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Active Member Health Coverage

The purpose of the Major Medical/Drug Plans is to help cushion the blow in the event that you or your dependents run into high medical expenses.


MAJOR MEDICAL AND DRUG BENEFITS

If you or a dependent are totally disabled as a result of injury or illness when your Major Medical/Drug Benefits terminate and you have expenses for the injury or illness for the disabling condition which would have been paid had your coverage continued, your benefit payments for Major Medical / Drug expenses will continue until the earliest of the following:

  • the date which is 90 days after the Health Benefits Plan terminates,
  • the date on which you have received maximum benefits, if any,
  • the date on which you have received benefits for a period equal in length to the period for which you were covered for benefit,
  • the second December 31st following termination of your coverage,
  • the date your disability ends.

DEPENDENTS ARE DEFINED AS:

  • your legal or common-law spouse, and
  • your unmarried children under the age of 21 years, and
  • your unmarried children aged 21 and over who were continuously covered under the Plan and who are full time students and under the age of 26 years or who are unable to support themselves because of mental or physical handicap,
  • but excluding any children who are not financially dependent on you or a handicapped or unmarried child who was not covered under the Plan up to his or her 21st birthday.Your common-law spouse and dependents are only eligible six months after notice of cohabitation is received by the Benefits Office.

For coverage purposes you and your dependents are deemed to be covered under the Hospital and Health Insurance Acts in your province of residence. For Quebec residents, all aspects of RAMQ, the Act respecting prescription drug insurance, relating to drug coverage, including the Act’s provisions regarding maximum coinsurance, out-of-pocket maximums, eligible drugs and exception drugs will be considered part of this Plan.

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