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For retiree health, dental & travel insurance
®
Insurance solutions for the education community
2015 RTIPGuide
What's inside?» Five health plans to choose from » How to decide which plan you need» Special services and extra benefits» Make an easy transition from any group plan to RTIP» Application form
Visit rtip.com to apply online today!
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Why choose RTIP (Retired Teachers Insurance Plan)?
Flexibility is important. Your needs will change throughout your retirement, so having the freedom to increase or decrease your coverage is very important. It is especially important once you turn 65, because the Ontario Drug Benefit Program (ODB Program) may cover the majority of your prescription drug costs. RTIP gives you the flexibility to decrease your prescription drug coverage at your next renewal (January 1)*, therefore reducing your monthly premiums. Don't pay for more prescription drug coverage than you need!
For more information about the ODB Program, visit www.health.gov.on.ca and search “ODB Program”.
* Once you decrease your health coverage, you must wait two years before you are able to increase your coverage again. An increase to the Gold Elite plan or an increase of more than one plan level requires medical evidence of insurability.
† Gold Elite is the only RTIP plan with an age limit. Once you turn 65, this plan terminates, and you are automatically enrolled in the RTIP Gold plan (with a $750 drug maximum), unless you select a different RTIP plan.
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®
Insurance solutions for the education community
Our StoryWhen someone chooses to be an educator, they’re choosing more than a career. They’re choosing a life — a life dedicated to putting others first.
Our name is OTIPOur initials stand for Ontario Teachers Insurance Plan. What we stand for is putting educators first. Educators are our reason for being — helping them protect the things they care about is what gets us out of bed in the morning, and it’s what makes us look forward to tomorrow.
It’s been like that since day one.Almost 40 years ago, a group of like-minded individuals came together to create OTIP. They strongly believed the insurance needs of Ontario’s educators would be better served by a not-for-profit insurance advocate that was part of the education community; an insurance advocate with the determination, skill and vision to work with the best insurance companies to shape and innovate products and services specially built for educators.
Today, we proudly offer a full range of group and individual insurance products that all share one thing in common. They were created to specifically address and satisfy the unique needs of our members.
Why? Because we believe that insurance built around our members is the best insurance of all. At OTIP, we don’t have a profit motive. We have something more inspiring: a “putting educators first” motive. The proceeds we generate by meeting the needs of our members and going beyond expectations enable us to continually develop new and better ways to protect what matters to them most.
OTIP is proudly governed, led and inspired by the four education affiliates and their local leaders who daily champion the employees of Ontario’s education communities. Being affiliate-led means we understand, like no other, the needs and hopes of our members. Every product and service we offer has been shaped and improved by this deep understanding.
And that will always be true.
RTIP plans are underwritten by Manulife Financial.
For more information, please contact OTIP.
Phone: 1.800.267.6847 Online: www.rtip.com Mail: 125 Northfield Drive West, PO Box 218, Waterloo ON N2J 3Z9
How to decide which plan you need . . . . . . . . . . . . . . 4
Eligibility and when medical evidence is required . . . . . . . . 5
RTIP Gold Elite . . . . . . . . . . . . . 6
What’s insideRTIP Plus . . . . . . . . . . . . . . . . . . 8
RTIP Gold . . . . . . . . . . . . . . . . 10
RTIP Basic . . . . . . . . . . . . . . . . 12
RTIP Deluxe Travel . . . . . . . . . 14
RTIP Dental . . . . . . . . . . . . . . . 15
Plan Comparison Chart . . . . 16
Rate Comparison Chart . . . . 18
Application Form . . . . . . . . . . 19
Important services included in all RTIP Plans . . . . . . . . . . . 22
No age restrictions† and no membership fees.
Five health care plans to choose from, with four different prescription drug maximums and the freedom to increase or decrease your coverage at your next renewal.*
Deluxe travel insurance is included in every RTIP plan and provides coverage for trips up to 95 consecutive days!
You have the option to add dental coverage at any time, without penalty.
Online claims are easy! Submit your claims online and your reimbursement will be deposited directly into your bank account.
Complimentary access to these important services:
CAREpath – the Cancer Assistance Program.
Express Scripts Canada Pharmacy – a home delivery program that covers 100% of your generic maintenance prescription drug expenses (or 90% of brand name prescriptions).
Edvantage – savings, contests and special events.
See pages 22-23 for more information about these programs.
Our commitment to insurance built around our members doesn’t stop at retirement. OTIP’s health, dental and travel insurance is the most flexible program available to the retired education community. Because when you retire, you want insurance coverage that is tailored to you.
Visit rtip.com to apply online today!
5 4
How to decide which plan you need
Complete the application form on page 19 or visit rtip.com to apply online today!
If at any time you are having trouble understanding something or making the best decision, call us at 1-800-267-6847 and we'll help you find the right coverage.
* Once you decrease your health coverage, you must wait two years before you are able to increase your coverage again. An increase to the Gold Elite plan or an increase of more than one plan level requires medical evidence of insurability.
Who is eligible for RTIP?All retired Ontario education employees, their families and survivors are eligible to apply for coverage under a RTIP plan. There is no age restriction to join RTIP.You must reside in Ontario and be covered under OHIP at the time of application.
Have a dependant?Members’ unmarried, unemployed children under the age of 21 (under 31 if attending school full-time) are eligible for dependant coverage under a RTIP plan. There is no age limit for unmarried, dependant children who are incapable of self-sustaining support due to a mental or physical disability that occurred prior to age 21. Keep in mind, any two family members can qualify for couple coverage. If you do not have an eligible spouse, you and your dependant child can qualify for couple rates.
Now that you’ve selected the appropriate plan based on your annual prescription drug costs – find your plan in this book and use this checklist to further customize your coverage. Choose single, couple or family coverage.
Ensure the monthly premiums fit your budget.
Review and understand your prescription drug coverage.
What else is important to you? Travel Insurance – Coverage for trips up to 95 consecutive
days is included in every RTIP health plan!
Vision Care
Paramedical Services (Chiropractic, Physiotherapy, Acupuncture, etc.)
Hospital Accommodation – Included in some plans or your choice to add.
Dental Coverage – Always optional. Add it at any time without penalty.
Match your current annual prescription drug costs to the RTIP plan with the closest annual prescription drug maximum.
