loblaws gf benefits comparison
TRANSCRIPT
BENEFITS COMPARISONS
The following benefits comparison tables are meant to assist you with a career decision if:
•YouareamemberofUFCWLocal1000Aand
•YourstorehasbeenannouncedforconversiontoaGreatFoodbanner
Particularattentionisgiventobenefitdifferencesbetweenthebanners.
Important:Thisinformationbookletisnotalegaldocument.Inaddition,these tables are
NOT a complete description of each banner’s benefits. Forcompleteand
accuratedescriptionsofthebenefitplans,seethecollectiveagreementorcontact
the union (1-800-637-5936).
Loblaws&
Loblaw Great Food Stores
PART-TIME page 2
FULL-TIME page 5
BENEFITS COMPARISONSPART-TIME
PRESCRIPTION DRUGS
ELIgIbILITy Great Food
•Youarecoveredifyouhavebeenemployedfor3yearsandhaveworkedatleast600hoursinthepreviouscalendaryear.
•Yourinsurabledependentchildrenandspousearecoveredifyouhavebeenemployedfor5yearsandhaveworkedatleast900hoursinthepreviouscalendaryear.
LOBLAWS
•Youarecoveredifyouhavebeenemployedfor1yearANDhaveworkedatleast400hoursinthepreviouscalendaryear.
•Ifyouareasingleparent,yourinsurabledependentchildrenarecoveredonceyoumeettheaboveeligibilitycriteria.
•Dependenteligibility:Yourimmediatefamilymembersareeligibleforcoverageifyouhavebeenemployedforatleast1yearandhaveworkedatleast650hoursinthepreviouscalendaryear.
COvERAgE Great Food
•100%ofcertainprescribedlife-sustainingdrugsdispensedbyalicensedpharmacistupto$10,000percalendaryear.Nodeductible.
•Thisincludesdrugsadministeredbyadoctorforwhichnonon-injectablealternativeisavailable,excludingthecostofadministration;insulin,insulinsyringeandtestingsuppliesfordiabetics.
Note:Nobenefitsarepaidfordrugsusedtotreaterectiledysfunction,oralcontraceptives,fertilitydrugs,smokingcessationproducts,oranti-obesitydrugs.
Dispensingfeecoveredtouptotheaveragefeechargedinprovincewherethedrugisdispensed.
LOBLAWS
•100%ofdrugsdispensedonaprescriptionofa duly qualified medical practitioner including thedispensingfee.Noannuallimitandnodeductible.
•Coverageincludesinjectabledrugs,serumsandvaccineswhenadministeredbyaqualifiedperson,excludingtheactualchargeofadministration.
•Insuliniscoveredwithorwithoutaprescription.Diabeticsuppliesarecoveredwhenpurchasedon the prescription of a duly qualified medical practitioner.
•Coverageislessrestrictive.
MAkINg A CLAIM Great Food
•Obtainaprescriptiondrugexpenseformfromyouremployer,completeit,attachyourdrugreceiptsand submit it to the benefit payments office for reimbursement.
LOBLAWS
•DrugcardusedataLoblawCompaniespharmacy;ORcompleteclaimformandsubmittothebenefitpaymentofficeforreimbursement.
VISION/OPTICAL
ELIgIbILITy Great Food
•Youandyourdependentchildrenunderage18arecoveredifyouhavebeenemployedfor3yearsandhaveworkedatleast600hoursinthepreviouscalendaryear.
LOBLAWS
•Youarecoveredonthefirstofthemonthcoincident with or following 2 years of continuousemploymentprovideda)youhaveworkedatleast400hoursinthepreviouscalendaryearandb)youdonothaveanyotherformofopticalcoverage.(Ifyouareasingleparent,yourdependentchildrenarecoveredaswellafteryoumeetthesequalifiers.)
•Ifyouarenotasingleparent,yourdependentsarenotcovered.
2
VISION/OPTICAL CONTINUED
COvERAgE Great Food
•Upto$200every24months,whichcanincludeupto$60foraneyeexamevery24months.
•CoveredExpenses:Eyeglassframesandlenses(orcontactlensesselectedinplaceoflensesandframes)whenrequired for an initial lens prescription or a change in a lens prescription;upto$60foraneyeexam.
