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Know Your Benefits

Know Your Benefits

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Know Your Benefits

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  1. Your Logo Here Know Your Benefits Jennifer Drummond Diane Ross Mathers

  2. Our Goal today • Is to get you more familiar with your Sun Life Benefits and Human Resources Services highlighting our website and other College services. • As part of our green initiative we will not be supplying copies of the presentation today but they are available on our HRS website. • Tour of Human Resources Website

  3. Information Sources & Services • Internal communications: • MyAlgonquin • • Good Morning Algonquin • Human Resources Services website at • College Services • College Directives

  4. Benefits • Our Benefits carrier is Sun Life of Canada • Mandatory Benefitsyou participate in are: • Basic Life Ins • LTD coverage • Extended Health (single or family coverage) • Dental (single or family coverage) • Optional Benefits are additional term life insurances over and above the Basic Life Insurance. Each employee group has different life insurance options to choose from.

  5. Benefits • All leave and benefit information is available on our website. • Please visit the Human Resources Service website at • Please notify Human Resources Services if you have a change in address. • Please note that Notification to Sun Life of a change in address will occur upon completion and submission of your next claim form. • Please notify Human Resources Services of changes in your personal status, or life-change such as a Birth, Marriage or Divorce which will affect your coverage needs and /or your beneficiaries to your life insurance and/or your pension.

  6. Benefits • Changes in personal status may affect your benefit coverage. You must contact the benefits administrator to discuss your coverage within 31 days following the change. A change in marital status, birth of a child or death qualifies as a “change in life” listed in your benefits handbooks • It is important to notify HRS within the 31 day “change in life” requirement as Sun Life will not allow back dating of changes to dependent status. • A Sun Life health questionnaire will be required if request received after 31 days. There is no guarantee of approval. • Any benefit changes must be done on the appropriate forms requiring original signatures. No changes will be made via email or telephone, unless approved by HRS.

  7. What is Covered? Extended Health Plan • Semi private hospital room • 85% reimbursement on prescription drugs • $1,500 Paramedical Services • Vision and Hearing Care Dental coverage • see your employee group benefit booklets for more details.

  8. Dental Coverage • Preterminations are required on services over $300 or major treatments (cap/crown) • $2000 Maximum per calendar year Type ABC for Support and $2500 Maximum per calendar year Type ABC for Academic and Administrative. • $2000 Maximum per calendar year for Type E, (Crowns and Bridges) for Support and $2500 Maximum per calendar year for Type E for Academic and Administrative. • Orthodontic coverage insured at 50% to a lifetime maximum of $2500 • Please have your dentist request a predetermination electronically to Sun Life or you can fax your request to SL at 416-490-0224

  9. Calendar Year for EHC and Dental • January 1 to December 31 each year for both Ext. Health and Dental coverage • Deadline for claims is 18 months from date of service or 90 days if your coverage has terminated.

  10. Benefit Year for Vision and Hearing Care ONLY • Vision : September 1 to August 31 every 2 years (under 18 – entitled each year) • The current 2 year period for vision is September 1/06 to August 31/08 • Please note both an Ophthamologist and Optomotrist are covered at 85% under the combined paramedical services providing they are registered in the province. • Hearing : the coverage is every 3 years (all ages) The current 3 year period for hearing is Sept 1/06> Aug 31/09

  11. Laser Eye Surgery • You can combine your unused portion of the $1,500 in Paramedical coverage with your unused vision coverage to go towards laser eye surgery. • Please contact Sun Life directly for a predetermination and available coverage to ensure eligibility PRIORto surgery.

  12. What is not Covered • Athletic Therapy Services • Over the counter Meds • Smoking Cessation • Weight Loss Treatments • Hair Growth Stimulants • Some Vaccines and the injection costs • Blood Pressure Monitors Please see the benefit booklet for your employee group on the HRS website for further details on exclusions from our plan.

  13. List of Paramedical ServicesCombined Maximum of $1500 per Benefit Year • In any calendar year the plan will cover 85% of the costs, up to a combined maximum of $1500 for the licensed paramedical specialists listed below per person. • chiropractor, chiropodist, podiatrist, naturopath, massage therapist, osteopath, speech therapist, physiotherapist, audiologist, optometrist, ophthalmologist, occupational therapist, psychologist and acupuncturists.

