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Benefit Plan Maxima Changes Effective January 1st, 2018

Friday, January 5, 2018

The Pension & Benefits Committee has reviewed the maxima corresponding with retiree life, extended health, and dental benefit provisions and approved the following changes effective January 1st, 2018:

Benefit

Provision

Previous maxima

New maxima

Extended Health

Paramedical/hearing aids

$671

$701

Private duty nursing

$20,331 per year

$21,242 per year

Out-of-pocket cap

$124 single / $250 family

$127 single / $256 family

Dental

Basic services

$2,150

$2,193

Major services

$3,242

$3,306

Orthodontia

$3,242

$3,306

Retiree Life Insurance

Coverage for eligible employees who retire on or after January 1, 2018

$5,300

$5,400


In addition, in keeping with the 2 year lag in the dental fee guide used to calculate eligible dental expenses, the 2016 guide will be used to determine eligible expenses commencing January 1, 2018.

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 $701, instead of $671 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 as outlined in the following table:

Eligible Extended Health Expenses (per calendar year)

Reimbursement*

Employee

University

Up to $635 (single coverage) or $1,280 (family coverage)

20%

80%

Over $635 (single coverage) or $1,280 (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.

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