Plan Annual prescription drug max. What else is included? Go to:
RTIP Gold Elite Unlimited Page 6
RTIP Plus $3,000 Page 8
RTIP Gold $1,500Page 10
RTIP Gold $750
RTIP Basic $750 Page 12
Remember, you’re not locked in! We offer multiple plans because we know your needs will change throughout your retirement, and when they do, you'll be able to increase or decrease your coverage at your next renewal (January 1).*
1 How old are you? What are your current annual prescription drug costs?
Under age 65? Age 65 or older?If you haven’t kept track of the cost of your prescription drugs – don’t worry! Call your pharmacist to determine the total annual cost of your prescription drugs.
If you are 65 or older and living in Ontario with a valid Ontario health card you are eligible for the Ontario Drug Benefit (ODB) Program. This program may cover the majority of your prescription drug costs. Call your pharmacist to determine the annual cost of your prescription drugs that are not covered under the ODB Program. Use that number to find the coverage that is right for you.
My current annual prescription drug costs (not including dispensing fees) are: $
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*A medical evidence of insurability form is required to apply for, or increase to, the Gold Elite plan.
I’ve set my retirement date.
Apply before your current health coverage ends to ensure your RTIP coverage is ready when you need it. Applying early also ensures that your benefits card is in your hands when your coverage begins. Medical evidence is not required unless you are applying for the RTIP Gold Elite plan.*
This is the best time to apply!
I’ve recently retired. No medical evidence* is required if you apply for a RTIP plan within 60 days of your group health plan termination date.
I'm already retired and want to switch from a different group health benefits plan.
If you want to switch to RTIP (even from another retiree group health benefits plan), you can apply within 60 days of your current group health plan termination date, without providing medical evidence.* There is no age restriction to join RTIP. See the outside back cover for more reasons to make the easy switch to RTIP.
I have not been covered under a group health benefits plan in the last 60 days.
If you apply for any retiree health plan more than 60 days after your health coverage ends, medical evidence is required. YES
NO
NO
NO
I’m still working or I’m semi-retired.
Even if your current health plan is not terminating, you can still apply for a RTIP plan to coordinate benefits. Medical evidence is required. YES
What retirement stage are you at?
Is medical evidence required when you apply?
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RTIP Gold EliteIt’s a reality that some families have catastrophic medical expenses. In response to this need, OTIP created the RTIP Gold Elite plan. Available to all retired members of Ontario’s education community under the age of 65, this plan is designed to provide insurance protection from significant health care expenses. With RTIP Gold Elite, you can afford to treat your condition while protecting your family’s finances and your retirement plan. A medical evidence of insurability form is required to apply for, or increase to, the Gold Elite plan.
This plan covers:(For more details, see the Plan Comparison Chart on pages 16-18.)
Prescription drugs
First $500 Next $4,000 After $4,500 – UNLIMITEDEligible prescription drug expenses
are reimbursed at 80% until you have received a total payment of $500 per
person, per calendar year.
You pay for the next $4,000 in eligible prescription drug
expenses per person, per calendar year.
100% of eligible prescription drug expenses are reimbursed with no
annual maximum. When each calendar year is up, the process begins again.
» OR when you use the Express Scripts Canada Pharmacy home delivery program, you receive 100% coverage for your generic maintenance prescription drug expenses (or 90% of brand name prescriptions). See page 22 for details.
» You are responsible for dispensing fees.
» Sexual dysfunction drug coverage is included up to $500 per person.
Also included at no additional cost:
» Combined coverage for: » Home care » Private duty nursing » Medical aids equipment & supplies » Prosthetic appliances
Once paid claims exceed $7,500, you are reimbursed at 100% to a combined maximum of $25,000 per person, per calendar year, to a lifetime maximum of $100,000.
» Paramedical services – 80% reimbursement of eligible charges up to a combined maximum of $1,250 per person, per calendar year.
» RTIP Gold Elite also offers unlimited chiropractic and physiotherapy coverage for 12 consecutive months following an accident that requires a hospital stay of at least 24 hours. Members are eligible once the $1,250 paramedical maximum has been reached.
» Vision care – 100% reimbursement of eligible charges up to $250 per person in any two calendar years.
» Deluxe travel insurance for trips up to 95 consecutive days! Details on page 14.
» Access to CAREpath Cancer Assistance Program and Edvantage rewards program. Details on pages 22 and 23.
You can choose to add: » Hospital coverage – Your choice of unlimited or $100 per day semi-private hospital accommodation.
See coverage and premium chart to the right.
» RTIP dental coverage – You can add this at any time, without penalty. Coverage and premium details on page 15.
RTIP Gold Elite
Remember to claim your unreimbursed medical
expenses on your income tax return, including the $4,000 deductible, your premiums, and all other out-of-pocket expenses
for the calendar year.
Monthly Hospital Accommodation Premiums
Coverage $100 per day Unlimited semi-private
Single $12.89 $21.06
Couple $23.40 $40.32
Family $29.09 $51.00
» PST & HST do not apply.
Monthly Premiums(including deluxe travel insurance)
Single $95.06
Couple $179.37
Family $205.36
» PST & HST do not apply.
Note: Plan change required at age 65
» The Ontario Drug Benefit covers many prescription drug costs for Ontarians once they turn 65. Because of this, the RTIP Gold Elite plan terminates at age 65, and members are automatically enrolled in the RTIP Gold plan (with a $750 drug maximum), unless they select a different RTIP plan.
Gold Elite You can choose to add:
Eligible expenses are reimbursed at 80% until you have received a total payment of $7,500 per person, per calendar year.
7 Visit rtip.com to apply online today!
8 9
RTIP PlusThis comprehensive plan provides $3,000 in prescription drug coverage per person, per calendar year. With superior health care coverage, unlimited semi-private hospital accommodation and deluxe travel insurance built in, it is the choice of many education employees.
This plan covers:(For more details, see the Plan Comparison Chart on pages 16-18.)
Prescription drugs
$3,000 drug maximum » Eligible prescription drug expenses are reimbursed at 85% to a maximum of $3,000 per person, per calendar year.
» No deductible.
» Sexual dysfunction drug coverage is included up to $750 per person.
» You are responsible for dispensing fees.
