AUPE Auxiliary Nursing Benefits - Alberta Health Services by pengxuebo


									This is a quick reference guide to the Alberta Health Services Benefit Plan for the Alberta Union of Provincial Employees Auxiliary Nursing group. A detailed
description of the benefit plan can be viewed by employees on Insite at
The Alberta Health Services AUPE Auxiliary Nursing Benefit Plan offers core coverage as well as a Flex Spending Account. Employer provided credits in the Flex
Spending Account are allocated at initial eligibility and annually before the start of each new calendar year. If there is a question of interpretation between this
summary and the official plan documents, the terms of the formal policies and official plan documents shall prevail.

Maximum $1,000,000 for Basic Life, Additional Basic Life                               Short Term Disability (STD)
and Optional Employee Life combined. Premiums paid via                                   75% employer paid
payroll deduction.                                                                      66 2/3% of your regular salary payable after the
Basic Life Insurance                                                                    expiration of sick leave for a maximum of 24 weeks from
Basic coverage is 1X your basic annual salary                                           the date of disability
  Coverage is mandatory                                                                 If you have enough sick leave credits to satisfy the LTD
  75% employer paid                                                                     elimination period, STD will not be initiated – you will go
                                                                                        directly to an LTD claim
Additional Basic Life Insurance
                                                                                        The benefit is taxable when received
Additional basic coverage is 1X your basic annual salary
  Coverage is optional and is 100% employee paid                                       Long Term Disability (LTD)
  If Additional Basic Life is selected, Additional Basic AD&D                            75% employer paid
  must be selected as well.                                                             66 2/3% of your regular salary payable after 24 weeks of
Optional Employee Life                                                                  disability
  Coverage is optional and is 100% employee paid                                        LTD benefits continue after 24 months only if you are
  You may select the amount of coverage in units of                                     totally disabled
  $10,000 to a maximum of $250,000                                                     The benefit is taxable when received
Optional Dependent Life
  Coverage is optional and is 100% employee paid                                       PENSION PLAN
  Spouse $25,000; Each eligible child $10,000
                                                                                       Local Authorities Pension Plan (LAPP)
ACCIDENTAL DEATH AND DISMEMBERMENT                                                     The Local Authorities Pension Plan is a defined benefit
(AD&D) INSURANCE                                                                       pension plan designed for employees of the provincial
Maximum $1,000,000 for Basic AD&D and Additional AD&D                                  health system, school boards, colleges and technical
combined. Premiums paid via payroll deduction.                                         institutes in the Province of Alberta.
                                                                                         Participation in the plan is mandatory for regular full time
Basic AD&D Insurance
                                                                                         or regular part-time employees working 30 or more hours
Basic coverage is 1X your basic annual salary
                                                                                         per week.
  Coverage is mandatory
                                                                                         Participation in the plan is optional as a regular part-time
  75% employer paid
                                                                                         employee working from 14 – 29 hours per week.
Additional AD&D Insurance                                                                Employee and employer paid
Additional basic coverage is 1X your basic annual salary                                 Contribution rates are reviewed each year and are set by
  Coverage is optional and is 100% employee paid                                         the LAPP Board.
  If Additional Basic Life is selected, Additional Basic AD&D                            Additional LAPP information is available in Insite and the
  must be selected as well.                                                              LAPP website at
Optional AD&D Insurance
  Coverage is optional and 100% employee paid                                          ADDITIONAL OPTIONAL BENEFITS
  You may select coverage in units of $25,000 to a                                     Participation is optional. Contact your entity payroll to
  maximum of $500,000 for yourself                                                     determine if this option is currently available to you.
  If you choose the family plan, your spouse is insured at
                                                                                       Group RRSP (Standard Life)
  50% of your coverage and each child is insured at 25% of
  your coverage to a maximum of $50,000 per child                                         100% employee paid
                                                                                          Payroll contributions for immediate tax savings
DISABILITY INSURANCE                                                                      Invest in a choice of funds/GIC terms.
Coverage is mandatory                                                                     No employer matching contributions
Sick Leave                                                                             If you wish to contribute to an RRSP, you must open an
  100% employer paid                                                                   account through Standard Life first. Visit
  Sick bank accrues at 1.5 days per month to a maximum                        for more information or contact
  of 120 days                                                                          your Benefits Representative for details.
  Sick leave is prorated based on your FTE

