Canadian Association of Professional Educators
Health and Life Benefits
The Canadian Association of Professional Educators is pleased to offer health and life benefits to qualifying members across Canada. The benefits have been specifically designed for educators who rely on education as a primary income, this package is designed for the individual and small groups. . . Coverage includes:
| | | Prescription drugs
Life insurance
Accidental death, disease, and dismemberment
Out of province coverage
Dependant life insurance
Dental care
Medical supplies. |
|
. . .
Mandatory benefits:
| | | Life Insurance
Dependant life
ADD&D
Extended health care
Out of country coverage
Optional benefits: |
|
. . . Dental:
| | | Members may opt out of the health care portion but only if there is coverage under a spouse health care
All benefit rates are subject to Provincial Sales Tax
Standard administration fees per group or individual will be subject to GST
Rate will be reviewed annually |
|
. . . Advantages include:
| | | Protection for the whole family.
Tax deductable expense
Claims can be paid with pre tax dollars |
|
. . . Eligibility requirements:
| | | All members are required to complete a medical questionnaire, a small group may be declined on the basis of an ineligible employee
All members must be insured under the Ontario Provincial Health Insurance Plan
Pre-authorized checking is mandatory
In the case of small groups, the group must be a legally incorporated company, sole proprietorship or partnership with true employer employee relationship
Full time employees of small group must work a minimum of 24 hours per week to qualify |
|
. .. . Summary of benefits life insurance:
| | | The life insurance will be paid to the employee’s appointed beneficiary upon the death of the employee
Benefit will be reduced by 50 per cent at age 65
Benefit will be terminated at age 70 or retirement, whichever comes first
All eligible members $25,000.00 benefit |
|
. . Dependant life insurance:
| | | Benefit will be paid to the member upon the death of eligible dependant
Child benefit commencing at birth
Spouse $5,000.00 Child $2,500.00 |
|
. Accidental death, disease and dismemberment:
| | | Accidental death benefit equals twice the life insurance benefit
The benefit provides a lump sum payment
The benefit provides a cash payment
The benefit coverage is 24 hours per day seven days per week on or off the job
Example payout percentage for specific loss: |
| | . Both hands or both feet
One leg or one arm
Either hand or foot
Thumb and index finger on same hand
Quadriplegia
Paraplegia
Hemiplegia
Loss of use of both hands
Loss of use of both arms
Loss of use one arm/leg
Critical disease (named disease)
Rehabilitation maximum./per benefit
Spousal retraining maximum./per benefit
Child education on member death maximum./per year | . 100% 75% 66.67% 33.33% 100% 100% 100% 100% 100% 75% 10% . $10,000.00 . $10,000.00 . $5,000.00 |
|
. Extended health care: The following expenses have no deductible:
| | | Benefit . Pay direct prescription drugs Private duty nursing Paramedical practitioners Chiropractor Eye examination Orthopedic shoes/Orthotics Hearing aid Cardiac rehabilitation Medical supplies Emergency ambulance Accidental dental Anti smoking Fertility drugs and treatment Semi private hospital | Co-ins . 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% | Maximum . $1,500.00/yr/person $10,000.00 lifetime $400.00yr/practitioner $20.00visit$400.00/yr $50.00/24mths $250.00/yr $400.00/5 yr $500.00/yr unlimited unlimited $2,000.00 lifetime Excluded Excluded Excluded |
|
. Out of province coverage:
| | | Out of province coverage is included with extended health care coverage
In the event the member or eligible dependant becomes ill or injured while traveling outside the province, emergency hospital and medical expenses will be 100% covered
Amounts paid are in excess of the amount paid by the Provincial Health Insurance plan
The benefit is to a maximum of $1,000,000.00
The benefit does not include referrals
Eligible benefits are limited to a maximum of 60 days per trip
Days are counted from the first date of departure from the province
If the member or eligible dependant is hospitalized on the 60th day, coverage will be extended to date of discharge |
|
Survivor Benefit:
| | | Included with package at no additional cost
In the event the insured dies their extended health care and dental coverage will continue without premium payment for up to six months for all eligible dependants |
|
. Dental coverage (optional)
| | | Basic covered expenses have no deductible
Coverage is 80%
$1,000.00 per year per insured
Benefit payment is based on the current provincial fee schedule |
|
Covered expenses:
| | | Oral exam once per nine months
Cleaning once per nine months
Polishing once per nine months
Fluoride applications
X-rays
Fillings
Space maintainers
Extractions
Anaesthesia
Endodontics (root canal therapy)
Periodontics (treatment of gum and other tissues of the mouth)
Repairs or relining and rebasing of dentures |
|
All benefits terminate at age 70 or retirement, whichever comes first.
Life; dependant life; ADD&D; extended health care are mandatory in this program.
To enrol in CAPE's Health Benefits click on Health Plan Enrollment
|
