Mandatory Benefits
Basic Life Insurance
Schedule
Non-Evidence Maximum
Waiver of Premium Benefit
Reduction Clause
Termination Clause
Basic A.D. & D.
Schedule
Non-Evidence Maximum
Reduction Clause
Termination Clause
Dependent Life Insurance
Spouse
Dependent Child
Pre-Natal Benefit
Dependent Life Insurance
Schedule: $20,000/$10,000/$5,000
Non-Evidence Maximum: $20,000
Termination Clause: Earlier of employee retirement, or attainment of age 70
$25,000
$25,000
After 17 week waiting period
50% at age 65, additional 50% reduction at age 70
Earlier of employee retirement, or attainment of age 80
$25,000
$25,000
50% at age 65, additional 50% reduction at age 70
Earlier of employee retirement, or attainment of age 80
$20,000
$10,000
Upon Receipt by Wawanesa Life Insurance of satisfactory
proof that you or your spouse while covered under this
benefit have a stillbirth, we will reimburse you for funeral
expenses to a maximum not exceeding the dependent life
insurance amount shown in the schedule of benefits for a
dependent child. Stillbirth means the complete expulsion or
extraction from the mother of a fetus weighing 500 grams or
more; or with a body length of 25 centimetres or more; or
gestational age of 20 weeks or more which, after complete
separation from the mother, does not breathe or show any
sign of life at or after birth.
Termination Clause: Earlier of employee retirement, or attainment of age 80
“Our Health Care Solo Plan delivers comprehensive life, health and dental coverage with no medical questions and pooled rates for easy enrollment. Members benefit from prescription drug, vision and medical practitioner reimbursements. Fully pooled and straightforward, it offers simplicity and confidence with online claims for peace of mind and tax-deductible benefits.
Extended Health Care
Prescription Drugs
- Prescription Drug Deductible: N/A
- Reimbursement: 80%
- Drug Benefit Maximum: $1,500 Annually per person, Unlimited Lifetime
- Drug Substitution: Mandatory Generic
- Special Authorization: Yes
Vision Care
- Reimbursement: 100%
- Eye Examinations: Reasonable & Customary every 24 months
- Prescription eyeglasses: $200 every 2 years
Medical Practitioners
- Reimbursement: 100%
- Combined: Maximum per Year $500 per practitioner to a combined $1,000 annual maximum
- Annual Maximum per Practitioner
- Acupuncture
- Audiologist
- Chiropractor
- Naturopath/Doctorate of Natural
- Osteopath: $75.00 per visit maximum
- Physiotherapist
- Podiatrist/Chiropodist
- Registered Dietician
- Registered Massage Therapy
- Speech Therapist
- Psychologist/Psychotherapy/Master of Social Work ( , MSW CCPA) /CCC): $500 per calendar year (separate from combined maximum)
Hospital Accommodation
- Reimbursement: 100%
- Public General Hospital: Semi-Private
- Convalescent or Rehabilitation Hospital: $40 per day to a maximum of 180 days per disability
Medical Items and Services
- Reimbursement: 100%
- Annual maximum: $5,000 annual maximum
- Accidental Dental: Reasonable & Customary
- Audio (hearing aids): $500 per 60 consecutive months
- Private Duty Nursing in the Home: $10,000 per year
- Intrauterine Devices (IUD’s): Reasonable & Customary
- Orthotics & Orthopedic Shoes: $300 per insured person per year
- Orthopedic Braces required for medical reasons: Reasonable & Customary
- Emergency Transportation (Ambulance – Air & Ground): Reasonable & Customary
- Diagnostic Lab Tests (Includes X -Rays, MRI’s, PSA Tests): $1,000 annually per person
- Artificial Limbs: Reasonable & Customary
- Prosthetics (including myoelectric prosthesis & artificial eyes): Reasonable & Customary
- Breast Prosthetics: 1 prosthesis per breast per 36 consecutive months.
