Community Living Services Collective Agreement - British Columbia ...

CSSBA and CSSEA - Community Living Services (03/2012) Page 83
• enrolment is a mandatory condition of employment
Dual Coverage Restriction
• employees and/or dependants are ineligible for coverage if enrolled in another extended health
plan
Dependants
• husband, wife, common-law spouse (spousal partners who have co-habited for a period of not less
than one year)
• unmarried children until the end of the month in which they turn the age of 19 years, if they are
mainly dependent on and living with the employee or the employee's spouse
• unmarried children until the end of the month in which they turn the age of 25 years, if they are in
full-time attendance at a recognized school, college or university, if mainly dependent on the
employee or the employee's spouse
• unmarried physically or mentally handicapped children to any age, if mainly dependent on and
living with the employee or the employee's spouse
Effective Date
• first day of the month following the month in which the employee successfully completes their
probation or trial period not to exceed three months
Benefit Provisions
• deductible of $45 per person or family per calendar year
• Direct Pay card must be provided for prescription medications
• prescription drug charges are tied to Pharmacare
• eligible expenses are reimbursed at 80% of eligible expenses for the first $1,000 in a calendar
year; 100% of eligible expenses over $1,000 in a calendar year; 100% of eligible out-ofprovince/out-of-country
emergency expenses
• lifetime maximums per person are unlimited
Eligible Expenses
• acupuncturist – fees of an approved acupuncturist up to 80% of $500/person/calendar year
• ambulance –in an emergency from the place where the sickness/injury occurs to the closest acute
care hospital with adequate facilities to provide the required treatment (including transportation
by railroad, boat, airplane, or air-ambulance in an acute emergency); includes round trip fare for
one attending person (doctor, nurse, first aid attendant) where necessary
• chiropractor – fees of a registered chiropractor up to 80% of $500/person/calendar year
excluding the cost of x-rays taken by the chiropractor; reimbursed at 80% of $10/visit for the first
12 visits/calendar year (15 visits for age 65 and older)
• dentist – fees for repairs, including replacement, of natural teeth which have been injured
accidentally; treatment must occur within one year of the date of the accident; orthodontic
services, amounts paid by a dental benefit or charges exceeding the carrier dental fee schedule are
not covered
• diabetic supplies and equipment – needles, syringes and testing supplies; blood glucose
monitors (lifetime maximum of 80% of $250); insulin infusion pumps when basic methods are
not feasible (physician's letter required); carrier pre-approval required for expenses in excess of
80% of $5,000