Employee Benefit Funds Administration Ltd

Employee Benefit Funds Administration Ltd.


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Page updated: October 10, 2018

 

CHANGES TO BENEFITS

 
Effective July 1, 2018
The Board of Trustees confirmed that medicinal marijuana is not a covered expense under the Plan.
 
Effective June 7, 2018
The Plan is not considering payment of Libre Diabetic Testing Kits (or other such kits) at this time.
 
Effective April 1, 2018
Dental benefits have been updated to provide reimbursement at 90% in accordance with the 2018 Schedule of fees.
 
Effective March 1, 2018
All Self-Payments must be made using the Preauthorized Debit Plan. When making your first Self-Payment, your Application and PAD Agreement must be received in the Fund Office prior to losing your Hour Bank.
 
Effective January 1, 2017
The waiting period for Weekly Disability benefits has been reduced from 2 weeks to 1 week. The maximum payment duration for Weekly Disability benefits increased to 51 weeks, combined with E.I. Sickness and Accident Benefits.
 
Effective January 1, 2017
The following changes were introduced for the prescription drug benefit:

Lower Cost Alternative (LCA) Pricing – The Plan covers 90% of the LCA price for drug categories in which there is a LCA drug. Plan Members who choose the higher cost drug will be responsible for the amounts in excess of the LCA drug cost.

Prior Authorization – Drugs categorized as Prior Authorization drugs require prior approval based on medical diagnosis and form of treatment.

Dispensing Fee Limit – The Plan limits dispensing fees to $13.00.

Fertility Drug Maximum – Fertility drugs are limited to $5,000 per calendar year and $15,000 per lifetime.

The Plan’s maximum remains at $10,000 per person per calendar year. Prescription drugs are administered by NexgenRx.

 
Effective June 1, 2015

In the event of a Plan Member’s death, and provided the Plan Member is eligible, the Life Insurance benefit is now $150,000.

Accidental Death benefits increased from $125,000 to $150,000. Accidental Dismemberment benefits also increased. Details can be found in the Plan booklet.

Weekly Disability benefits are $524.00 per week and the Long-Term Disability benefit is now $2,269 per month.

The Vision Care benefit increased to $500 every two calendar years per person.

Eye exams increased to a maximum of $90 for one eye exam in a two calendar year period.

 
Effective January 1, 2013
Paramedical expenses will only be covered if medically necessary and must be prescribed by a physician or specialist once per year. Physician referrals are required for services provided by a qualified osteopath, chiropractor, podiatrist, chiropodist, physiotherapist, registered massage therapist, registered acupuncturist, naturopath and Christian Science practitioner. The Plan will also accept Chiropractic referrals from a Chiropractor.
 
Effective October 1, 2012
Massage therapy expenses must be performed by an accredited provider. A massage therapist must have 2200 hours /2 years of schooling program in order to be an accredited provider in Alberta.
 

SELF-PAYMENTS

 
Effective March 1, 2018
The following Self-Payment rates are:
• Plan Members Age 16-64 $294.00
• Retired Plan Member Age 50-54$294.00
• Retired Plan Member Age 55-64 $271.00
• Active Plan Members Over 65 $222.00
• Retired Plan Members Over 65 $206.00
• Plan Members on LTD Benefits $147.00
• Retired Plan Members 55-64 on LTD $136.00
 

MISCELLANEOUS

 
Employee Family Assistance Program (EFAP)
Call Toll Free:
English: 1-877-207-8833
French: 1-877-307-1080
or TTY Hearing Assistance:1-877-371-9978

Lifeworks, by Morneau Shepell provides confidential Employee and family assistance, crisis services 24 hours a day, or to book an appointment for professional counseling services during regular office hours.

 
Incapacitated Children
Plan Members who are registering a functionally impaired Dependent child must provide proof of incapacity within 31 days following the Dependent’s 21st birthday. The Dependent child must also meet the requirements for a Dependent child, under the Plan rules.