» Save more money when you use the Express Scripts Canada Pharmacy home delivery program for your maintenance prescription medications. You receive 100% coverage for your generic maintenance prescription drug expenses (or 90% of brand name prescriptions). See page 22 for details.
Also included at no additional cost:
» Paramedical services – 80% reimbursement of eligible charges up to a combined maximum of $1,250 per person, per calendar year.
» Vision care – 80% reimbursement of eligible charges up to $375 per person in any two calendar years.
» Unlimited semi-private hospital accommodation.
» Diabetic supplies – 85% reimbursement of eligible charges up to $1,000 per person, per calendar year.
» Deluxe travel insurance for trips up to 95 consecutive days! Details on page 14.
» Access to CAREpath Cancer Assistance Program and Edvantage rewards program. Details on pages 22 and 23.
You can choose to add: » RTIP dental coverage – You can add this at any time, without penalty. Coverage and premium details on page 15.
9
RTIP Plus
Our most POPULAR
PLAN!
Monthly Premiums(includes unlimited semi-private hospital accommodation and deluxe travel insurance)
$3,000 drug maximum per person, per calendar year
Single $102.27
Couple $200.73
Family $240.02
» PST & HST do not apply.
Plus
Visit rtip.com to apply online today!
11 10
RTIP GoldRTIP Gold is the perfect plan for members who need less prescription drug coverage but still want all of the other comprehensive health care services and deluxe travel insurance.
With two prescription drug limits to choose from and the option to add dental and/or hospital coverage, RTIP Gold is our most flexible plan. Customize your coverage.
This plan covers:(For more details, see the Plan Comparison Chart on pages 16-18.)
Prescription drugs Choose your maximum
$1,500 drug maximum $750 drug maximumEligible prescription drug expenses are reimbursed
at 80% to a maximum of $1,500 per person, per calendar year.
Eligible prescription drug expenses are reimbursed at 80% to a maximum of $750 per person,
per calendar year.
» No deductible.
» Sexual dysfunction drug coverage is included up to $750 per person.
» You are responsible for dispensing fees.
» Save more money when you use the Express Scripts Canada Pharmacy home delivery program for your maintenance prescription medications. You receive 100% coverage for your generic maintenance prescription drug expenses (or 90% of brand name prescriptions). See page 22 for details.
Also included at no additional cost:
» Paramedical services – 80% reimbursement of eligible charges up to a combined maximum of $1,250 per person, per calendar year.
» Vision care – 100% reimbursement of eligible charges up to $250 per person in any two calendar years.
» Diabetic supplies – 80% reimbursement of eligible charges up to $1,000 per person, per calendar year.
» Deluxe travel insurance for trips up to 95 consecutive days! Details on page 14.
» Access to CAREpath Cancer Assistance Program and Edvantage rewards program. Details on pages 22 and 23.
You can choose to add: » Hospital coverage – Your choice of unlimited or $100 per day semi-private hospital accommodation.
See coverage and premium chart to the right.
» RTIP dental coverage – You can add this at any time, without penalty. Coverage and premium details on page 15.
RTIP Gold
This plan is the most popular choice for
members over age 65 because most of their
drugs are covered under the ODB Program.
Only OTIP helps you save by giving you choices.
11
Monthly Hospital Accommodation Premiums
Coverage $100 per day Unlimited semi-private
Under age 65
Single $12.89 $21.06
Couple $23.40 $40.32
Family $29.09 $51.00
Age 65 or older
Single $24.43 $40.88
Couple $45.33 $77.91
Family $56.79 $98.50
» PST & HST do not apply.
Monthly Premiums(including deluxe travel insurance)
$1,500 or $750 drug maximum per person, per calendar year
Drug maximum $1,500 $750
Single $65.82 $51.60
Couple $124.31 $97.30
Family $151.47 $117.30
» PST & HST do not apply.
Gold You can choose to add:
Visit rtip.com to apply online today!
12 13
RTIP BasicIf you are looking for a lower-cost health care plan, RTIP Basic may be right for you. This option is most suited for those who require limited prescription drug coverage, do not require vision or hearing care benefits, and may be purchasing a plan mainly to coordinate benefits with another health care plan.
This plan covers:(For more details, see the Plan Comparison Chart on pages 16-18.)
Prescription drugs
$750 drug maximum » Eligible prescription drug expenses are reimbursed at 80% to a maximum of $750 per person, per calendar year.
» An annual deductible of $100 applies for single coverage and $200 for family and couple coverage.
» Sexual dysfunction drug coverage is included up to $750 per person.
» You are responsible for dispensing fees.
» Save more money when you use the Express Scripts Canada Pharmacy home delivery program for your maintenance prescription medications. You receive 100% coverage for your generic maintenance prescription drug expenses (or 90% of brand name prescriptions). See page 22 for details.
Also included at no additional cost:
» Paramedical services – 80% reimbursement of eligible charges up to a combined maximum of $750 per person, per calendar year.
» $100 per day in semi-private hospital accommodation.
» Vision tests are covered, however, vision care coverage is not included.
» Hearing tests are covered, however, hearing aid coverage is not included.
» Diabetic supplies – 80% reimbursement of eligible charges up to $750 per person, per calendar year.
» Deluxe travel insurance for trips up to 95 consecutive days! Details on page 14.
» Access to CAREpath Cancer Assistance Program and Edvantage rewards program. Details on pages 22 and 23.
You can choose to add: » RTIP dental coverage – You can add this at any time, without penalty. Coverage and premium details on page 15.
13
RTIP Basic
Monthly Premiums(includes deluxe travel insurance and hospital accommodation)
$750 drug maximum per person, per calendar year
Single $46.76
Couple $87.13
Family $106.72 » PST & HST do not apply.
Basic
Visit rtip.com to apply online today!
14 15
Our deluxe travel insurance offers comprehensive coverage and is included in all RTIP health care plans at no additional cost. So in most cases, you will not need to purchase travel insurance when travelling outside the province or country.
Coverage includes:Emergency medical treatment
» Coverage up to $2 million per person, per trip while travelling outside your province of residence.
» Coverage is effective for trips up to 95 consecutive days, with an unlimited number of trips per year.
Trip cancellation and/or trip interruption
» Coverage up to $6,000 per person, per trip, for pre-paid, non-refundable, unused expenses if you are unable to travel or continue to travel due to death, illness, or serious injury to yourself or a member of your immediate or extended family (as defined in the contract).