Note:Replacementofeyeglassframesandlenseswhichhavebeenlost,stolenorbroken,willonlybecoveredifyouhavebeencontinuouslycoveredundertheplanforatlease36monthsandthefamilymemberrequiringthereplacementhasnotreceivedbenefitsforthesevisioncaresuppliesforaleast36months.Inadditionnobenefitsarepaidforeyetestsorexaminationsrequiredbyanemployer,schoolorgovernmentforscreenpurposes,artificialeyes,sunglassesorsafetyglasses.
Ifyouneedcontactlensfor“specialconditions”,thereisa$450lifetimemaximumpayment.
LOBLAWS
•Upto$200every24months,whichcanincludeupto$60foraneyeexamevery24months.
•Coverageislessrestrictive.
MAkINg A CLAIM Great Food
•Haveyourdoctororoptometristcompletetheclaimformandsendittothebenefitspaymentsoffice.
LOBLAWS
•Completeclaimform.Paymentwillbemadeupon the receipt of proof of purchase
DENTAL CARE
ELIgIbILITy Great Food
•Youandyourinsurabledependentchildrenuptoage21arecoveredifyouhavebeenemployedfor2yearsandhaveworkedatleast800hoursinthepreviouscalendaryear.
LOBLAWS
•Youarecoveredonthefirstofthemonthcoincident with or following one year of continuousemploymentprovidedyouhaveworkedatleast400hoursinthepreviouscalendaryear.Ifyouareasingleparent,yourdependentchildrenarecoveredaswellafteryoumeetthesequalifiers.
•Ifyouarenotasingleparent,yourdependentsarenotcovered.
•Youarealsocoveredforuptothreemonthsafteryour retirement or if you are not working because ofadisabilityoralayoffduetolackofavailablework.
COvERAgE Great Food
•80%ofeligibleexpensesundertheOntarioDentalAssociation(ODA)FeeGuideineffectonthedateofthetreatment.
•Maximum$1500/yearperfamilymember.
•Seecollectiveagreementforfulldetailsofcoveredprocedures.
LOBLAWS
•100%ofbasicdentalcareand80%forotherworkunderafeeguidethatis1yearaheadoftheIndustryPlan.Maximumclaim:$500/year.
•Seecollectiveagreementforfulldetailsofcoveredprocedures.
DEDUCTIbLE Great Food
•None
LOBLAWS
•$25/year
3
DENTAL CARE CONTINUED
MAkINg A CLAIM Great Food
•Askyouremployerforadentalclaimform.Haveyourdentist complete this form and send it in to the benefits paymentsoffice.
LOBLAWS
•Submitreceiptofpaymentandclaimformwithin90daysofthedateofbillingbythedentistorcanbe sent in electronically through your dentist’s officeifyourdentistissetuptodoso.
GENERAL
MISCELLANEOUS Great Food
•Youwillbecoveredassoonasyoubecomeeligible.Youmustbeactivelyatworkforinsurancetotakeeffect.
DEFINITION OF DEPENDENT(PART-TIME)
Great Food
•ForPrescriptioncoverageonly:Dependentmeansspouseandinsurablechildrenunderage21.
•OtherDependentcoveragemeans:Yourinsurablechildrenage18forvisioncareandyourinsurablechildrenunderage21fordentalcare.
•Childrenareinsurableiftheyareyourunmarriednatural,adopted,orstepchild,ORanunmarriedchildyouhavebeenappointedguardianforallpurposesbyacourt.
Note:Eligiblechildrenunderage18orunderage21mustnotbeworkingmorethan30hoursaweek,unlesstheyareafull-timestudent.Unmarriedchildrenofyourspouseareconsidereddependentonlyiftheyarealsoyourchildren,ORyourspouseislivingwithyouandhascustodyofthechildren.
Note:Ifyouhavebeenappointedguardianandyouareclaimingthemasadependent,theinsurancecompanymustreceivesatisfactoryproofofguardianshipforthemtobeinsurable.
•Childrenareconsideredfulltimestudentsiftheyhavebeeninregisteredattendanceatanelementaryschool,highschool,universityorsimilareducationalinstitutionfor15hoursaweekofmoresometimewithinthelast6months.Childrenarenotconsideredfull-timestudentsiftheyarebeingpaidtoattendaneducationalinstitution.
LOBLAWS
•ForthePrescriptiondrugplanandOptical/Visioncare,EligibleDependentmeansapersonwhoisaresidentofCanadaortheUnitedStatesandisthespouseofanemployee,ANDanyunmarrieddependent child of the employee from birth toage21andanyunmarriedchildrenwhoarementallyorphysicallyinfirmtoanyage.