                                                                                                                                                  January 1, 2013
SUPPLEMENTARY HEALTH                                            OUT OF PROVINCE/COUNTRY EMERGENCY
Coverage is mandatory unless you are covered under
another group plan. Single coverage is provided if no             Coverage is provided if you are enrolled in
other election is made. Employees may view coverage               Supplementary Health
levels, exclusions and premium rates in detail on Insite.         Maximum benefit 30 days per trip, $2,000,000 per
                                                                  covered person per incident
  75% employer paid                                               Covers 100% of reasonable and customary charges
  Benefit year: January 1 – December 31                           for most emergency expenses including physician,
  Reasonable and customary charges, no deductible                 diagnostic, prescription, paramedical, dental, hospital
Prescription Drugs                                                services, medical aids, medical evacuation, incidental
                                                                  expenses, repatriation and travel assistance for the
  80% Least Cost Alternative (LCA) pricing                        insured and covered dependents
  $7 dispensing fee cap
  Covers prescription drugs listed on the Alberta Blue          DENTAL
  Cross Drug Benefit List that are dispensed by a               Coverage is mandatory unless you are covered under
  pharmacist                                                    another group plan. Single coverage is provided if no
Hospital Services                                               other election is made. Employees may view coverage
                                                                levels, exclusions and premium rates in detail on Insite.
  Hospital charges in excess of the Alberta Health Care
                                                                  75% employer paid
  standard ward accommodation for a private or
  semi-private room in a public general active treatment          Benefit year: January 1 – December 31
  hospital in Canada.                                             Current Alberta Blue Cross Dental Schedule
  Other services at 100% unless otherwise specified             Basic Dental Services
Other Health Services                                           80%, no maximum
                                                                  Recall exams, bite-wing x-rays and polishing - once
  Ambulance and air ambulance; accidental dental;                 per 12 months for adults and once per 6 months for
  blood testing monitors; cervical collars, traction kits,        children under age 18
  splints, trusses, crutches, casts, canes and walkers;           Fluoride treatments once per 6 months for dependent
  custom fitted braces; home nursing care; foot                   children under age 18
  orthotics; hearing aids; ileostomy and colostomy
                                                                  Preventative and restorative services, surgical
  supplies; urinary catheters; insulin pump and specified
                                                                  procedures, endodontics, denture services
  supplies; mastectomy prosthesis; orthopedic shoes;
  oxygen and supplies; prosthetic appliances; manual            Periodontic Services
  wheelchairs and hospital beds                                 50%, maximum 13 units
  Paramedical practitioners including Licensed                    Periodontal surgery; osseous surgery, osseous and
  Audiologist, Podiatrist/Chiropodist, Chiropractor,              soft tissue grafts; provisional splinting; scaling and root
  Massage Therapist, Occupational Therapist, Speech               planing
  Language Pathologist and Physiotherapist.
                                                                Extensive Dental Services
  Psychology services
                                                                50%, maximum $3,000 per person per benefit year
VISION CARE                                                       Crowns, inlays and onlays, fixed bridges, processed
                                                                  veneers, post and cores, bridge repairs, general
  Coverage is provided if you are enrolled in                     prosthodontic exam
  Supplementary Health                                            Full or partial dentures, rebasing and resetting,
  75% employer paid, claims reimbursed                            denture adjustments, major denture repairs
  100% coinsurance, no deductible
                                                                Orthodontic Services
  Adult (age 18+) – up to $150 per 24 consecutive
  months                                                        50%, maximum $3,000 per person per lifetime
  Child (under age 18) – up to $150 per 12 consecutive            Orthodontic examination, Cephalograms, facial and
  months                                                          intraoral photographs, diagnostic models, consultation
  Eye exam – up to $40 per person age 19 – 64 years,              and case presentation
  included                                                        Habit breaking appliances

                                            COORDINATION OF BENEFITS
   Coordination of Benefits is a process whereby individuals, couples or families with more than one benefit plan may
combine their benefits coverage. This allows you to have coverage up to 100% of the eligible dollar amount. Coordination
                           of Benefits is standard practice among benefits carriers in Canada.

