employer or the administrator for the recovery of money payable under the plan is absolutely barred unless commenced within the time set out in the Insurance Act or applicable legislation. Claim Payment Pay ment of Ex tended Health Care and Den tal Claims Once the claim has been processed, Manulife Financial will send a Claim Statement to you. The top portion of this form outlines the claim or claims made, the amount subtracted to satisfy deductibles, and the benefit percentage used to determine the final payment to be made to you. If you have any questions on the amount, your employer will help explain. The bottom portion of this form is your claims payment, if applicable. Simply tear along the perforated line, endorse the back of the cheque and you can cash it at any chartered bank or trust company. You should receive settlement of your claim within three weeks from the date of submission to Manulife Financial. If you have not received payment, please contact your employer. Co-or di na tion of Ex tended Health Care and Den tal Care Ben e fits Co-ordination of Extended Health Care and Dental Care Benefits If you or your dependents are covered for similar benefits under another Plan, this information will be taken into account when determining the amount of expenses payable under this Program. This process is known as Co-ordination of Benefits. It allows for reimbursement of covered medical and dental expenses from all Plans, up to a total of 100% of the actual expense incurred. 18 Greyhound Canada Transportation Corp.

19 The Claims Pro cess Plan means: other Group Benefit Programs, any other arrangement of coverage for individuals in a group, and individual travel insurance plans. Plan does not include school insurance or provincial plans. Order of Benefit Payment A variety of circumstances will affect which Plan is considered as the Primary Carrier (i.e., responsible for making the initial payment toward the eligible expense), and which Plan is considered as the Secondary Carrier (i.e., responsible for making the payment to cover the remaining eligible expense). If the other Plan does not provide for Co-ordination of Benefits, it will be considered as the Primary Carrier, and will be responsible for making the initial payment toward the eligible expense. Order of Benefit Payment If the other Plan does provide for Co-ordination of Benefits, the following rules are applied to determine which Plan is the Primary Carrier. For Claims incurred by you or your dependent Spouse: The Plan covering you or your dependent spouse as an employee/member pays benefits before the Plan covering you or your spouse as a dependent. In situations where you or your spouse has coverage as an employee/member under more than one Plan, the order of benefit payment will be determined as follows: The Plan where the person is covered as an active full-time employee, then The Plan where the person is covered as an active part-time employee, then The Plan where the person is covered as a retiree. For Claims incurred by your dependent child: The Plan covering the parent whose birthday (month/day) is earlier in the calendar year pays benefits first. If both parents have the same birthdate, the Plan covering the parent whose first name begins with the earlier letter in the alphabet pays first. However, if you and your spouse are separated or divorced, the following order applies: The Plan of the parent with custody of the child, then Greyhound Canada Transportation Corp. 19

20 The Claims Pro cess The Plan of the spouse of the parent with custody of the child (i.e., if the parent with custody of the child remarries or has a common-law spouse, the new spouse s Plan will pay benefits for the dependent child), then The Plan of the parent not having custody of the child, then The Plan of the spouse of the parent not having custody of the child (i.e., if the parent without custody of the child remarries or has a common-law spouse, the new spouse s Plan will pay benefits for the dependent child). Where you and your spouse share joint custody of the child, the Plan covering the parent whose birthday (month/day) is earlier in the calendar year pays benefits first. If both parents have the same birthdate, the Plan covering the parent whose first name begins with the earlier letter in the alphabet pays first. A claim for accidental injury to natural teeth will be determined under Extended Health Care Plans with accidental dental coverage before it is considered under Dental Plans. If the order of benefit payment cannot be determined from the above, the benefits payable under each Plan will be in proportion to the amount that would have been payable if Co-ordination of Benefits did not exist. If the person is also covered under an individual travel insurance plan, benefits will be co-ordinated in accordance with the guidelines provided by the Canadian Life and Health Insurance Association. Submitting a Claim for Co-ordination of Benefits Submitting a Claim for Co-ordination of Benefits To submit a claim when Co-ordination of Benefits applies, refer to the following guidelines: As per the Order of Benefit Payment section, determine which Plan is the Primary Carrier and which is the Secondary Carrier. Submit all necessary claim forms and original receipts to the Primary Carrier. Keep a photocopy of each receipt or ask the Primary Carrier to return the original receipts to you once your claim has been settled. Once your claim has been settled by the Primary Carrier, you will receive a statement outlining how your claim has been handled. Submit this statement along with all necessary claim forms and receipts to the Secondary Carrier for further consideration of payment, if applicable. 20 Greyhound Canada Transportation Corp.