•ForDentalExpenseInsurance,thesamecriteriaasaboveexcepttheageis22.
4
BENEFITS COMPARISONS FULL-TIME
GENERAL ELIGIBILITYLIFE INSURANCE; ACCIDENTAL DEATh AND DISMEMbERMENT (AD&D) bENEFITS; SEMI-PRIvATE hOSPITAL AND CAR AMbULANCE ExPENSE, WEEkLy INDEMNITy, OThER hEALTh CARE bENEFITS (ExCLUDINg PRESCRIPTION DRUg)
Great Food
•Youareeligibletojointhegroupinsuranceplanafter3monthsofcontinuousfull-timeemploymentduringwhichyouhavebeen“activelyatwork.”Thismeansyouarenotdisabledfromworkandyouhavebeeneitheratworkorabsentbecauseofvacation,weekends,statutoryholidaysorshiftdifferentials.
Note:ThereisdependentcoverageforLifeInsurance.Pleaseseedetailsofthecoverageineachrelevantsection.
LOBLAWS
•Youareeligibleforinsuranceonthe1stdayofthemonthnextfollowingyourdateoffull-timeemploymentwiththeCompany.
PRESCRIPTION DRUg bENEFITS; vISION CARE; DENTAL CARE
Great Food
•Samecriteriaasabove:Yourdependentsarecoveredassoonasyoubecomeeligible.
LOBLAWS
•Youandyourdependentsareeligibleforcoverageuponcompletionof3monthsofcontinuousfull-timeemploymentwiththeCompany.
SURvIvOR INCOME bENEFITS
Great Food
•PaidtonamedbeneficiaryifyoudiewhileonLTD.
LOBLAWS
•Ifyouhaveeligibledependents-onthe1stdayofthemonthnextfollowing6monthsofcontinuousfull-timeemploymentORthedateonwhichan employee acquires an eligible dependent whicheveristhelater.
SICk PAy ALLOWANCE(FIRST 3 DAyS OF SICkNESS)
Great Food
•NosickpayallowancebutcanmakeuplosttimeduetosicknessbeforeWeeklyIndemnitybegins,upto40hoursperyear.Companywillbe“reasonable”whenitcomestoreschedulingtheselosthours.(SeeLetterofUnderstanding#47)
NOTE:Youareannuallyentitledto2fullypaidpersonalleavedays.Thesedayswillbepaidoutattheendofeachyearifnottaken.Youcanalsousethesedaysifyouaresick.
LOBLAWS
•After6monthsofcontinuousfull-timeemploymentwiththeCompany.
•100%ofbasicdailypayforfirst3daysofabsenceduetosickness,beforeWeeklyIndemnitykicksin.Uptomaximumof12days/year.Amedicalcertificatemayberequired.
LONg TERM DISAbILITy (LTD)
Great Food
•SamecriteriaasLifeInsuranceetcabove
LOBLAWS
•Oncompletionof1yearofcontinuousfull-timeemploymentprovidedyouhaveattainedage18andhavenotattainednormalretirementage.
DEPENDENT INSURANCE
Great Food
•Yourdependentsareeligibleforthespecifiedbenefitplanwhenyoubecomeeligible.Ifyouarealreadyeligible,anydependent(s)youacquirethereafterareimmediatelyeligible.
Note:Temporary,part-timeandseasonalemployeesmaynotjointheGroupInsurancePlan.
LOBLAWS
•Yourdependentsareeligibleforthespecifiedbenefitplanwhenyoubecomeeligible.Ifyouarealreadyeligible,anydependent(s)youacquirethereafterareimmediatelyeligible.
5
GENERAL ELIGIBILITY CONTINUEDCONTINUATION OF bENEFITS UPON EARLy RETIREMENT
Great Food
•Benefitsceaseuponretirement.
•Exception:ifyouwereeligibleforearlyretirement(age55to64)benefits(includingspousalcoverageunderLetterofUnderstanding22)atLoblawswhenyouconvertedtoGreatFoodyoumaintainentitlement(SeeLettersofUnderstanding8and22).
