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Winter 2014
Post Retirement Benefits – What they mean to you.
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Purpose of this Seminar
• Ontario Drug Benefit (ODB)Program• Eligibility• Healthcare Spending Account (HSA)• YUSA post retirement benefits• CPM post retirement benefits• YUFA and Osgoode post retirement benefits• Purchasing extra benefits• Out of country coverage• Other
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Ontario Drug Benefit Program (ODB)
• If you are age 65, live in Ontario and have a valid Ontario health card, you qualify for the ODB program. If the ministry has your correct address, they will notify you by mail about two months before you turn 65.
• On the first day of the month after you turn 65 years of age, take your prescription and health card to your pharmacy. Tell the pharmacist that you are now eligible for the ODB program.
• Link to the ODB website http://www.health.gov.on.ca/en/public/programs/drugs/programs/odb/odb.aspx
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ODB Benefit Continued• The ODB Program covers most of the cost of 3,800 prescription
drug products, some nutrition products and some diabetic testing supplies.
• Under special circumstances there is an Exceptional Access Program that may cover most of the cost of an additional 850 prescription drug products that are not on the Formulary for people in the ODB Program. Your doctor must apply on your behalf. Approval must be given by the ministry before a drug will be funded by the program if it is not on the Formulary.
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ODB Benefit - Continued
• Every benefit year starts on August 1st. Most seniors will pay the first $100 of the prescription drug (the deductible)
• Once the deductible is paid, most seniors will then be asked to pay up to $6.11 for each approved prescription
• If your net income is less than $16,018 (single) or $24,175 (combined) you might be able to pay a lower payment per prescription ($2.00) through the Seniors Co-Payment Program.
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Eligibility
Post retirement benefits are available to those that retire direct from being an active member
Must have active benefits the day before retirement date
Only those dependants that were covered as an active employee immediately preceding retirement are eligible for post retirement benefits
Changes can not be made following retirement
Monthly pension option has to be elected for all affiliations except for YUFA and Osgoode
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Health Care Spending Account (HSA)• Available for retired IUOE, YUELI, CUPE 1356, 1356-1 and 3903
unit 2 (refer to your collective agreement for eligibility)
• Set amount of funds per year
• Use it or lose it – there is no carry forward
• Expenses need to be submitted within 90 days of the end of the calendar year in order for them to be included in the last calendar year
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HSA Continued
• Items that are tax deductible medical expenses under the Income Tax Act (Canada) and are not payable under any other private or government plan are eligible for reimbursement.
• Items such as those covered when you were active are covered
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YUSA
• Health benefits are reimbursed at 80%
• $10,000 per lifetime out of country coverage
• $100 per calendar year per person for vision coverage (eye exams included in this maximum)
• $1,000 per calendar year per person for dental coverage• Basic dental covered at 100%
• Major restorative reimbursed at 50%
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CPM
• Health benefits are reimbursed at 80%
• $10,000 per lifetime out of country coverage
• $100 per calendar year per person for vision coverage (eye exams included in this maximum)
• $800 per calendar year per person for dental coverage• Basic dental covered at 100%
• Major restorative reimbursed at 50%
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YUFA and Osgoode
• $18 single or $34 family per month cost
• $130 per person per calendar year deductible
• Health benefits are reimbursed at 80%
• $20,000 per lifetime out of country coverage
• $1,250 per calendar year per person for dental coverage• Basic dental covered at 100%
• Major restorative reimbursed at 85%
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Purchasing Extra Benefits
Additional coverage can be purchased through various providers such as:
Ontario Teachers Insurance Plan (OTIP)
http://www.otip.com/Individual-Insurance/Retiree-Health,-Travel---Dental.aspx
Municipal Retirees Organization Ontario
http://www.encon.ca/mroo/
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Ontario Teachers Insurance Plan (OTIP)
• Basic, Gold, Plus or Gold Elite coverage available
• Deluxe Travel also available
• Costs range from $41.44 per month for single basic health to $241.31 per month for family Plus coverage (hospital coverage not included)
• Dental costs per month range from $62.58 for single basic to $149.94 for family Plus coverage
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Municipal Retirees Organization Ontario
• Three different plans available
• Premiums range from $40.03 for single coverage up to $265.17 per month for retiree and spouse coverage
• Can purchase additional travel insurance at $25 per month for single coverage or $50 per month for retiree and spouse
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Additional Coverage
• There may be other benefit programs available for you
• Only you can determine if it is in your best interest to purchase additional coverage
• Note that coverage through York or another carrier may change
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Out of Country Coverage
• Emergency services only are covered
• Contact Europ Assistance as soon as possible – preferably before having any treatment – for them to coordinate coverage and payment
• Coverage provided under any of the York post retirement benefit programs is not sufficient therefore you need to purchase additional coverage
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Europ Assistance contact information
• In an emergency while traveling, call Europ Assistance:
• +1-800-511-4610 (Toll Free From U.S. and Canada) +1-202-296-7493 (Collect from outside of the U.S.)
• +1-800-368-7878 (Toll Free From Mexico)
• Toll Free dialing is not available in Cuba. Use international operator.
• Or email: [email protected]
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Living out of Country
• Coverage is provided only if you have OHIP coverage i.e. you must be physically present in Ontario for 153 days in any 12 month period
• Dental claims are paid based on the Ontario fee guide
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Survivor Benefit Coverage
• In the event of your death your surviving dependent can continue coverage as follows:
• Note costs are subject to change
Affiliation Cost per month (single)
Any group with a Healthcare Spending Account
No cost however benefit is reduced to 50% and coverage provided for a maximum of five years
YUSA $107.47
CPM $ 99.00
YUFA First two years pay $18.00 then full cost of $113.96
Osgoode First two years pay $18.00 then full cost of $114.95
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Keep in Mind
• Claims as an active employee must be submitted within 90 days following your retirement – remember to use your employee number
• Remember to give your dentist your new retiree number
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Sun Life Member Website
Policy number remains as 14098
Change first digit of employee number from one to nine (i.e. 100100200 to 900100200)
Sun Life has a member website https://www.sunnet.sunlife.com/signin/mysunlife/home.wca? which provides you access to items such as
• benefit coverage information
• set up direct deposit for benefit reimbursement
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Group Life Insurance
• If you have the group life insurance the coverage is on your life only
• Coverage is three times your salary rounded to the nearest thousand until normal retirement date
• If you continue to work beyond your normal retirement date the coverage reduces to one times your salary rounded to the nearest thousand
• You can not purchase additional coverage
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Group Life Insurance Continued
• Coverage ends at termination, retirement or age 71 whichever is earliest.
• Upon termination or retirement you have the option of converting the insurance to an individual policy.
• It is extremely expensive to convert the coverage so we suggest you contact an insurance company/broker at an earlier age to explore other life insurance options.
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General HR Questions
• Try asking your question through ASKHR
• Type your question in the box and click GO!
• Please provide feedback so we are able to continually improve the information in this database.
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ASK HR
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ASKHR
• A full question does not have to always be typed
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Need to contact Pension & Benefits?
• E-mail [email protected]
• Call 416-736-2100 extension 27572 (askpb) – the phone line is open from 9:00 am to 4:00 pm Monday to Friday. For Fridays in June, July and August the phone line closes at 3:00 pm.
• Please have your employee ID ready when you call us.
• Any form or document that we may need from you can be completed, scanned and emailed to [email protected].