                                                                                                              January 1, 2013
This 100% employer paid plan provides you with flex credits annually to allocate among your choice of Health Spending,
Personal Spending and/or Group Savings. The benefit year is January 1 to December 31. One flex credit = one dollar.
Information regarding eligible expenses for spending accounts is provided to employees on Insite. Every January 1st, eligible
employees are provided with new credits which are deposited into their Flexible Spending Accounts per the collective
agreement. Prorated credits, based on the number of full months remaining in the calendar year, will be applied for new
employees commencing employment after January 1st. Details regarding Flex Accounts may be viewed by employees on Insite.

                                                                      FLEX CREDITS
                                               $1,000 for each eligible employee that is prorated relative to
                                                           FTE as of the previous December 1st

          HEALTH SPENDING ACCOUNT                             PERSONAL SPENDING ACCOUNT                                  GROUP SAVINGS PLAN
            Non-taxable health spending           Taxable spending account for items related to your wellness,                  Group RRSP
         account for health related expenses        professional development and/or family care expenses

Waiting Period                                                                     Eligible Dependents
Coverage commences on the 1st day of the month following
                                                                                   Eligible dependents are your spouse and dependent
three (3) calendar months from the date of hire or the date
                                                                                   children, living in Canada.
you become benefits eligible
                                                                                      Spouse: To qualify under the benefit plan, a person must
Enrolment                                                                             be your legal spouse or a person of the same or opposite
You have 31 days from your benefits eligibility date to enroll                        sex who is not your blood relative with whom you have
in the benefit plan. If you do not enroll, your coverage will                         lived and publicly represented as your spouse for a
automatically default to the following:                                               minimum of 12 consecutive months. The person legally
   Supplementary Health and Dental – single coverage                                  married to you will be considered as your spouse unless
                                                                                      you specify the name of a common law spouse on
   All flex credits default to a Health Spending Account
                                                                                      appropriate forms.
   Basic Life and AD&D Insurance
   Sick Leave, Short Term and Long Term Disability                                    Dependent Children: Your natural, adopted or step
                                                                                      child; or a natural, adopted or step child of your spouse
Eligibility                                                                           who is in your care and control; or your legally appointed
  Regular full time or part-time employees regularly                                  ward. The child must be unmarried, financially dependent
  scheduled to work at least 15 hours per week on average                             on you for support, and must be: under age 21; under
  are eligible to join the plan                                                       age 25 and in full time attendance at an accredited post
  Temporary employees regularly scheduled to work at                                  secondary institution; or over age 21 but dependent on
  least 15 hours per week on average for a minimum of 6                               you due to a physical or mental handicap which occurred
  months are eligible for most benefits                                               prior to attaining age 21 or while attending an accredited
  Temporary employees are not eligible for the Flexible                               college, university or other education institution prior to
  Spending Account                                                                    attaining age 25, having been continuous since that time.
  You must normally reside in Canada                                               Costs
Changes and Life Events                                                               Employees may view employer and employee premium
Following initial enrolment, if you wish to enroll in an                              rates on Insite.
optional plan or change your coverage under
Supplementary Health or Dental, certain conditions or                                                             CONTACT
restrictions may apply. Life events that enable changes to
Supplementary Health and Dental coverage may include:                                                  Health, Dental, Spending Accounts
                                                                                 Alberta Blue Cross Customer Services Contact Centre: 1-800-661-6995 toll free;
  Your spouse lost his/her coverage; addition/removal of a
                                                                                                 hours Monday to Friday, 8:30 a.m. to 5:00 p.m.
  legal or common law spouse; death of a spouse or                                             Online:
  dependent; addition of a child; or if a five year period or
  more has elapsed since the date of the most recent life                                                          All Benefits
  event.                                                                        Your Benefits Representative: see Insite for contact information, or view detailed
                                                                                     information on Insite at
Your application for benefits changes is required within 31
days of a new life event.                                                                                           Group RRSP
                                                                                        Standard Life: Toll free: 1-800-242-1704, extension 4000, Online:

                                                                                                                                              January 1, 2013

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