  14. Paramedical Services • Reimbursement for Paramedical expenses are as follows: • Payment is made according to the qualifications of the person providing the service. • All specialists/practitioners must be registered in their province of practice , where the services are rendered. If services rendered by a non-licensed and/or a specialist/practitioner registered in another province, expenses are not eligible for reimbursement. • For Example: ANN members (licensed naturopaths in Quebec) who provide services in Ontario are not eligible. • The services must be within the scope of the provider's practice

  15. Naturopath Coverage • Naturopaths that are members of the ANN associations are only eligible if practicing in Quebec. They are not eligible if the ANN member is practicing out of any other province. You must be a Quebec Resident to be eligible for ANN services reimbursement. • In order to practice Naturopathic Medicine in Ontario, Naturopathic Doctors must be registered with the BDDT-N (Board of Directors of Drugless Therapy - Naturopathy). Qualifications are as follows : N.D. (Doctor of Naturopathic Medicine). • Please note there is currently no coverage for Homeopathy.

  16. Psychologist ServicesEducational Assessments • There are provisions for an educational assessment performed by a Psychologist. This coverage is applicable if the child is under the age of 18 and if a medically restrictive condition is suspected, such as attention Deficit Disorder or Dyslexia. The Psychologist must be properly qualified and registered in the province they are practicing in. Coverage is at 85% of the reasonable and customary amount specified by the province falling under the shared dollar maximum of $1500 for paramedical services. • An assessment would not be considered eligible if it was conducted in order to determine if a child is gifted, pre-school evaluations, career planning. Any charges for a report or paperwork will also not be covered by the policy.

  17. Orthopaedic Shoes and Orthotics • The CAAT health care plans recognize orthopaedic shoes and orthotics as a combined maximum under the $1500 Paramedical Services. Therefore, you and your dependents are eligible for either orthopaedic shoes OR orthotics, not both, in each calendar year. • Academic Staff - contract 50832: • up to a maximum of two (2) pairs for persons under 8 years of age, and one (1) pair for persons 8 years of age and over, in a calendar year. Administrative Staff – contract 50833: • up to a maximum of two (2) pairs for persons under 8 years of age, and one (1) pair for persons 8 years of age and over, in a calendar year. Support Staff – contract 50834: • up to a maximum of three (3) pairs for persons under 8 years of age, two (2) pairs for persons 8 years of age and over but under 18 years of age, and one (1) pair for persons 18 years of age and over, in a calendar year. • Prescription from physician, podiatrist or chiropodist is required and must be medically necessary. • If you have co-ordination with another plan (including the College Plans) that also allows one pair per year, you could receive the difference between what you actually paid for the orthopaedic shoes and what you were reimbursed from the CAAT health care plans. Under both plans, the claim would be deemed as one pair regardless of how much each carrier paid towards the pair.

  18. Osteopath Coverage OSTEOPATH • Under the CAAT Extended Health Care Plans (Academic, Administrative, Support), services provided by a Doctor of Osteopathy (DO) are eligible expenses. WHAT IS A DOCTOR OF OSTEOPATHY? • A Doctor of Osteopathy (DO) is a physician (MDs) who has additional qualification in osteopathy. (treatment of the muscuoskeletal system). They are regulated and certified by the College of Physicians and Surgeons of Ontario. Osteopathic services provided by anyone other than a Doctor of Osteopathy are not eligible for reimbursement, as they were not provided by a practitioner who has completed the doctorate degree. COVERAGE IN QUEBEC • Quebec is the only province with a regulatory body for osteopaths. The CAAT Extended Health Care Plans cover osteopathic services from practitioners registered with the Institut d’enseignement de l’ostéopathie du Québec (IEOQ).

  19. Medical Services and Equipment • Breast Prostheses and surgical bras, required as a result of surgery, up to a maximum of $600 per person in any Calendar Year. • Wigs are an eligible expense at 85% of what is considered reasonable and customary which is currently $500 per person every benefit year. • Casts, splints, trusses, braces and crutches • Iron lungs, wheelchairs, or other durable equipment rented for temporary therapeutic use. Where the purchase of durable equipment is less expensive than rental, it will be given consideration by Sun Life. • Oxygen and its administration • Artificial limbs and eyes, including repairs and replacements when medically necessary • Compression stockings. All receipts require compression value (which should be 20mm-40mm HG to be eligible)

  20. Medical Services and Equipment • Standard walkers, crutches and canes are eligible expenses at 85%. A doctor’s referral is required for a standard walker but not for crutches and canes. • Guideline for walkers is one every 60 months. Repairs and replacements are considered based on the member’s medical criteria. • Sun Life will ask for duration of rental and if rental costs exceed purchase cost they may suggest the purchase of the equipment.