» Trip cancellation and trip interruption coverage are not available if you depart prior to the effective date of your RTIP policy. However, in the event of trip interruption, return airfare is covered if the expense is incurred after the effective date of your RTIP policy.
24-hour emergency assistance
» While you are away, 24-hour emergency assistance is always available. Services include arranging for: payment to health care providers, medical referrals, transportation, notification of physician and family, and local care of dependants. If you are hospitalized and your dependant children and/or grandchildren under the age of 16 are left unattended, their return home will be coordinated and paid for. If necessary, a qualified escort will accompany the dependant children, and the escort's expenses for round-trip transportation will be paid.
Before you decide to travel: » If you depart on your trip prior to the effective date of your
RTIP policy, your coverage will begin the day your RTIP policy comes into effect. The 95-day limit will begin on the day you depart.
» Claims adjudication uses a standard administrative practice to determine if an insured member was clinically stable at the time of the incident. Because decisions on the eligibility of a claim are made after the claim has been submitted, OTIP cannot guarantee before you leave that claims related to your pre-existing medical condition will be covered.
» As with any insurance plan, it is important to check the details of your contract to ensure you are protected. Complete details of the coverage and exclusions under the RTIP deluxe travel insurance plan can be found online at www.rtip.com.
RTIP dental coverage can be added to any of our health care plans, or purchased alone, at any time.
RTIP’s dental plan covers regular examinations and preventive care in addition to many more substantial procedures, as outlined below. Reimbursement is based on the current year’s Ontario Dental Association fee guide for general practitioners.
Coverage includes:Basic and preventive care*
» 80% coverage for dental examinations, extractions, fillings, X-rays, scaling (16 units of time), cleaning and preventive procedures with no overall maximum. Coverage for recall examinations is limited to nine months from last appointment.
Basic restorative care*
» 80% coverage for root canals (endodontics) and gum disease treatments (periodontics), up to a combined annual maximum of $750.
Major restorative care*
» 50% coverage for crowns, bridges, implants and dentures, up to a combined annual maximum of $700.
Denture care*
» 80% coverage for rebasing and relining of upper and lower dentures, up to a maximum of one treatment per year.
*terms and conditions of coverage apply
No penaltyYou may add dental coverage to your plan at any time. If you initially forego this option and apply for coverage at a later date, there is no penalty or restriction period before you can claim full benefits.
The only requirement is that you remain enrolled for at least 12 months after adding dental care to your plan. If you decide to cancel your dental coverage after the minimum 12-month requirement, you must wait 24 months before you can repurchase this benefit.
Monthly Dental PremiumsSingle $61.59
Couple $120.92
Family $147.56 » PST & HST do not apply.
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RTIP Deluxe Travel InsuranceIncluded in all RTIP plans at no additional cost
RTIP Dental Coverage – Optional
Beware of dental plans with late-entry
penalties and restrictions. Many dental insurance plans impose waiting periods or restrictions
before full benefits can be claimed. Access to a competitive
top-up travel insurance program for trips over 95 consecutive days
through 21st Century Travel Insurance.
Find out more at www.rtip.com or call 21st Century Travel Insurance
at 1-800-567-0021.
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arge
s fo
r Chi
ropr
acto
r and
Phy
sioth
erap
ist
serv
ices
for 1
2 co
nsec
utive
mon
ths,
onc
e th
e $1
,250
par
amed
ical s
ervic
es m
axim
um h
as b
een
reac
hed.
Doc
umen
tatio
n of
a 2
4-ho
ur h
ospi
tal s
tay
will b
e re
quire
d.
80%
reim
burs
emen
t of
elig
ible
char
ges
up to
a c
ombi
ned
max
imum
of $
1,250
pe
r cale
ndar
yea
r.
80%
reim
burs
emen
t of
elig
ible
char
ges
up to
a c
ombi
ned
max
imum
of $
1,250
pe
r cale
ndar
yea
r.
80%
reim
burs
emen
t of
elig
ible
char
ges
up to
a c
ombi
ned
max
imum
of $
750
pe
r cale
ndar
yea
r.
Visi
on
Car
eCo
vera
ge fo
r pur
chas
e an
d re
pair
of p
resc
riptio
n le
nses
and
fram
es, p
resc
riptio
n su
ngla
sses
, con
tact
lens
es o
r las
er e
ye s
urge
ry.
100%
reim
burs
emen
t of e
ligib
le ch
arge
s up
to
$250
in a
ny 2
cale
ndar
yea
rs.
80%
reim
burs
emen
t of
elig
ible
char
ges
up to
$37
5 in
any
2 ca
lenda
r yea
rs.
100%
reim
burs
emen
t of
elig
ible
char
ges
up to
$25
0 in
any
2 ca
lenda
r yea
rs.
Not a
vaila
ble.
Ad
ditio
nal
cove
rage
follo
wing
ca
tara
ct su
rger
y
Cove
rage
for i
ntra
ocul
ar le
ns im
plan
ts, c
onta
ct le
nses
or e
yegl
asse
s fo
llowi
ng
cata
ract
sur
gery.
100%
reim
burs
emen
t to
a m
axim
um o
f $2
50 p
er s
urge
ry.80
% re
imbu
rsem
ent
to a
max
imum
of
$375
per
sur
gery.
100%
reim
burs
emen
t to
a m
axim
um o
f $25
0 pe
r sur
gery.
80%
reim
burs
emen
t to
a m
axim
um o
f $2
00 p
er su
rger
y.
Dia
betic
Sup
plie
sCo
vera
ge fo
r dia
betic
nee
dles
, syr
inge
s an
d te
stin
g su
pplie
s. T
hese
max
imum
s ar
e se
para
te fr
om th
e an
nual
pre
scrip
tion
drug
max
imum
s.
80%
reim
burs
emen
t of e
ligib
le ch
arge
s up
to a
m
axim
um o
f $1,0
00 p
er c
alend
ar y
ear.
85%
reim
burs
emen
t of
elig
ible
char
ges
up to
a m
axim
um
of $
1,00
0 pe
r ca
lenda
r yea
r.
80%
reim
burs
emen
t of
eligi
ble
char
ges
up to
a m
axim
um
of $
1,000
per
ca
lenda
r yea
r.