- Surgical Bras: 2 bras
- Wigs/Hairpieces: $500 Lifetime
- Laryngeal Speaking Aids: Reasonable & Customary
- Glucometers: $175 per 48 consecutive months
- Needles & Diagnostic Test Materials for Diabetes: Covered through Pay Direct Drug Plan
- Standard Syringes: Reasonable & Customary
- CPAP: Reasonable & Customary
- Apnea Monitors: Reasonable & Customary
- Respiratory Equipment: Reasonable & Customary
- Oxygen & Its Delivery Equipment: Reasonable & Customary
- Ileostomy or Colostomy Supplies: Reasonable & Customary
- Surgical Stockings & Support Hose: combined $250
- Jobst Sleeves (Arm & Leg): Reasonable & Customary
- Extremity Pumps for Lymphedema: $1,000 per lifetime
- Standard Hospital Beds: Reasonable & Customary
- Mobility Aids (cane, crutch, walker, trusses): Reasonable & Customary
- Wheelchair: $1,000 per lifetime
- Transcutaneous Nerve Stimulator (TENS): $500 per Lifetime
- Viscosupplementation: 3 Injections per knee Lifetime
Out of Province/Country
- Reimbursement: 100%
- Emergency Services & Trip Cancellation/Interuption Maximum: $5,000,000 per covered person per incident
- Maximum Number of Days per Trip: 90 Days per covered person per trip
- Referral Services: Maximum $50,000 per covered person per calendar year
- Termination Clause: *Earlier of termination of employment, retirement, or age 85
Rates:
Single $120.07
Couple $175.61
Family $201.69
Single 70+ $143.00
Couple 70+ $234.86
Family 70+ $253.43
Optional Benefits
Rates:
Single $56.92 / per employee
Couple $122.66 / per employee
Family $144.32 / per employee
Maple
- Schedule: Telemedicine
- Termination Clause: Earlier of employee retirement, or attainment of age 85
- Rates: $4.00 / per employee
Rates: $4.00 / per employee
Employee & Dependant Assistance Program (EAP)
Schedule: Counselling & therapy, addiction support, cancer support, health & life coaching, child/eldercare services, financial support, health/wellness support, legal support, mindfulness program, crisis management & trauma-related services
Termination Clause: Earlier of employee retirement, or attainment of age 85
Eldercare and Caregiving Support
Schedule: Consultation (Nursing case management for caregiving
issues), Caregiving (Homecare options for loved ones), Tools
and Ongoing Support (discounts and resources that will
assist with optimal care)
Termination Clause: Earlier of employee retirement, or attainment of age 85
Rates: $2.00 / per employee
Rates: $2.00 / per employee
Second Medical Opinion Consultation
Schedule: A second opinion could result in confirmation or modification of the original diagnosis, confirmation, modification and enhancement of the original treatment plan, or even the recommendation of alternative treatments or therapies.
Termination Clause: Earlier of employee retirement, or attainment of age 85
CyberBoxx
Schedule
Termination Clause
Rates: $4.99 / per employee
Rates: 10.00% Administration Fees
Healthcare Spending Account
Schedule:As set by each client
Termination Clause: Earlier of employee retirement, or attainment of age 85
Extended Health Care
Features
- Definition of Full-time Employee: 20 hours per week
- Minimum Number of Employees to Qualify for Coverage One: (1)
- Definition of Dependent Child: Unmarried – > age 21, or > age 26 and full-time student
- Survivor Benefit: 24 months
- Termination Clause: Earlier of termination of employment, retirement, or age 85
- Conversion Privilege: 60 days following the termination of employment prior to age 70
- Truely Pooled Plan: Fully Pooled
- Mobile App: Yes
- Pay Direct Cards: Yes
- Online Claims: Yes
- Renewal Guaranteed: Yes
- EP3 Qualified: No
- EHC & Dental Tax Deductible: Yes, tax deductible as a business expense
587-787-4478
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