  21. Medical Services and Equipment CPAP Machines • CPAP Machines (Continuous Positive Airway Pressure) used for Sleep Apnea are eligible at 85% up to a maximum of what is considered reasonable and customary charges. • If CPAP Machine is approved by a provincial plan such as ADP (Assistive Devices Program) the balance is paid by Sun Life up to 85%. • The CPAP machine is not included as part of the $1500 Paramedical maximum. • Members are to submit their claim through ADP first, then submit the explanation of benefits from ADP which confirms the amount they have reimbursed, along with a copy of the receipt for the purchase to Sun Life for reimbursement.

  22. Medical Services and Equipment • OHIP covers the cost of licensed ambulance services, where medically necessary, for local transportation of the person to and from the nearest hospital. You are responsible to pay a co-payment which is currently $45.If the member receives a bill for emergency transportation, they can submit the claim to SL along with the detailed receipt. The plan only has provisions for a licensed ground ambulance. • Non-emergency transportation by an ambulance provider is not covered.

  23. Out of Country Coverage • Your Extended Health Care Plan is NOT intended as full travel insurance and it is strongly recommended that employees obtain additional coverage. • The intent of the out of country benefit is for emergency medical treatment. An emergency is an acute illness or accidental injury that requires immediate, medically necessary treatment prescribed by a doctor (e.g. at a hospital or clinic). This includes non-elective treatment for immediate relief of severe pain or illness that cannot be delayed until you or your insured dependent is medically able to return to your province of residence. • It covers a portion of the cost of semi-private hospital room accommodations, out-patient services in a hospital and the services of doctor, up to the difference charged by a doctor and the amount equal to the medical fee schedule of the person's province of residence for emergency health services. • See your employee group benefit booklets for details on out of country coverage or visit the HRS website. • Worldwide Assistance Services Inc., Sun Life's emergency travel assistance provider, changed its name to Europ Assistance USA, Inc.

  24. Sun Life Travel Card

  25. Benefits EAP Program – Employee Assistance Program • Algonquin College recognizes that personal difficulties experienced by an employee may have serious effects on their health, well-being, personal life, and their involvement and performance in the workplace.  The Employee Assistance Program (EAP) has been developed to help you and your family with personal concerns, tensions and stress before they lead to more serious problems. • The service provider for Algonquin College is WarrenShepellfgi. Please see our website for additional information, or visit their website at • Professional, confidential support is offered through WarrenShepell 24 hours per day, 7 days a week, by calling the following numbers: • English Service: 1 800 387 4765 • French Service: 1 800 361 5676

  26. Benefits • Each employee group has a specific policy number and certificate number • When you contact Sun Life, it is important to have your policy information readily available.  Each group's policy information is summarized below. Group Policy/Contract # Certificate# Support 50834 101 +Employee # Administrative 50833 301 +Employee # Academic 50832 201 +Employee # • Coordination of benefits is also available should you have coverage under your spouses benefits plan. • Please note when retiring your plan number will change.

  27. Benefits You can also contact Sun Life directly: By Phone: 1-800-361-6212 By Email: Via the Web: Your contract and certificate number will be required when contacting Sun Life

  28. Sun Life On-Line Member Services

  29. Using your Sun Life Drug Card • Present your card and your pharmacist will send your claim electronically to Sun Life. Sun Life will pay the covered amount directly to your pharmacy so you only have to pay the balance. • Having a Pay-Direct drug card does not mean all drug claims are covered or that they will be fully reimbursed. If the drug your doctor has prescribed isn't eligible under the plan, it will not be covered. You may want to discuss another option with your doctor before filling this prescription. • Keep in mind any medication that does not have a DIN number (drug identification number) will not be covered by the plan. For example, some newer experimental cancer drugs. • If you do not use the card for all your drug purchases, your reimbursement could be affected due to the pharmacist mark ups on the cost of the drugs. This means you may have to pay more out-of-pocket. • Be sure to review your benefit booklet so you understand what the plan covers.

  30. Pension CAAT Pension Plan – Mandatory enrolment • CAAT Pension Plan • Defined Pension Plan • College matches penny for penny • 2% rule = for each year of service you receive 2% towards your annual pension • Contributions are based on your year-to-date earnings as follows: • 10.1 % on the first $3,500 of earnings (matched by College) bi-weekly • 8.3 % on the next $3,501 to $44,900 of earnings (matched by College) bi-weekly • 10.1 % on any earnings over $44,901 (matched by College) bi-weekly • PLEASE NOTE: You cannot contribute to two registered pension plans at the same time. • Please see for more detail on the plan.

  31. Contributions to the Plan will be increasing by 1% of salary on each of January 1, 2008, 2009, and 2010. total increase of 3% of salary applies to both Plan Members and Colleges.

