Group Extended Health Insurance

Note: Must select Life and LTD coverage. This is an optional benefit. All staff members must participate and be eligible for benefits under their provincial government health plan. Family coverage can be chosen to cover spouse and dependent children.

Coverage and Eligibility:

Prescription Drugs

→   The firm chooses either 80% or 100% reimbursement for all eligible staff
→   Reimbursement for brand-name drugs is based on lowest-cost generic alternative
→   Pay-direct drug card
→   Includes contraceptives
→   Includes vaccines
→   Includes Vitamin B12 for treatment of pernicious anemia
→   Includes allergy serums
→   Includes smoking cessation drugs ($300 lifetime maximum)
→   Includes fertility drugs ($5,000 lifetime maximum)
→   Includes erectile dysfunction drugs ($1,000 annually)


→   Diet aids/weight-loss products
→   Over the counter items with or without a prescription

Please note: Reimbursement for certain expensive drugs should be submitted to GWL for predetermination and may be subject to participation in a health case management program. Participants on an 80% reimbursement plan can have a 90% reimbursement if they use Costco pharmacy.

Paramedical Practitioner

100% reimbursement customary and reasonable charges

→   Up to $500 per year, per practitioner (except for speech therapist which has a maximum of $1,000 per year)
→   Paramedical practitioners include: registered massage therapist, physiotherapist/athletic therapist, chiropractor, acupuncturist, osteopath, naturopath,        podiatrist, registered dietitian, registered clinical psychologist, speech therapist

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Vision Care

Optional benefit. 100% reimbursement customary and reasonable charges

→   One eye exam every 12 months from date of service
→   Firm can choose to add an allowance of $200 or $350 to be used every 2 years from date of service
→   For dependent children, chosen amount resets every 12 month
→   Allowance can be used for prescription eyeglasses, prescription contact lenses, prescription sunglasses, and laser eye surgery 

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Professional Ambulance Services

100% reimbursement to the nearest hospital

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Emergency Services of a Dentist

Fees of a dentist to repair natural teeth as a result of an accidental blow to the mouth which occurs when the person is insured under this plan, and if treatment is given within one year of the accident. If treatment is to be received more than 90 days after the accidental blow, a treatment plan must be submitted to Great-West Life within 90 days of the accident.

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Semi-Private Hospital Room

100% reimbursement

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Medical Equipment

100% Reimbursement

→   Hearing aids ($500 every 4 years)
→   Orthopedic shoes (1 per year)
→   Orthotics ($200 per year)
→   Oxygen
→   Blood and blood plasma
→   CPAP machine, masks, hoses, equipment
→   Artificial limbs or eyes
→   Crutches and splints
→   Casts
→   Trusses or braces
→   Stump socks and surgical stockings
→   Ostomy and ileostomy supplies
→   Wigs and hairpieces ($700 lifetime maximum, as a result of chemotherapy or the disease Alopecia Totalis)
→   Mastectomy Bras
→   Rentals, or purchases (if more economical), of equipments for therapeutic treatment (i.e. wheel chair and hospital bed)

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In-Home Nursing and Home Care (By RN or RNA)

100% Reimbursment. $10,000 yearly maximum or lifetime maximum of $25,000 upon attainment of age 65 for you or your dependent

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Emergency Travel In Canada

100% reimbursement of travel medical expenses: $10,000 lifetime maximum Incurred outside your province of residence if they are not available in your province. Reasonable and customary charges will apply.

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Emergency Out of Country Travel

100% reimbursement of travel medical expenses for:
→   first 60 days of a trip
→   $3,000,000 lifetime maximum
→   If over age 65: $1,000,000 lifetime maximum
→   60 days limitation does not apply to dependent children attending an accredited educational institution

Travel Assistance Center: Please have the group policy number (56579) and your certificate number with you when traveling

→  1-866-530-6024 (Canada and US)
→  905-816-1901 (Outside of North America)

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Termination Provision

→   Extended health care benefits will automatically terminate on your last day worked or retirement
→   Compassionate Clause: 24-month survivor benefit for a deceased employee's spouse and/or dependent children

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Limitations and Exclusions

No benefits payable:

→   Trip cancellation insurance
→   Due to accident caused by illegal activity, self inflicted injury, participation in war/riot including if impaired by alcohol or drugs
→   Due to pregnancy or childbirth outside of Canada within 9 weeks of expected delivery
→   Due to any pre-existing medical condition which has not been stable for 90 days immediately prior to your departure date
→   For treatments mainly for cosmetic reasons
→   For treatments not normally recognized/eligible under you provincial health care system

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