NOTE:Ifyouareunderage55atthetimeofconversionandyouwishtohaveretireebenefitspast55whenyouretire,thenconsiderwhetherOption2oftheconversionoptionsisforyou.Tolearnmore,seeOption#2inthedocumenttitled“SecuringYourFuture”or“KnowYourOptions.”
LOBLAWS
•Ifyouretirebetweenage55and64,youkeepOHIP,DentalandPrescriptionDrugcoverageuntilyouattainage65.Youreligiblespousealsohascoverageuntilage65.
•Forcontinuationofbenefitsforyoureligiblespouseuntilage65anddependentstothemaximumageseeLettersofUnderstanding8and22.
•Ifyouretireatage55orlateryouwillhavesemi-privatehospitalandambulanceexpensebenefitcontinueduntildeath.
•Lifeinsurancecoveragecontinues,howevertheamountisreducedovertime–seedetailsunder“LifeInsurance”below.
ChANgES AT ThE FIRST DAy OF ThE MONTh AFTER yOU REACh AgE 65 (kNOWN AS “NORMAL RETIREMENT DATE”)
Great Food
•Allbenefitscease,evenifyoucontinuetoworkatage65.
•Exception:Eligibleemployeeswhoconvertfromaconventionalstoreandwhocontinuetoworkfull-timebeyondage65willreverttotheconventionalcompanyretireebenefits(SeeLetterofUnderstanding8).Howeverall benefits will cease for your spouse and dependents whenyoureachage65.SeeLoblawsboxaboveforanexplanationofretireebenefits.
LOBLAWS
•AllbenefitsceasewiththeexceptionofAD&DandSemi-privateHospitalwhichremainsinaffectuntildeath.
•Survivorincomebenefitscease
•Lifeinsurancecoveragecontinues,howevertheamountisreducedovertime–seedetailsunder“LifeInsurance”below.
•Ifyouareafull-timeworker,youareeligibleforfull-timebenefitsifyouareworkingfull-timepastage65.
MISCELLANEOUS Great Food
•Notapplicable
LOBLAWS
•LTDcoverage;Survivorincomebenefitscoverage;ceases when you reach normal retirement date or yourearlyretirementdatewhicheverisearliest;
•Dental:Ifyouremploymentisterminatedbecauseof retirement at normal retirement age insurance will be continued for you and eligible dependents forupto3monthsfollowingthelastmonthyouworked.
6
DEFINITION OF DEPENDENTSURvIvOR INCOME bENEFITS AND SEMI-PRIvATE hOSPITAL COvERAgE
Great Food
•Dependentmeans:
–Yourspouseifhe/sheisyourlegal,common-laworformerspouseasdefined.
–Wherethereismorethanoneeligiblespouse,yourcoveredspouseistheoneforwhomyoufirstsubmitaclaimforanybenefitprovidedundertheemployer’sbenefitsprogram.PleaseseeAppendixJofthecollectiveagreementforfurtherdetails.
LOBLAWS
•ForSurvivorIncomeBenefits,EligibleDependentmeans:
–yourspouse,and(exceptforaspousewhoisboth estranged from you and not dependent onyouforsupport);
–anyofyourdependentchildrenwhohavenotreachedage18.
•ForSemi-privateHospitalcoverage,EligibleDependentmeansapersonwhoisaresidentofCanadaortheUnitedStatesandis:
–yourspouse;
–anyofyourunmarrieddependentchildrenuptoage21;
–anyunmarriedchildrenwhoarementallyorphysicallyinfirmtoanyage.
ONTARIO hEALTh INSURANCE, AMbULANCE ExPENSE INSURANCE, PRESCRIPTION DRUg bENEFITS, vISION CARE, AND DENTAL CARE
Great Food
•Spouse:SamecriteriaasSurvivorIncomeBenefitsandSemi-PrivateHealthCoverage.
•Children:OntarioHealthInsurance(includingprescriptiondrug): –youroryourinsuredspouse’sunmarriednatural,
adoptedorstepchild,or
–anunmarriedchildifyouoryourinsuredspousehavebeenappointedguardianforallpurposesbyacourtofcompetentjurisdictionifcriteriaismet.
•DependentLifeInsurance:Childrenareinsurableiftheyareyouroryourinsuredspouse’sunmarried,natural,adoptedorstepchildasdefined.
CriteriaforInsuredChildren:
•Anyofyoureligibledependentchildrenundertheageof21andnotworkingmorethan30hours/weekunlesstheyareaFull-Timestudentasdefined.