21 Who Qual i fies for Cov er age? El i gi bil ity You are eligible for Group Benefits if you: are a full-time employee of Greyhound Canada Transportation Corp. and work at least the Required Number of Hours, Eligibility are a member of an eligible class, are younger than the Termination Age, are residing in Canada, and have completed the Waiting Period. The Termination Age and Waiting Period may vary from benefit to benefit. For this information, please refer to each benefit in the section entitled Your Group Benefits. Your dependents are eligible for coverage on the date you become eligible or the date you first acquire a dependent, whichever is later. You must apply for coverage for yourself in order for your dependents to be eligible. Re quired Num ber of Hours Full-time employee - 30 hours per week Required Number of Hours Medical Evidence Medical evidence is required for all benefits, except Dental, when you make a Late Application for coverage on any person. Medical evidence is required when you apply for coverage in excess of the Non-Evidence Limit. Late Application An application is considered late when you: apply for coverage on any person after having been eligible for more than 31 days, or Medical Evidence Late Application re-apply for coverage on any person whose coverage had earlier been cancelled. If you apply for benefits that were previously waived because you were covered for similar benefits under your spouse s plan, your application is considered late when you: apply for benefits more than 31 days after the date benefits terminated under your spouse s plan, or apply for benefits, and benefits under your spouse s plan have not terminated. Medical evidence can be submitted by completing the Evidence of Insurability form, available from your employer. Further medical evidence may be requested by Manulife Financial. Greyhound Canada Transportation Corp. 21

22 Who Qual i fies for Cov er age? Late Dental Application Late Dental Application If you apply for coverage for Dental for yourself or your dependents late, the benefit will be limited to $100 for each covered person for the first 12 months of coverage. Effective Date of Coverage Effective Date of Coverage If medical evidence is not required, your Group Benefits will be effective on the date you are eligible. If medical evidence is required, your Group Benefits will be effective on the date you become eligible or the date the evidence is approved by Manulife Financial, whichever is later. You must be actively at work for plan benefit coverage to become effective. If you are not actively at work on the date your coverage would normally become effective, your coverage will take effect on the next day on which you are again actively at work. Your dependent s coverage becomes effective on the date the dependent becomes eligible, or the date any required medical evidence on the dependent is approved by Manulife Financial, whichever is later. Your dependent s coverage will not be effective prior to the date your coverage becomes effective. This does not apply to Spousal Optional Life Insurance which may still become effective if you are declined for Employee Optional Life. Termination of Coverage Termination of Coverage Your Group Benefit coverage will terminate on the earliest of: the date you cease to be an eligible employee the date you cease to be actively at work, unless the Group Policy or the Plan Document allows for your coverage to be extended beyond this date the date your employer terminates coverage the date you enter the armed forces of any country on a full-time basis the date the Group Policy or Plan Document terminates or coverage on the class to which you belong terminates the date you reach the Termination Age the date of your death for Extended Health Care and Dental Care, the date any required contribution is due but not paid Your dependents coverage terminates on the date your coverage terminates or the date the dependent ceases to be an eligible dependent, whichever is earlier. 22 Greyhound Canada Transportation Corp.

23 Employee Life Insurance The Employee Life Insurance Benefit is insured under Manulife Financial s Policy G Employee Life Insurance If you die while insured, this benefit provides financial assistance to your beneficiary. If your beneficiary dies before you or if there is no designated beneficiary, this benefit is payable to your estate. The Benefit Benefit Amount for single employees under age 65 - $25,000 Employee Life - The Benefit for employees under age 65 with dependents - $50,000 for employees age 65 and over - $12,500 Non-Evidence Limit for single employees under age 65 - $25,000 for employees under age 65 with dependents - $50,000 for employees age 65 and over - $12,500 Qualifying Period for Waiver of Premium - 6 months Termination Age - your benefit amount terminates at retirement. On retirement, your coverage may continue under the appropriate retiree Class Participation Basis - mandatory Waiting Period none for employees hired on or prior to the Group Policy Effective Date first of the month coincident with or immediately following 3 months of continuous service for all other employees Greyhound Canada Transportation Corp. 23

