Benefit Plan Maxima Changes Effective January 1st, 2017

Friday, December 23, 2016

The Pension & Benefits Committee recently reviewed the maxima corresponding with retiree life, extended health, and dental benefit provisions and approved the following changes effective January 1st, 2017:

Benefit

Provision

Previous maxima

New maxima

Extended Health

Paramedical/Hearing Aids

$649

$671

Private Duty Nursing

$19,653 per year

$20,331 per year

Out-of-Pocket Cap

$122 single / $245 family

$124 single / $250 family

Dental

Basic Services

$2,108

$2,150

Major Services

$3,178

$3,242

Orthodontia

$3,178

$3,242

Retiree Life Insurance

Coverage for eligible employees who retire on or after January 1, 2017

$4,600

$5,300

In addition, in keeping with the 2 year lag in the dental fee guide used to calculate eligible dental expenses, the 2015 guide will be used to determine eligible expenses commencing January 1, 2017.

What does this mean?

The amount available for reimbursement has increased to the new maxima as outlined above. For example, the coverage for paramedical practitioners (e.g. physiotherapy) has an annual reimbursement maximum of $671, instead of $649 per year.

Out-of-Pocket Cap

Eligible paramedical and prescription drug expenses are shared between the University and employees - 80% reimbursement is provided until the out-of-pocket cap is reached and then 100% reimbursement applies up to the benefit maxima, as outlined in the following table:

Eligible Extended Health Expenses (per calendar year)

Reimbursement*

 

Employee

University

Up to $620 (single coverage) or $1,250 (family coverage)

20%

80%

Over $620 (single coverage) or $1,250 (family coverage)

$0

100%

*Subject to the annual maxima and dispensing fee maxima; note that expenses for out of country, ambulance, dental and private duty nursing do not apply to the out-of-pocket cap nor do any pharmacist fees charged over the prescription drug dispensing fee cap.

For more information on your University benefits please visit the Benefits section.