80%
reim
burs
emen
t of
elig
ible
char
ges u
p to
a m
axim
um o
f $75
0 pe
r cale
ndar
year.
Hea
ring
A
ids
Reim
burs
emen
t of e
ligib
le c
harg
es fo
r pur
chas
e an
d re
pair
of h
earin
g ai
ds
follo
win
g an
app
licat
ion
to th
e As
sistiv
e De
vices
Pro
gram
.10
0% re
imbu
rsem
ent o
f elig
ible
char
ges
up to
$1
,000
eve
ry 3
cale
ndar
yea
rs.
100%
reim
burs
emen
t of
elig
ible
char
ges u
p to
$1,0
00 e
very
3
calen
dar y
ears
.
100%
reim
burs
emen
t of
elig
ible
char
ges u
p to
$1,0
00 e
very
3
calen
dar y
ears
.
Not a
vaila
ble.
Cus
tom
-mad
e
Ort
hotic
sCu
stom
-mad
e or
thot
ics
mus
t be
pres
crib
ed b
y a
phys
icia
n or
pod
iatri
st/
chiro
podi
st a
nd re
quire
s a
biom
echa
nica
l exa
m a
nd g
ait a
nalys
is.
80%
reim
burs
emen
t of e
ligib
le ch
arge
s to
a
max
imum
of $
500
(limite
d to
1 p
air) in
any
2
calen
dar y
ears
.
80%
reim
burs
emen
t of
elig
ible
char
ges t
o a
max
imum
of $
500
(limite
d to
1 p
air) in
an
y 2 c
alend
ar ye
ars.
80%
reim
burs
emen
t of
elig
ible
char
ges t
o a
max
imum
of $
500
(limite
d to
1 p
air) in
any
2
calen
dar y
ears
.
80%
reim
burs
emen
t of
elig
ible
char
ges t
o a
max
imum
of $
450
(limite
d to
1 p
air) in
an
y 2 c
alend
ar ye
ars.
Cus
tom
-mad
e O
rtho
paed
ic
Sho
es/B
oots
Mod
ifica
tions
and
adj
ustm
ents
onl
y to
sto
ck-it
em o
rthop
aedi
c bo
ots/
shoe
s
are
elig
ible
. 80
% re
imbu
rsem
ent o
f elig
ible
char
ges
to a
m
axim
um o
f 2 p
airs
per c
alend
ar y
ear.
80%
reim
burs
emen
t of
elig
ible
char
ges t
o a
max
imum
of 2
pair
s pe
r cale
ndar
year.
80%
reim
burs
emen
t of
elig
ible
char
ges t
o a
max
imum
of 2
pair
s pe
r cale
ndar
year
.
80%
reim
burs
emen
t of
elig
ible
char
ges t
o a
max
imum
of 2
pair
s pe
r cale
ndar
year.
Inco
ntin
ence
su
pplie
sM
ust p
rovid
e w
ritte
n au
thor
izatio
n by
an
atte
ndin
g ph
ysic
ian.
80%
reim
burs
emen
t of e
ligib
le ch
arge
s up
to a
m
axim
um o
f $75
0 pe
r cale
ndar
yea
r.80
% re
imbu
rsem
ent
of e
ligib
le ch
arge
s up
to a
max
imum
of
$750
per
cale
ndar
year.
80%
reim
burs
emen
t of
elig
ible
char
ges u
p to
a
max
imum
of
$750
per
cale
ndar
year.
80%
reim
burs
emen
t of
elig
ible
char
ges u
p to
a m
axim
um o
f $2
00 p
er c
alend
ar ye
ar.
Sup
port
Sto
ckin
gsCo
vera
ge fo
r sur
gica
l sup
port
stoc
kings
. Min
imum
20-
30 m
mHg
com
pres
sion
fact
or.
80%
reim
burs
emen
t of e
ligib
le ch
arge
s up
to a
m
axim
um o
f $95
0 pe
r cale
ndar
yea
r.80
% re
imbu
rsem
ent
of e
ligib
le ch
arge
s up
to a
max
imum
of $
950
per c
alend
ar ye
ar.
80%
reim
burs
emen
t of
eligi
ble
char
ges u
p to
a
max
imum
of $
950
per
calen
dar y
ear.
80%
reim
burs
emen
t of
elig
ible
char
ges u
p to
a m
axim
um o
f $75
0 pe
r cale
ndar
year.
Hos
pita
l A
ccom
mod
atio
nIn
clud
ed w
ith a
ll hos
pita
l acc
omm
odat
ion
bene
fits,
whe
n a
sem
i-priv
ate
room
is
not a
vaila
ble,
the
hosp
ital c
ash
bene
fit w
ill pr
ovid
e $1
0 pe
r day
to a
max
imum
of
$100
per
sta
y to
cov
er e
xpen
ses
such
as
park
ing,
tele
phon
e an
d te
levis
ion
rent
als.
Choi
ce o
f unl
imite
d se
mi-p
rivat
e co
vera
ge o
r $10
0 pe
r day
to b
e us
ed to
ward
s th
e co
st o
f sem
i-priv
ate
or p
rivat
e ro
om a
ccom
mod
atio
n.
Unlim
ited
sem
i-priv
ate
acco
mm
odat
ion.
Choi
ce o
f unli
mite
d se
mi-p
rivat
e co
vera
ge
or $
100
per d
ay to
be
use
d to
ward
s the
co
st o
f sem
i-priv
ate
or p
rivat
e ro
om
acco
mm
odat
ion.
$100
a d
ay to
ward
s th
e co
st o
f sem
i-pr
ivate
or p
rivat
e ro
om
acco
mm
odat
ion.
Incl
uded
in a
ll R
TIP
Pla
ns
Del
uxe
Tr
avel
In
sura
nce
Our d
eluxe
trav
el in
sura
nce
offer
s com
preh
ensiv
e co
vera
ge a
nd is
inclu
ded
in all
RTI
P he
alth
care
plan
s at n
o ad
ditio
nal c
ost.
Cov
erag
e is
effe
ctiv
e fo
r tr
ips
up to
95
cons
ecut
ive
days
, with
med
ical e
mer
genc
y co
vera
ge u
p to
$2
milli
on p
er p
erso
n, p
er tr
ip. Y
ou m
ay b
e re
imbu
rsed
for u
p to
$6,
000
for t
rip in
terru
ptio
n or
can
cella
tion
cove
rage
. See
pag
e 14
for d
etail
s.
