Employee Benefit Funds Administration Ltd

Employee Benefit Funds Administration Ltd.


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Page updated: October 10, 2018

 

Health and Welfare Plan

 

Disclaimer

This very brief summary is intended to provide only an overview of the main features of the Health & Welfare Plan. The amounts payable and all your rights under the Health & Welfare Plan are governed by the actual wording of the Rules and Regulations in the Electrical Industry Insurance Benefit Trust Fund of Alberta Plan booklet.

Eligibility

  • 300 hours reported by your employer to the Fund Office within 2-4 consecutive months, followed by a 1 month waiting period. Eligibility commences the first day of the month following the waiting period.

Continuation

  • 120 hours per month deducted for one month of coverage.

Hour Bank

  • The maximum Hour Bank of 1,080 hours allows for nine months of coverage in case of unemployment, or leave of absence.

Self Payments

  • An Application and Preauthorized Debit Plan Agreement must be received in the Fund Office prior to losing your Hour Bank.
  • Self-Payments are withdrawn on the last business day of each month.
  • If you wish to continue your coverage when your Hour Bank expires, you must make Self-Payments until you requalify for coverage through hours worked (see Eligibility).
  • Self-Payments must be made consecutively after your Hour Bank expires or your Years-of-Service Bank is forfeited.

Years-Of-Service Bank

  • Contact the Fund Office to determine qualification at retirement.

Summary of Benefits

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Life Insurance
  • Member  $ 150,000
  • Spouse   $   10,000
  • Child       $     2,000
  • Accidental Death $ 150,000 (Plan Member only)

Weekly Disability

  • $ 524 per week.
  • Commences on the 8th day of disability.
  • Maximum of 51 weeks of disability combined with Employment Insurance (EI) Sickness benefits.
  • E.I. Sickness benefits pay up to a maximum of 15 weeks.

Long Term Disability

  • $ 2,269 per month from 53rd week of disability.
  • Accidental Injury - until no longer totally disabled, or until age 60, whichever occurs first.
  • All other disabilities - until no longer totally disabled, or for 10 years, or until age 60, whichever occurs first.
  • • If requirements are met, a Plan Member who is younger than age 60, disabled and is receiving Long Term Disability benefits shall have 85 hours per month of Future Hours Credit contributed to the Electrical Industry Pension Trust Fund of Alberta.

Hospitalization

  • Semi-Private accommodation.

Supplementary Health Expense

  • 100% of eligible covered expenses (e.g. ambulance, artificial limbs, eye exams for medical purposes, orthopedic devices) are limited to Reasonable & Customary fees.
  • Paramedical expenses such as physiotherapy, chiropractic, acupuncture or massage therapy, are limited to Reasonable & Customary fees. A doctor’s referral is required and is valid for one year from the date issued.

Prescription Drugs

  • 90% coverage
  • Calendar year maximum of $10,000 per person
  • Drug cards
  • Lower Cost Alternative Pricing (LCA)
  • Dispensing Fee Limit - $13.00
  • Fertility Drugs - $5,000 per calendar year and $15,000 per lifetime.
  • Prior Authorization Drugs
  • Smoking Cessation Drugs - $500 lifetime maximum
  • Erectile Dysfunction Drugs - $500 calendar year maximum per person

Hearing Aids

  • $ 1,250 per person, every 5 calendar years.

Vision Care

  • Prescription glasses, contact lenses, or laser eye surgery, $500 every 2 calendar years for those 18 and over.
  • $90 - maximum of one eye examination every 2 calendar years.
  • For eligible Dependents under the age of 18 years, the $500 is available each calendar year if required due to a prescription change.
  • Exclusions - no allowances are provided for non-corrective lenses, repairs to glasses or frames purchased separately.

Dental Care (Routine and Major Restorative)

  • 90% of the Schedule of Dental Fees, maximum $3,000 per calendar year
  • Oral Recall Examinations - once per calendar year
  • Polishing - once per calendar year
  • Scaling - no limit on units
  • Bitewing x-rays - once per calendar year
  • Extractions
  • Oral surgery
  • Fillings
  • Anesthetic
  • Root canals
  • Pit & fissure sealants
  • Initial installation of removable partial or full denture
  • Replacement denture - once every 5 years
  • Initial installation of fixed bridgework
  • Repair and reline

Orthodontia

  • 90% of the Schedule of Dental Fees; separate $2,500 lifetime maximum per Plan Member or Dependent

Employee and Family Assistance

  • Voluntary and confidential short term counselling and advisory service that is available 24 hours a day, 7 days a week, 365 days a year
  • Call: 1-877-207-8833 (English)
    1-877-371-9978 (Hearing Impaired)
    1-877-307-1080 (French)


For more information, contact Employee Benefit Funds Administration Ltd.

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