Extended health care benefit

Out-of-pocket cap

Eligible paramedical and drug expenses are shared 80% by the plan and 20% out-of-pocket by the employee. Once the employee reaches the out-of-pocket cap, the plan pays 100% of eligible expenses, subject to benefit maxima.

The out-of-pocket cap for 2022 is $133 single/$267 family coverage. This represents 20% of a total of $665 in expenses for single or $1,335 in expenses for family.

Drug coverage

There is a $7 maximum dispensing fee cap for prescription drugs. The employee must pay any amount above this level. The benefit has a maximum allowable dispensing fee for eligible prescription drugs. If the drug fee exceeds the dispensing fee cap, the difference in values is the responsibility of the employee and the fee is not applied to the employees out of pocket amount.

Prescription drug management programs 

Preferred provider network of pharmacies

For a number of years a Preferred Provider Network (PPN) has been established with local pharmacies. While the use of PPN pharmacies is voluntary, the University is committed to providing its employees with sufficient information to spend health care dollars in the most cost-effective ways.

Pharmacies that participate in the PPN have agreed to provide guaranteed levels of service, competitive (if not reduced) dispensing fees and competitive drug prices. Some of the PPN pharmacies have also agreed to provide discounts on other non-prescription drug items.

Your benefits ID card is required to ensure PPN prices and discounts where available.

Several local pharmacies have agreed to participate in our PPN effective January 1, 2022. Refer to the PPN website for further details. Please call pharmacies directly for home delivery information.

Predetermination of coverage

To determine if a specific medication/treatment will be covered by our plan we advise you to contact Canada Life directly at 1-800-957-9777.

In the event that you expect any significant extended health or dental expenses, it is advisable to submit a cost estimate/predetermination to Canada Life to confirm how much you can expect to be reimbursed.