Visi
on
Test
sVi
sion
test
s are
cov
ered
at a
rate
of 8
0% to
a m
axim
um o
f $12
5 in
any
2 c
alend
ar y
ears
. Heid
elber
g Re
tina
Tom
ogra
ph (H
RT) e
xam
s ar
e co
vere
d at
a ra
te o
f 80%
to a
sep
arat
e m
axim
um o
f $12
5 in
any
2 ca
lenda
r yea
rs.
Hea
ring
Te
sts
Hear
ing
test
s are
cov
ered
at a
rate
of 1
00%
to a
max
imum
of $
75 p
er c
alend
ar ye
ar.
Sle
epin
g
Aid
s80
% re
imbu
rsem
ent o
f elig
ible
char
ges,
cov
erag
e fo
r the
rem
ainin
g 25
% o
f the
cos
t of a
Con
tinuo
us P
ositiv
e Ai
r Pre
ssur
e un
it (C
PAP)
follo
wing
app
licat
ion
to th
e As
sistiv
e De
vices
Pro
gram
. Sup
plies
for t
he C
PAP
unit
are
cove
red
as fo
llows
: Mas
k, h
eadg
ear,
hose
can
nula
and
pillo
w – o
nce
ever
y 12
mon
ths.
Filte
rs –
max
imum
of 3
pac
kage
s of 5
eve
ry 1
2 m
onth
s. Hu
mid
ifier –
onc
e ev
ery 2
4 m
onth
s.
Com
fort
&
Con
veni
ence
Ite
ms
80%
reim
burs
emen
t of e
ligib
le ch
arge
s, up
to $
200
per p
erso
n, p
er c
alend
ar ye
ar fo
r pos
t-sur
gica
l sup
ports
(Obu
s For
me,
bat
h aid
s, et
c.) r
ecom
men
ded
by yo
ur p
hysic
ian fo
llowi
ng su
rger
y (inc
ludes
out
-pat
ient
treat
men
t, e.
g., d
ay su
rger
y) pr
ovid
ed p
urch
ase
take
s plac
e wi
thin
30 d
ays o
f ret
urnin
g eq
uipm
ent p
rovid
ed th
roug
h an
equ
ipm
ent l
oan
prog
ram
such
as C
CAC,
Red
Cro
ss, e
tc.
Dia
gnos
tic
Ser
vice
s80
% re
imbu
rsem
ent o
f elig
ible
char
ges.
Cove
rage
for t
ests
not
per
form
ed in
a h
ospi
tal b
ut u
nder
the
dire
ctio
n of
a p
hysic
ian (e
.g.,
CEA
canc
er le
vel, C
A 12
5 fo
r wom
en a
nd P
SA fo
r men
).
Den
tal
Acc
iden
t 80
% re
imbu
rsem
ent o
f elig
ible
char
ges.
Cove
rage
for d
amag
e ca
used
by a
dire
ct a
ccid
enta
l blo
w to
the
mou
th. T
his b
enefi
t doe
s not
app
ly to
injur
ies c
ause
d by
an
objec
t plac
ed w
itting
ly or
unw
itting
ly in
the
mou
th.
Am
bula
nce
S
ervi
ces
80%
reim
burs
emen
t for
cos
ts th
at e
xcee
d yo
ur p
rovin
cial h
ealth
insu
ranc
e pl
an’s
limit.
Priv
ate
Dut
y
Nur
sing
80%
reim
burs
emen
t of e
ligib
le ch
arge
s. Co
vera
ge fo
r the
serv
ices o
f a R
egist
ered
Nur
se (R
N), a
Reg
ister
ed P
ract
ical N
urse
(RPN
), Re
gist
ered
Nur
sing
Assis
tant
(RNA
) or L
icens
ed P
ract
ical
Nurs
e (L
PN),
up to
$2,
000
per p
erso
n ev
ery c
alend
ar ye
ar.G
old
Elit
e O
nly:
Once
paid
clai
ms
exce
ed $
7,500
, you
are
re
imbu
rsed
at 1
00%
to a
co
mbi
ned
max
imum
of
$25,
000
per p
erso
n, p
er
calen
dar y
ear,
to a
lifet
ime
max
imum
of $
100,
000.
Se
e pa
ge 6
for d
etail
s.
Hom
e
Car
e80
% re
imbu
rsem
ent t
o a
max
imum
of $
75 p
er d
ay, f
or a
max
imum
of 3
0 da
ys fo
llowi
ng a
n ac
tive,
acu
te c
are
hosp
ital s
tay
for a
min
imum
of 2
4 ho
urs,
and
a m
axim
um o
f 3 d
ays
follo
wing
no
n-ele
ctive
day
sur
gery.
To c
over
cha
rges
for c
onva
lesce
nt h
ome
care
pro
vided
in o
wn h
ome,
main
ly fo
r the
pur
pose
of a
ssist
ance
with
act
ivitie
s of
dail
y liv
ing.
Med
ical
Aid
s,
Equ
ipm
ent &
S
uppl
ies
80%
reim
burs
emen
t of e
ligib
le ch
arge
s, on
going
cov
erag
e fo
r med
ical n
eces
sities
such
as h
ospi
tal b
eds,
crut
ches
and
can
es, o
xyge
n eq
uipm
ent,
etc.
, as w
ell a
s med
ical a
ids a
nd
supp
lies,
includ
ing su
rgica
l ban
dage
s, dr
essin
gs, g
rab
bars
, com
mod
es, e
tc.,
with
writ
ten
auth
oriza
tion
by a
n at
tend
ing p
hysic
ian.
Pro
sthe
tic
App
lianc
es80
% re
imbu
rsem
ent o
f elig
ible
char
ges.
Cove
rage
inclu
des a
rtific
ial lim
bs a
nd e
ye re
plac
emen
ts, s
plint
s, to
rso
cast
s, ce
rvica
l col
lars,
brac
es (o
nce
ever
y 24
mon
ths p
er b
ody p
art),
etc
. W
igs c
over
ed to
a lif
etim
e m
axim
um o
f $75
0.