•Childrenoverage21musteitherbeFull-Timestudentsunderage25orincapacitatedasdefined.
•UnmarriedChildrenofYourSpouseareconsidereddependents only if:
-theyarealsoyourchildren,or
-yourspouseislivingwithyouandhascustodyofthechildren.
LOBLAWS
•SameasforSemi-PrivateHospitalabovebutage22forDentalCare.
7
LIFE INSURANCEEMPLOyEE INSURANCE
Great Food
•$25,000
LOBLAWS
•$40,000
•Afterretirementat62orolder,amountisgradu-allyreducedoverfiveyearsto$10,000,whereitremainsuntildeath.
DEPENDENT INSURANCE
Great Food
•Spouse–$5,000
•Child–$2,500
LOBLAWS
•Nocoverage
DURATION Great Food
•Payabletobeneficiaryupondeath.
•Ifyoubecomedisabledwhileinsuredbeforereachingage65andthedisabilitycontinueswithoutinterruptionforatleast6months,yourlifeinsurancewillremaininforcewithoutpremiumpayment.
•After6months,youmustsubmitformsforwaiverofpremiumpayment.
•Premiumsmaybewaiveduptoage65.
•Ifthewaiverisnotapprovedyoumay,undercertainconditions,paypremiumsonyourownforaspecificduration.
LOBLAWS
•Ifyoubecometotallydisabledbeforenormalretire-ment age your insurance will be continued during thecontinuanceoftotaldisabilityuntilyourecoverorattainnormalretirementage.
•Thedefinitionof“totaldisability”isthesameasundertheLTDBenefitPlan.
•Note:AlthoughtheCollectiveAgreementdoesnotspecifically say the insurance will be paid to benefi-ciaryupondeath–thisisthepractice.
ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D)PRINCIPLE SUM Great Food
•PrincipalAmount:$25,000;varyingamountdependingupondismemberment.
•Note:Themaximumpayablefordismembermentistheprincipalamountresultingfromoneaccident,dependentuponthedismemberment.Forexample:Lossofbothfeetandbothhandswouldnotresultinpayoutof$50,000.
LOBLAWS
PrincipalAmount:$30,000;varyingamountdependingupondismemberment.
bREAkDOWN OF LOSSES
Great Food
•TheRCSSAppendixhasamoredetailedlistingofcoverage(i.e.lossofhearing);and
•Thepercentagetobepaidbasedonlossisbrokendowninmorefractions.Forexample:
–Lossofbothhands–(fullamount)$25,000;
–Lossof1foot-(½amount)$12,500;
–Lossof1leg–(¾amount)$18,750.
LOBLAWS
•TheLoblawsAppendixbreaksdowntheamountofcoverageforvariouslosses(includinglossoflife)aseither the full amount or half the amount and does notprovideforasmuchdetailedcoverageinareaoflosses.Forexample
–Lossofbothhands-$30,000;
–Lossof1foot-$15,000;
–Lossof1hand-$15,000.
SURVIVOR INCOME AND OTHER BENEFITS AMOUNT UPON ThE DEATh OF AN INSURED EMPLOyEE
Great Food
•IfyoudiewhileLTDbenefitsarepayable,yourbeneficiarywillbepaidasurvivorbenefitlumpsumequalto3timesyourmonthlyLTDbenefit.
LOBLAWS
Amonthlybenefitispayabletoyourspouseand/oreligiblechildrenunderage18withconditionsonwhenthisbenefitends.
8
SURVIVOR INCOME AND OTHER BENEFITS CONTINUEDAMOUNT OF MONThLy bENEFIT
Great Food
•None-LumpsumpaymentonlyiftheemployeedieswhileonLTDbenefits.
LOBLAWS
•1/12thofthegreaterof: –$600permonth;OR
–20%ofyouraveragepayduringthreeyearspriortodeathOR
–66%ofyourearnedpensionbenefitpriortodeath;toamaximumpayoutof$700permonth.
ADDITIONAL PROvISION
Great Food
•Notapplicable
LOBLAWS
•Intheeventofaremarriagewhereyourspousehasdependentchildren,therearecriteriaforprovisionof50%ofmonthlybenefitsforsucheligiblechildren,toamaximumof$700permonth.
