BENEFITS AT A GLANCE rated). Allocation can be made once a year to either a Health Spending account Page 1 of 3 Life & AD&D Company Paid Basic Life 2 x Annual Base Salary Earnings to a maximum of $850,000 Dependent Life - Spouse: $10,000, Children: $5,000 each Basic AD&D - 2 x Annual Base Salary, to a maximum of $500,000 Employee Paid Optional Life - Purchase units of $10,000, up to a combined Basic and Optional Life Insurance amount of $850,000 Option Dependent - Spouse: purchase units of $10,000, up to $500,000; Children: purchase a flat amount of $15,000 per child. Optional AD&D - Purchase units of $10,000 for you and/or your spouse to a maximum of $500,000. Health Care Company Paid Prescription Drugs - 100% prescription generic drugs (other than drugs used in the treatment of a sexual dysfunction, which are paid at 50% reimbursement) Paramedical - $500 per calendar year for each (100% reimbursement up to reasonable and customary limits) Practitioners: Osteopath, Podiatrist/ Chiropodist, Chiropractor, Naturopath, Massage Therapist, Speech Therapist, Physiotherapist, Psychologist/Social Worker, Acupuncturist Mental Health Care - 100% for diagnosis and assessment, 50% for all other treatment of mental or emotional illness subject to a combined maximum of $500 per Participant each benefit year. Orthotics - 70% of reasonable and customary costs, $200 per calendar year. Vision - Eyewear, contact lenses, intraocular lenses, industrial safety glasses, sunglasses. Adult: $225 per Participant each 24 months. Child: $125 per Participant each 12 months. Hearing Aids - $1,000 per 5 calendar years Other Medical Equipment - 100% of reasonable and customary costs for medical supplies and equipment prescribed by a physician Hospital Room - Covers 100% for a private hospital room up to $395 daily maximum; covers 100% for a semi-private hospital room up to $305 daily maximum. Any amount above the daily maximum may be eligible for payment from your Health Spending Account Home Care - $25,000 lifetime maximum per participant. Ambulance - 100% of reasonable and customary costs for emergency transportation to or from a hospital by an ambulance service when medically necessary. Air and rail transport is covered when normal ground transportation is not. Out of Province/Country Emergency - 60 Days 100% of reasonable and customary costs for hospital care and treatment required due to a medical emergency beyond what are covered by provincial health care plan. Lifetime Maximum payment is $5 million/person/incident. Wellness $1,000 per year for all permanent full-time employees (new hires, part-time employees and employees on a leave of absence will have their amount pro-(non-taxable) or Wellness cash payment (taxable) or a combination of both.