Visit rtip.com to apply online today!18 19
Any two family members can qualify for couple coverage. If you do not have an eligible spouse, you and your dependant child can qualify for couple rates. Limit one policy per member. Provincial Sales Tax (PST) and Harmonized Sales Tax (HST) are NOT applicable to RTIP premiums. The premiums listed in the 2015 RTIP Guide to Retirement are effective from January 1, 2015 to December 31, 2015. The RTIP Guide to Retirement is a summary of the important features of each of our plans, and does not constitute a contract. Once you enroll, we will provide you with a contract containing the specific terms and conditions. Only the terms and conditions of the contract are binding.
Please return to: 125 Northfield Drive West PO Box 218 Waterloo ON N2J 3Z9
Phone: 1.800.267.6847 Fax: 1.888.646.3842
Section B | EligibilityI wish to be covered under a RTIP plan starting: | mm | 01 | yyWithin the last 60 days: If you select any of the three options below, please complete the policy information box, indicated by the yellow arrow.
m I have been insured as an active member under a group health benefits plan. Plan Termination Date: | mm | dd | yy
m I have been insured as a retired member under a group health benefits plan. Plan Termination Date: | mm | dd | yy
m My current health plan is not terminating and I am looking to coordinate my benefits.
Please call OTIP for a medical evidence of insurability form and complete the policy information box below.
Policy/Group No: Identification/Certificate No:
Insurance Company Name:
m I have not been covered under a group health benefits plan in the last 60 days. Please call OTIP for a medical evidence of insurability form.
First Name & Middle Initial (Provide last name if different from applicant)
Date of Birth (mm/dd/yy)
Gender
Spouse/Partnermm dd yy
Dependant Childmm dd yy
Dependant Childmm dd yy
Dependant Childmm dd yy
Coordination of Benefits (COB) Are you, your spouse or dependants covered under any other plan?
Name of other insurance company Policy/Group # ID/Certificate #
Complete if you have an eligible dependant student over the age of 21
School Year Start
School Year End
Name of School
m yes m no
RTIP Application FormBenefits are administered by OTIP and underwritten by Manulife Financial. Please print using ballpoint pen.
Section A | General InformationDate of Birth (mm/dd/yy) Applicant’s Last Name First Name Middle Initial | mm | dd | yy
Address Apt. Gender
City/Town Province Postal Code | | | | | | |
Home Telephone No. Alternate Telephone No. Email Address I prefer all correspondence in: m English m French
Monthly Health Care Premiums
RTIP Gold Elite (Under age 65) RTIP Plus RTIP Gold RTIP Basic
Initial $500 Annual Drug MaximumThen $4,000 deductible
Following that – UNLIMITED
$3,000 Annual Drug
Maximum(Includes unlimited
semi-private hospital accommodation
coverage.)
$1,500 Annual Drug
Maximum
$750 Annual Drug
Maximum
$750 Annual Drug
Maximum(Includes $100 a day semi-private hospital
accommodation coverage.)
Single $95.06 $102.27 $65.82 $51.60 $46.76
Couple $179.37 $200.73 $124.31 $97.30 $87.13
Family $205.36 $240.02 $151.47 $117.30 $106.72
Optional coverage:You can choose to add hospital coverage to RTIP Gold Elite (Under age 65) and RTIP Gold health plans.
Monthly Hospital Accommodation PremiumsUnder age 65 Age 65 or older
Coverage $100 per day Unlimited semi-private $100 per day Unlimited
semi-private
Single $12.89 $21.06 $24.43 $40.88
Couple $23.40 $40.32 $45.33 $77.91
Family $29.09 $51.00 $56.79 $98.50
Optional coverage:You can choose to add dental coverage to any RTIP health plan.
Monthly Dental PremiumsSingle Couple Family
$61.59 $120.92 $147.56
RTIP Rate Comparison Chart
m If you wish to receive emails about OTIP's products services or promotions, please check here.
20 21
Section C | Coverage Selection (Please select your options below and fill in the appropriate information.)Monthly Premium
Section D | Authorization & Payment Method (Please select ONE payment method and sign accordingly.)
I hereby apply for benefits coverage (“Coverage”) and certify that the information provided is true and complete. I authorize OTIP and its Insurer to collect, use, maintain and disclose my personal information, including personal health information (“Information”), relevant to this application, for the purposes of evaluating my eligibility to the plan, benefits plan administration, providing me with ongoing services, protecting us both from error and fraud and complying with various legal requirements (“Purposes”). I am authorized to consent to the collection, use, maintenance and disclosure of Information pertaining to my Dependant(s) (spouse/child), if applicable, for the Purposes. I agree that the Information in this application will be shared with the Insurer and any Coverage shall not become effective until approved by the Insurer. I agree that my Coverage may be denied or terminated at any time as a result of any false, incomplete, or misleading information having been provided in support of this application. This authorization shall remain valid unless cancelled by me in writing.
m METHOD A – Automatic monthly pension deduction for those in receipt of a pension from the Ontario Teachers’ Pension Plan Board I hereby apply for coverage under the Retired Teachers Insurance Plan with OTIP and direct the Ontario Teachers’ Pension Plan Board to deduct and remit premiums from my pension for my contribution towards the cost of this benefit contract. I consent to the collection, use and disclosure of any information required to administer the program including personal information such as my social insurance number. SIN # X ________________________ Signature X _________________________________ Date ______________
ORm METHOD B – Monthly pre-authorized payment plan I hereby authorize OTIP to withdraw premium payments from my
account on or about the first day of each month. OTIP may terminate coverage should a withdrawal be refused for any reason and the financial institution shall in no way be held liable should such an event occur. This authorization shall remain valid unless cancelled by me in writing, subject to providing notice of five days. I have certain recourse rights if any debit does not comply with this agreement. For example, I have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD agreement. To obtain more information about my recourse rights, I may contact my financial institution or visit www.cdnpay.ca.
Type of Account: m Savings | m Chequing A void cheque MUST accompany this application.
Is this a joint account requiring only one signature? m Yes | m No If both signatures are required, both persons must sign this form.
Signature of Account Holder(s): X ___________________________ X ___________________________ Date ______________
RTIP Gold Elite* m Single | m Couple | m FamilyHealth Care (coverage for catastrophic expenses available until age 65, includes deluxe travel) $Hospital Accommodation (Optional) Daily Max: m $100 | m Unlimited Semi-Private $Dental Coverage (Optional) m Single | m Couple | m Family $Total Premium (add all choices) $
*A medical evidence of insurability form is required to apply for the Gold Elite plan.