CONTINUED SURvIvOR INCOME bENEFIT COvERAgE FOR INSURED EMPLOyEES
Great Food
•Notapplicable
LOBLAWS
•Therearecriteriaforwhencoverageterminatesfortheeligiblesurvivor(s).•Therearecriteriaforcontinuedcoveragefortheinsuredemployeeintheeventoftotaldisabilityuntiltheemployeerecoversorattainsnormalretirementage.•Thedefinitionof“totaldisability”isthesameasundertheLTDBenefitPlan.
OThER bENEFITS ThAT CONTINUE AFTER DEATh OF ThE INSURED EMPLOyEE
Great Food
•Intheeventofanemployee’sordependent’sdeathwhiletravellingonbusiness,vacationortoorfromaneducationalfacility,theGlobalMedicalAssistance(GMA)program pays for the preparation and transportation ofthedeceasedhome.Thereisalsocoverageforreturntransportation home for children and an escort when necessary,intheeventofadeathoftheemployeeordependentwhiletraveling.
LOBLAWS
•Thefollowingbenefitsarecontinuedforsurvivors: –Semi-privateHospitalandAmbulance
ExpenseInsurance;
–PrescriptionDrugExpenseInsurance;
–QuebecresidentsSupplementalHospital&MedicalInsurance;
–DentalExpenseInsurance;and
–OntarioHealthInsurancePlan.
WEEKLY INDEMNITY/INCOMECOvERAgE Great Food
•Yourdisabilitymustbesevereenoughtopreventyoufrom performing your regular work
•Youmustbeunderthecontinuouscareandpersonalattendanceofaphysician.
•Yourbenefitswillnotstartuntilafteryourfirstvisittothephysician.
LOBLAWS
•YoumustbetotallydisabledandunabletoworkduetosicknessoraccidentthatisnotcoveredbyWorker’sCompensation(WSIB)•Youmustbeundertheregularcareandattendance
of a licensed physician during the period for which benefitsarebeingclaimed.
AMOUNT PAyAbLE Great Food
•662/3%ofweeklyearningsuptotheallowablemaximumundertheEmploymentInsuranceAct.
•Note:ThisamountwillbereducedbyanyamountpayableunderanAutomobileInsurancePlanwherepermittedbylawand/oranyWorker’sCompensationorsimilarprogram.
LOBLAWS
•75%ofyourbasicweeklywageonceyouareeligiblebuthavelessthan3years’continuousFull-Timeemployment.•85%ofyourbasicweeklywageifyouhavemorethan3yearscontinuousFull-Timeemployment.
9
WEEKLY INDEMNITY/INCOME CONTINUEDDURATION Great Food
•Benefitswillbepaidforatotalofnotmorethan4weeksforeachperiodofdisability.
LOBLAWS
•Maximumperiodof26weeks•Exception:Maximumof10weeksifcertification
of illness for loss of time benefits is completed by a licensedChiropractor,PodiatristorOralSurgeon.
CRITERIA FOR INELIgIbILITy
Great Food
ThereareseveralcriteriaspelledoutintheCAforineligibility including the following:
•NoWeeklyIndemnity(WI)benefitsarepayablefor“disabilityduetoinjurysustainedwhileworkingforpayorprofit.”
•NoWIbenefitsarepayablefor“disabilityduringthescheduleddurationofaleaveofabsence.”
LOBLAWS
Thereareseveralcriteriaspelledoutinthecollectiveagreementforineligibility,includingthefollowing:•IneligibleforbenefitsifsicknessoraccidentiscoveredbyWorker’sCompensationorsimilarlaw.•NoWIbenefitsarepayableifyouarenotunder
treatment by a physician or surgeon duly licensed topracticemedicine,orduringthefirstfourweeksof disability if you are not under treatment by a licensedChiropractor.
SAME DISAbILITy AND/OR SUCCESSIvE AbSENCES
Great Food
•Successiveabsencesfromworkareconsideredtobeinthe same period of disability unless separated by:
–2completeconsecutiveweeksofactiveFull-Timework,OR
–1fulldayofworkifyourseconddisabilityisduetocompletelydifferentcauses.
LOBLAWS
•Disabilityresultingfromthesamecauseasapreviousdisabilitywillbetreatedasacontinuationofthepreviousdisabilityunlessyouhavereturnedtoworkonacontinuousfull-timebasisforatleast2weeks(14days).
