education community rtipguide - trent university€¦ · educators are our reason for being —...

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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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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.


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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.


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: $

2

3

4

*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


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.


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.



» 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.




» Unlimited semi-private hospital accommodation.

» Diabetic supplies – 85% reimbursement of eligible charges up to $1,000 per person, per calendar year.



You can choose to add: » RTIP dental coverage – You can add this at any time, without penalty. Coverage and premium details on page 15.

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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


Plus


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.


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.







» Diabetic supplies – 80% reimbursement of eligible charges up to $1,000 per person, per calendar year.



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.

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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


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


Gold You can choose to add:


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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.


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.





» 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.



You can choose to add: » RTIP dental coverage – You can add this at any time, without penalty. Coverage and premium details on page 15.

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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


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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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



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

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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...

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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)*.


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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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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