RTIP Gold m Single | m Couple | m FamilyHealth Care m $1,500 prescription drug max. | m $750 prescription drug max. $(includes prescription drug coverage beyond age 65 and deluxe travel)
Hospital Accommodation (Optional) Daily Max: m $100 | m Unlimited Semi-Private $Dental Coverage (Optional) m Single | m Couple | m Family $Total Premium (add all choices) $RTIP Basic m Single | m Couple | m FamilyHealth Care $750 prescription drug max. $(includes prescription drug coverage beyond age 65, deluxe travel and $100 per day hospital coverage)
Dental Coverage (Optional) m Single | m Couple | m Family $Total Premium (add all choices) $RTIP Dental Coverage Only m Single | m Couple | m Family $
RTIP Plus m Single | m Couple | m FamilyHealth Care $3,000 prescription drug max. $(includes prescription drug coverage beyond age 65, deluxe travel and unlimited semi-private hospital)
Dental Coverage (Optional) m Single | m Couple | m Family $Total Premium (add all choices) $
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An exclusive offer for retired education employeesSome things are better together. Like purchasing both your car and home insurance from OTIP. When you do, you will save up to 50% on your home insurance.
Call 1-866-605-6847 or visit www.otip.com/rtip15 to complete a quote
This is a one-time discount (of up to 50%) and is only applicable to new multi-line home and auto policies underwritten by Traders General Insurance Company, part of the Aviva Insurance Company of Canada. OTIP and Aviva have the right to withdraw this offer at any time. Must reside in Ontario to be eligible for this discount.
Except when it comes to getting up to 50% off home insurance
Combining home and auto isn’t always a good idea
2015 RTIP Guide - DS Ad Humour.indd 1 11/12/2014 9:00:08 AM
22 23 $ $ $ $ $ $ $ $
RTIP members can conveniently and securely submit claims online at www.otipservices.com. Your reimbursement will be deposited directly into your bank account. It’s the fastest and easiest way to receive reimbursement for your claims!
You can also choose to receive email alerts when your claim has been reviewed and access the status of current and previously submitted claims.
Another great reason to choose RTIP.
GET YOUR MONEY BACK
FASTER!
Another reason why being a RTIP member is better.
According to the Canadian Cancer Society, Canadians aged 50-79 represent almost 70% of all new cancer cases. The highest proportion of those new cases occurs in the 60-69 age group. It’s an unfortunate reality that cancer affects so many families, and we understand the importance of providing support to those affected.
As a RTIP member, if you or a qualified family member is diagnosed with cancer, your CAREpath personal oncology nurse will expertly guide and support you through every step of your cancer experience, from diagnosis through treatment and into post-treatment living.
For more information about CAREpath, visit www.rtip.com and click the CAREpath link.
Answers. Guidance. Support.
The Express Scripts Canada PharmacyRTIP’s home delivery program
Stretch your prescription drug benefit dollars further when you use the Express Scripts Canada PharmacyTM home delivery program for your maintenance prescription medications – those drugs that you take to treat ongoing medical conditions, such as asthma, diabetes or high cholesterol.
How can you save money?
1. When you use this home delivery program, you receive 100% coverage for your generic maintenance prescription drug expenses (or 90% of brand name prescriptions).
2. You can receive up to a 90-day supply of your maintenance prescription medications for a single dispensing fee of only $9 – that’s less than the average dispensing fee in Canada.
3. The Express Scripts Canada Pharmacy will work with you and your doctor to choose safe, approved, lower-cost medications, where possible. You can also use the online tool to find an equivalent drug that will cost you less!
More great benefits include:
Convenience – Your medications delivered – via free standard shipping – directly to your home or to any address that you designate in Canada*. Request prescription transfers, renewals and refills online, by phone or by mail.
Peace of Mind – Auto refills and refill reminders take the guesswork out of refilling prescriptions so that you don’t need to worry about running out of your maintenance medication.*This program is not currently available to residents in Quebec.
For more information about the Express Scripts Canada Pharmacy and its services, visit www.member.express-scripts.ca or call 1-855-550-6337.
Your access to exclusive rewards…
Canada-wide SaVinGS on:
Finance and InsuranceHealth and WellnessEducation
Travel and EntertainmentHome, Auto & Electronics
Clothing and Gifts
Subscribe today to Edvantage e-News to stay up to date on new and exciting offers and contests.
www.edvantage.ca/rtip15
PLUS access to over 45 Partners...
2015 RTIP Guide - Edvantage Ad.indd 1 10/29/2014 3:09:54 PM
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The switch to RTIP is easy!Retirement should be stress free! If you are currently covered under a different retiree group health benefits plan, our representatives will ensure a smooth transition to the RTIP plan of your choice, with coverage in place and ready to use the very next month with no interruption of benefits and no medical evidence (excluding Gold Elite).
How can RTIP save you money?Once you turn 65, the Ontario Drug Benefit Program (ODB Program) may cover the majority of your prescription drug costs. Only RTIP offers the flexibility to decrease your prescription drug coverage, therefore reducing your monthly premiums, while still maintaining other important health care coverage above and beyond prescription drugs. Don’t pay for more prescription drug coverage than you need!
Don’t worry – even after you switch to RTIP, you’re not locked in! We offer multiple plans because your needs may change throughout your retirement and when they do, you can increase or decrease your coverage at your next renewal (January 1)*.
* Once you decrease your health coverage, you must wait two years before you are able to increase your coverage again. An increase to the Gold Elite plan or an increase of more than one plan level requires medical evidence of insurability.
Learn more about all the options and flexibility that RTIP offers at www.RTIP.com or call us at 1-800-267-6847 and we’ll answer your questions or recommend options that best suit your individual needs.
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Insurance solutions for the education community
What could you do with an extra $500 a year?Too many education employees choose the same retiree health plan just because their colleague did – but not all education employees have exactly the same needs! It’s never too late to switch, even if they’re over age 65.
Tear out this card and share it with a colleague or member of RTO!
Do your RTO colleagues know?
Your colleagues can maintain their RTO social organization membership and make the easy switch to a RTIP health, travel and dental plan with no medical, no age restrictions and save!
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