MAkINg A CLAIM Great Food
•Obtainaclaimformfromyouremployer.Completetheemployeeportionoftheformandhaveyourdoctorcompletetheportiontitled“AttendingPhysician’sStatement”.Returnthecompletedformtoyouremployerassoonaspossible,butnolaterthanthreemonthsaftertheendofthewaitingperiod.
LOBLAWS
•Obtainaclaimformfromyouremployerandcompleteyourportionandhaveyourtreatingphysiciancompletetheirportion.
LONG TERM DISABILITYDURATION Great Food
•ForaslongasyourdisabilitycontinuesOR5years,whicheverisless,butonlyuntilyoureachage65.
LOBLAWS
•Theearliestof:Youceasetobecometotallydisabled,asdefined,oruntilyoureachnormalretirementage,ordie.
CRITERIA FOR ENTITLEMENT REgARDINg TOTAL DISAbILITy (TD)
Great Food
•Entitledafterbeingcontinuouslydisabledfor119days(17weeks).Therearecriteriaforwhenitmaybe“accumulated”vs.“continuous”.
•Duringthefirst2years,yourdisabilitypreventsyoufromperforming a combination of duties that regularly take atleast60%ofyourtimeatworktocomplete.Onlytheduties you performed before your disability started are considered.
•After2years,yourdisabilitymustpreventyoufrombeinggainfullyemployedinanyjob,withadditionalcriteriasetoutinthePlan.
LOBLAWS
•Entitledafterbeingtotallyandcontinuouslydisabledforaperiodof26weeks.•Duringthefirst2years,yourdisabilitypreventsyoufromperforminganyandeverydutypertainingtoyour own occupation;•After2years,yourdisabilitymustpreventyoufrom
engaging in “any occupation” for which you are fittedthrougheducation,trainingorexperience.
10
LONG TERM DISABILITY CONTINUEDAMOUNT OF MONThLy bENEFITS PAyAbLE
Great Food
•662/3%ofpre-disabilitymonthlyearningsuptoamaximumof$1500.
•YourLTDbenefitamountwillbereducedbydisabilityorretirementamountyouareentitledtounderCanadaorQuebecPensionPlan,and/orbenefitsunderanyWorkersCompensationActorsimilarbenefits.
•LTDbenefitswillthenbefurtherreducedif,togetherwith“otherincome”listedintheplan,thetotalexceeds80%ofthepre-disabilitymonthlyearnings.
•Note:“OtherIncome”includesbenefitsothermembersofthefamilyareentitledtoundertheCanadaorQuebecPensionPlanbecauseofyourdisability.
LOBLAWS
•66%ofbasicmonthlywageforthefirst$3030subjecttoamaximummonthlybenefitof$2000.•Ifbenefitincomefromallsourcesexceeds71%oftheemployee’saverageearnedmonthlyincomeduring the 2 year period immediately prior to the dateofdisability,thereisprovisionforreductionso that income benefits from all sources do not exceed71%oftheaverageearnedmonthlyincome.•Note:BenefitswillnotbereducedbyanyamountreceivedonbehalfofanydependentsofanLTDrecipient.
MAkINg A CLAIM Great Food
•Claimformavailablethroughyouremployer.ReturnthecompletedformtoyourEmployerassoonaspossible,butnolaterthansixmonthsaftertheendofthewaitingperiod.
LOBLAWS
•Claimformavailablethroughyouremployer.
HOSPITAL AND AMBULANCE EXPENSE INSURANCEhOSPITAL CONFINEMENT COvERAgE
Great Food
•Roomandboardchargesfromahospitalforsemi-privatecare.
•ReasonableandcustomarychargesforconfinementinIntensiveCareUnit.
•Confinementinaconvalescenthospitalforsemi-privatecareifthesituationmeetscertaincriteria.
•Outpatienttreatment–coversreasonableandcustomarychargesforservicesandsuppliesreceivedforthetreatment.
LOBLAWS
•Differenceofsemi-privateroom&boardratesversuswhatiscoveredbyprovincialhospitalinsuranceplanuptothedifferenceofastandardwardandsemi-privateaccommodationforeachday of confinement during any one period of disability.•Coveragecontinuesuntilyourdeathifyouretireat55orolder.
CAR AMbULANCE ExPENSES
Great Food
•Payat100%ofWorldwideTravelBenefitcoveredexpensesandconditionsnotedonPage12forout-of-provincecoverage.
LOBLAWS
•Payinfullbasedonconditionsnotedbelow.