  32. Pension – Marriage Breakdown • In the event of a marriage breakdown or separation by a Member, the CAAT Plan requires evidence that the ex-spouse is entitled to a share of the Member’s pension, or that he or she has waived such entitlement. • The best source of this evidence is a copy of the separation or divorce agreement that directly addresses the settlement of the pension entitlement.

  33. Pension – Marriage Breakdown • In the event that there is no agreement, or the agreement does not address the pension issue, or if the Member refuses or is unable to submit a copy of the agreement or a signed waiver, the Plan will accept a notarizedaffidavit, paid for by the Member or former Member. For information regarding your CAAT Pension and Separation or Divorce, please visit the CAAT Pension Website regarding Divorce and Separation Agreements at or contact Jodie Sourial of CAAT Pension at 1-866-350-2228.

  34. Types of Leave Short Term Disability (STD or sick leave) • Short Term Disability covers employees who are absent from work due to illness or injury for the first 130 days. The rate of pay received while off on sick leave depends on the number of days in the employees sick leave bank. 100% salary is paid for banked sick days and 75% for any days thereafter up to a maximum of 130 days. • Sick Leave Entitlements are as follows: Support Staff: September 1st-10 days Academic: September 1st-20 days Administrative: July 1st-130 days

  35. Medical Certificates • In general, medical certificates are requested after an absence of 5 or more consecutive days. However, the College reserves the right to request medical evidence in all circumstances as per College Directive D8 1.1.2 • Absences of 5 consecutive days duration or longer are to be reported to Human Resources Services immediately by the Supervisor. • For further information regarding the Short Term Disability processes, please contactKaren Petrie at x5363 or

  36. Types of Leave Long Term Disability (LTD) • Once the 130 day STD period has expired, the employee may then be eligible for LTD. • Completion of an LTD package by both the employee and physician is mandatory. This package is sent to the employee prior to the expiration of the 130 days STD. • Please contact Sandra Luck-Vinet at ext. 5488 or should you require further information regarding LTD process. Once approved: • Admin and Support staff receive 66 2/3% salary (taxable income) from Sun Life • Academic staff receive 60% salary (nontaxable income) from Sun Life • There are modified Work load accommodations available when necessary. Sandra is also the contact for modified workloads

  37. Leave Professional Development • Academic: 10 days per year • Support: 3 days per year • Administrative: Subject to conditions Vacation • Academic: 43 days once full academic year is completed • Support: 15 working days once a full year of service is completed. Increase as per C.A. • Administrative: 22 working days after one year of continuous service Maternity/Parental Leave • Pregnant employee employed at least 13 weeks before delivery date • 17 weeks of Maternity leave • 2 week EI waiting period paid at 93% of salary. • Salary is topped up by the college to 93% • Parental leave up to 37 weeks • Parental includes adoption

  38. Leave Prepaid Leave • Leave between 6 months to 1 year • Deferral of regular salary from previous year • Must have 3 years seniority Leave Without Pay • May vary in length not exceeding one year • Over 4 months must have President’s approval • Request in writing Leave With Pay (manager’s approval) • Bereavement Leave (3 days) • Extenuating Personal Circumstances (Compassionate Leave – 3 to 5 days) • Religious Leave (up to 3 working days) – As per directive D8 (1.3 - Religious Duty), Article 21 of the Academic Collective Agreement, Article 12.1 of the Support Staff Collective Agreement, and The Terms and Conditions of Employment for Administrative Employees, full-time College employees may be eligible for leave on religious holidays - when the proper documentation is provided. • Jury Duty/Subpoenas • Family Care Days (Academic staff only, taken from sick leave up to 5 days)

  39. Leave Reduced Workload • Upon approval • Salary and vacation is pro-rated • Maximum of 5 years Statutory Holidays • Family Day • Good Friday • Canada Day • Labour Day • Victoria Day • Civic Day • Thanksgiving Day • Christmas Day and New Year’s Day and days in between • The College will remain open on Easter Monday and Remembrance Day

  40. On-Line Pay Stubs • Bi-weekly basis • Electronic paystub • Username and password •

  41. Pension and BenefitsResignations and Retirement Resignation & Retirement • Notice Required (2 weeks for Support Staff, 90 days for Academic Staff and 30 days for Administrators) • Please contact Connie Powers at ext. 5119 or for further information. • Please contact Jennifer Drummond at ext. 5367 or drummoj@algonquincollege.comfor pension estimates. • Notice is required in writing to your manager and copied to HRS in C426

  42. Questions

  43. Thank you for attending!