24 Employee Life Insurance - Naming a Beneficiary Nam ing a Ben e fi ciary You have the right to designate and/or change a beneficiary, subject to governing law. The necessary forms are available from your Plan Administrator. You should review your beneficiary designation to be sure that it reflects your current intent. Employee Life Insurance - Submitting a Claim Submitting a Claim To submit an Employee Life Insurance claim, your beneficiary must complete the Life Claim form which is available from your Plan Administrator. Documents necessary to submit with the form are listed on the form. A completed claim form must be submitted within 12 months from the date of the loss. To submit a claim for the Waiver of Premium benefit you must complete a Waiver of Premium claim form, which is available from your Plan Administrator. Your attending physician must also complete a portion of this form. A completed claim form must be submitted within 12 months of the date disability commences. Employee Life Insurance - Waiver of Premium Employee Life Insurance - Totally Disabled Waiver of Pre mium If you become Totally Disabled while insured and prior to age 60 and meet the Entitlement Criteria outlined below, your Life Insurance will continue without payment of premium. Definition of Totally Disabled Totally Disabled means a restriction or lack of ability due to an illness or injury which prevents you from working for remuneration or profit. The availability of work will not be considered by Manulife Financial in assessing your disability. If you must hold a government permit or licence to perform the duties of your job, you will not be considered Totally Disabled solely because your permit or licence has been withdrawn or not renewed. 24 Greyhound Canada Transportation Corp.

25 Entitlement Criteria To be entitled to Waiver of Premium, you must meet the following criteria: you must be continuously Totally Disabled throughout the Qualifying Period. If you cease to be Totally Disabled during this period and then become disabled again within 3 weeks due to the same or related illness or injury, your Qualifying Period will be extended by the number of days during which you ceased to be Totally Disabled Employee Life Insurance - Entitlement Criteria Manulife Financial must receive medical evidence documenting how your illness or injury causes restrictions or lack of ability, such that you are prevented from working for remuneration or profit you must be receiving from a physician, regular, ongoing care and treatment appropriate for your disabling condition, as determined by Manulife Financial At any time, Manulife Financial may require you to submit to a medical, psychiatric, psychological, functional, educational and/or vocational examination or evaluation by an examiner selected by Manulife Financial. Ter mi na tion of Waiver of Pre mium Your Waiver of Premium will cease on the earliest of: the date you cease to be Totally Disabled, as defined under this benefit the date you do not supply Manulife Financial with appropriate medical evidence documenting how your illness or injury causes restrictions or lack of ability, such that you are prevented from working for remuneration or profit Employee Life Insurance - Termination of Waiver of Premium the date you are no longer receiving from a physician, regular, ongoing care and treatment appropriate for the disabling condition, as determined by Manulife Financial the date you do not attend an examination by an examiner selected by Manulife Financial the date of your death the date of your 60th birthday If you return to work for the employer, your coverage shall not exceed the Employee Life benefit amount in excess of the amount for which you are eligible upon return to work. If you are covered for Long Term Disability benefits and become disabled in the 12 months prior to attaining age 60, premiums will be waived while you are totally disabled, for a maximum of 12 months. Greyhound Canada Transportation Corp. 25

26 Employee Life Insurance - Recurrent Disability Re cur rent Dis abil ity If you become Totally Disabled again from the same or related causes as those for which premiums were previously waived, and such disability recurs within 6 months of cessation of the Waiver of Premium benefit, Manulife Financial will waive the Qualifying Period. Your amount of insurance on which premiums were previously waived will be reinstated. If the same disability recurs more than 6 months after cessation of your Waiver of Premium benefit, such disability will be considered a separate disability. Two disabilities which are due to unrelated causes are considered separate disabilities if they are separated by a return to work of at least one day. Employee Life Insurance - Compassionate Assistance Benefit Com pas sion ate As sis tance Ben e fit You may apply for an early payment of 50% of your Employee Life Insurance benefit amount to a maximum of $50,000, provided: a physician appointed by Manulife Financial determines you are certain to die within 24 months of the determination, you are competent to act, you request the benefit in writing, and consent is provided by any beneficiary you designated as irrevocable. Upon your death, the amount of Compassionate Assistance Benefit paid will be deducted from the Employee Life benefit amount in effect at the time of your death. Employee Life Insurance - Conversion Privilege Conversion Privilege If your Group Benefits terminate or reduce, you may be eligible to convert your Employee Life Insurance to an individual policy, without medical evidence. Your application for the individual policy along with the first monthly premium must be received by Manulife Financial within 31 days of the termination or reduction of your Employee Life Insurance. If you die during this 31-day period, the amount of Employee Life Insurance available for conversion will be paid to your beneficiary or estate, even if you didn t apply for conversion. However, if you received a Compassionate Assistance Benefit, the conversion amount shall not exceed the benefit amount for which you were eligible on the date of termination, less any amount paid to you as compassionate assistance, unless such amount has been reimbursed by you. For more information on the conversion privilege, please see your Plan Administrator. Provincial differences may exist. 26 Greyhound Canada Transportation Corp.

