CAEAS-ECAB

Plan summary

The following provides a high-level overview of the benefits plan for active members.

Overall benefits planCoverage details
Funding
  • Health, Dental, Basic Life and Accidental Death & Dismemberment (AD&D) insurance premiums are cost shared and members pay 5%. For those on LTD, after 24 months of disability, you pay 100% of the premiums

  • Optional benefits are fully member-paid (or subject to any applicable personal service contracts)

  • Additional member cost share for part-time members (FTE under 1)
Eligibility
  • You are eligible for the CAEAS-ECAB plan on the day your employment begins, provided you are a resident of Canada and you are a permanent full-time employee

  • Part-time employees and employees with a contract period of 12 months or longer are also eligible to join the plan

  • Those eligible are covered for Health, Dental, Basic Life and AD&D. You may opt out of health and/or dental coverage if you are already covered for these benefits under your spouse's plan
Reimbursement
  • 100% of eligible claims, unless otherwise stated (subject to reasonable and customary limits)
Health Care Spending Account (HCSA)
  • $850 HCSA credits allocated in 2022/23 benefit year. Credits from this period must be used by August 31, 2024

  • $850 HCSA credits allocated in 2023/24 benefit year. Credits from this period must be used by August 31, 2025
BenefitCoverage details
Prescription Drugs
Prescription formulary
  • 100% coverage of eligible drugs including coverage of reasonable & customary drug ingredient cost mark-ups (15% drug markup limit)

  • No deductible

  • Drugs legally requiring a prescription, diabetic supplies, preventative vaccines (excluding non-life-sustaining over-the-counter [OTC] vaccines)

  • May be subject to Prior Authorization

  • Pay-direct drug card available

  • Mandatory generic substitution

  • Therapeutic class pricing

  • $8 maximum dispensing fee

  • Limit of five dispensing fees paid by the plan per maintenance medication per year (note, this limit does not apply to drugs purchased in Quebec)

  • $5,000 lifetime maximum for fertility drugs (except as may be provided by law, such as in Quebec)
Paramedical Services:

  • Acupuncturist
  • Chiropodist/Podiatrist

  • Chiropractor

  • Dietitian

  • Naturopath

  • Osteopath

  • Registered massage therapist

  • Speech therapist/Speech language pathologist/ Audiologist
  • Maximum $550, per practitioner, per benefit year
Mental Health Services:
  • Psychologist/Social worker/ Psychotherapist/Registered family therapist
  • Maximum $2,100 per benefit year (combined)
Physiotherapist/ Athletic therapist and Occupational therapist
  • Maximum $1,500 per benefit year (combined)
Vision Care
Glasses and contacts
  • Maximum $500 per 24 months
Eye exam
  • Maximum $120 per 24 months
Laser eye surgery
  • $1,500 lifetime maximum
Medical Services and Supplies
Orthotics
  • $450 per benefit year
Orthopedic shoes
  • $450 per benefit year
Hearing aids
  • $2,000 per 60 months
Ambulance
  • Transport to nearest facility

  • Includes air ambulance
Private duty nursing (nursing care)
  • $25,000 per benefit year
Semi-private hospital
  • Covered (the trust will pay the difference between semi-private and ward accommodation)
Emergency Travel Medical Coverage
Global Medical Assistance and Out-of-Country Emergency Care
  • 100% coverage

  • Up to 60 days/trip

  • $1 million per trip
Dental
Reimbursement Guide
  • Based on current fee guide for province of treatment
Basic Services
  • 100% of checkups, x-rays, fillings, etc.

  • No annual maximum

  • Recall exams every nine months for adults; every six months for children under age 19

  • 10 units of basic/periodontal scaling (combined) per rolling 12 months
Major Restorative Services
  • 65%

  • $2,500 maximum per benefit year
Periodontics/Endodontics
  • 100% coverage of root canals and related services

  • 100% coverage of scaling, root planing, gum treatments, etc.
Orthodontics
  • 50% coverage for adults and children

  • $3,000 lifetime maximum
Life insurance
Basic Life (member only)
  • 2x annual salary, up to $1,000,000 combined maximum with Member Optional Life

  • No reduction at age 65

  • Ends at retirement
Member Optional Life
  • Member-paid, based on gender, age and smoking status

  • Up to $500,000, in units of $10,000
Spousal Optional Life
  • Member-paid, based on gender, age and smoking status

  • Up to $500,000, in units of $10,000
Child Optional LifeMember-paid
Up to $25,000, in units of $5,000
Optional Critical Illness insurance
Member Optional Critical Illness
  • Up to $250,000, in units of $10,000

  • $50,000 non-evidence maximum
Spousal Optional Critical Illness
  • Up to $250,000, in units of $10,000

  • $50,000 non-evidence maximum
Accident (AD&D) insurance
Basic AD&D (member only)
  • 2x annual salary, up to $500,000 maximum

  • No reduction at age 65

  • Ends at retirement or age 70 (whichever is earlier)
Member Optional AD&D
  • Member-paid

  • Up to $250,000, in units of $10,000

  • Ends at retirement or age 70 (whichever is earlier)
Spousal Optional AD&D
  • Member-paid

  • Up to $250,000, in units of $10,000

  • Coverage ends at member’s retirement or when member or spouse turns age 70 (whichever is earlier)

Notes:

  • The benefit year starts September 1 and ends on August 31, except where otherwise indicated.
  • Provincial coverage will be first payer where applicable.

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