27 Employee Optional Life Insurance Your Group Ben e fits The Employee Optional Life Insurance Benefit is insured under Manulife Financial s Policy G Employee Optional Life Insurance If you die while insured, this benefit provides financial assistance to your beneficiary, in addition to your Employee Life Insurance Benefit. If your beneficiary dies before you or if there is no designated beneficiary, this benefit is payable to your estate. The Benefit Benefit Amount - increments of $10,000 to a maximum of $200,000 Employee Optional Life Insurance - The Benefit Non-Evidence Limit - All amounts are subject to Evidence of Insurability. Qualifying Period for Waiver of Premium - 6 months Termination Age - age 65 or retirement, whichever is earlier Participation Basis - non-mandatory Waiting Period none for employees hired on or prior to the Group Policy Effective Date first of the month coincident with or immediately following 3 months of continuous service for all other employees To apply for Employee Optional Life Insurance you must complete the Application for Optional Life form which is available from your Plan Administrator. For details on Naming a Beneficiary, Submitting a Claim and Conversion Privilege, please refer to Employee Life Insurance. Waiver of Pre mium If your Employee Life Insurance premium is waived because you are totally disabled, the premium for this benefit will also be waived. (See Employee Life Insurance...Waiver of Premium). Ex clu sions If death results from suicide any amount of Optional Life Insurance that has been in effect for less than two years will not be payable. Employee Optional Life Insurance - Waiver of Premium Employee Optional Life Insurance - Exclusions Greyhound Canada Transportation Corp. 27

28 Spousal Optional Life Insurance Spousal Optional Life Insurance The Spousal Optional Life Insurance Benefit is insured under Manulife Financial s Policy G If one of your dependents dies while insured, the amount of this benefit will be paid to you. Spousal Optional Life Insurance - The Benefit The Benefit Benefit Amount - Spouse - increments of $10,000 to a maximum of $200,000 Non-Evidence Limit - All amounts are subject to Evidence of Insurability. Termination Age - employee s age 65, spouse s age 70 or employee s retirement, whichever is earlier Participation Basis - non-mandatory Waiting Period none for employees hired on or prior to the Group Policy Effective Date first of the month coincident with or immediately following 3 months of continuous service for all other employees To apply for Dependent Optional Life Insurance you must complete the Application for Optional Life form which is available from your Plan Administrator. Dependent Optional Life Insurance - Submitting a Claim Submitting a Claim To submit a Dependent Optional Life Insurance claim, you must complete the Life Claim form which is available from your Plan Administrator. Documents necessary to submit with the form are listed on the form. A completed claim form must be submitted within 12 months from the date of loss. 28 Greyhound Canada Transportation Corp.

29 Waiver of Pre mium Please refer to Employee Life Insurance for details on the Waiver of Premium provision. Dependent Optional Life Insurance - Waiver of Premium - Exception If you are not insured for Employee Optional Life, the Waiver of Premium provision will not apply to your spouse s Dependent Optional Life Insurance, unless: at the time you applied for Dependent Optional Life Insurance on your spouse, you also provided Manulife Financial with evidence of insurability for yourself, and Manulife Financial approved your evidence of insurability. Conversion Privilege If your spouse s insurance terminates, he or she may be eligible to convert the terminated insurance to an individual policy, without medical evidence. Your spouse s application for the individual policy, along with the first monthly premium, must be received by Manulife Financial, within 31 days of the termination date. If your spouse dies during this 31-day period, the amount of Dependent Optional Life Insurance available for conversion will be paid to you, even if your spouse didn t apply for conversion. Dependent Optional Life Insurance - Conversion Privilege For more information on the conversion privilege, please see your Plan Administrator. Provincial differences may exist. Ex clu sions If death results from suicide any amount of Dependent Optional Life Insurance that has been in effect for one or more years will not be payable. Dependent Optional Life Insurance - Exclusions Accidental Death and Dismemberment The Accidental Death and Dismemberment Benefit is insured under Manulife Financial s Policy G Accidental Death and Dismemberment If you sustain an accidental injury while insured and suffer a loss specified in the Schedule of Losses below, this benefit provides financial assistance to you or your beneficiary. In the event of your death, the benefit is payable to your beneficiary. If your beneficiary dies before you or if there is no designated beneficiary, this benefit is payable to your estate. For losses other than Loss of Life, the benefit is payable to you. Greyhound Canada Transportation Corp. 29