CRITERIA FOR ELIgIbILITy
Great Food
•Ambulancetransportationtothenearestcentrewhereadequatetreatmentisavailable(includinglicensedairambulance).
•Hospitalexpensesmustbeconsideredreasonableandcustomaryfortheservicesprovided.
•Wherethereisnoreimbursementfromtheprovincialhospitalplan.
LOBLAWS
•CarAmbulanceexpensepaidifhospitalizationis required and only if the insurer is satisfied that your physical condition precluded the use of other meansoftransportationtothehospital.•HospitalandCarAmbulancecoverageissubjecttothe“CoordinationofBenefitsProvision”underAppendix“D”,Article15ofthecollectiveagreement.
MAkINg A CLAIM Great Food
•Claimformavailablethroughyouremployer
LOBLAWS
•Claimformavailablethroughyouremployer
11
PRESCRIPTION DRUG AND OTHER HEALTH CARE BENEFITSDEDUCTIbLE Great Food
•$25/calendaryear/familymemberforallcoveredexpensestoamaximumof$50/calendaryear/family,withtheexceptionofWorldwideTravelBenefit(WTB),whichis100%funded.
•Anycoveredexpensesappliedagainstthedeductibleinthelast3monthsofacalendaryearmayalsobeappliedagainstthedeductibleforthenextcalendaryear.Afterthedeductibleispaid,insurancepays100%ofallothercoveredexpenses.
LOBLAWS
•Nodeductible
DRUg COvERAgE Great Food
•CoveragevariesbasedonsomeofthecriteriaanditappearstobemoreextensivethantheLoblawsagreementinsomeareas.
•Forexamplethefollowing(wherepermittedbylawandtotheextenttheyarenotcoveredundertheProvincialMedicarePlan)arecoveredforrentalor(attheInsurer’sdiscretion)purchase:
–Wheelchairs
–Splints(excludingdentalsplints),canes,walkers,crutchesandcasts.
•Lifestyledrugsareexcludedfromcoverage.
LOBLAWS
•Morerestrictionsofwhatisspecificallyexcludedinsomeareasbutsilentinotherareas.•Forexamplethefollowingarespecificallyexcludedfromcoverage:
–Wheelchairs
–Canesandcrutches;
•Lifestyledrugsarenotspecificallyexcludedfromcoverage.
COvERAgE CRITERIA
Great Food
•Coverageunderthisplanfordrugseligibleunderanygovernmentplanislimitedtothedeductibleamountandco-insuranceyouarerequiredtopayunderthegovernmentplan.
LOBLAWS
•Coverageissubjecttothe“CoordinationofBenefitsProvision”underAppendix“D”,Article15ofthecollectiveagreement.•Coveragecontinuesafterretirementbetween55and65.Endsat65ifretired.
QUEbEC RESIDENTS
Great Food •Notapplicable
LOBLAWS
•HaveSupplementalHealth&MedicalInsurancetotheequivalentofOHIPcoverage•Coverageissubjecttothe“CoordinationofBenefitsProvision”underAppendix“D”,Article15ofthecollectiveagreement.
OUT-OF-PROvINCE COvERAgE
Great Food •ThroughtheWorldwideTravelBenefitprogramthereiscoveragewhencertainexpensesariseasaresultofanemergencyorunexpectedsuddenillness(withincertainparameters)fortravelforbusiness,vacation,orfor educational or training purposes and where medical treatmentisnotavailableinhomeprovince.
LOBLAWS
•Nocoverage
12
PRESCRIPTION DRUG AND OTHER HEALTH CARE BENEFITS CONTINUEDOThER hEALTh CARE bENEFITS
Great Food •Coverageoncetheprovincialhealthplanhaspaidoutitsmaximumbenefit.Forexample:
–$10/visitfortheservicesofachiropractor,chiropodist/podiatrist,naturopathorosteopathtoamaximumof$300forallvisitsinacalendaryear.
•Othercoverage,toanannualmaximumof$300:
–$10/visitforout-of-hospitalservicesofapsychologist;
–$10/visitforout-of-hospitalservicesofaspeechtherapist,withincertaincriteria;
–$10/visitforParamedicalcoveredexpensessuchasphysiotherapistservices.
•Othercoveragesuchas:
–Orthopaedicshoes-$100/calendaryear,ifprescribed;
–Orthotics-annualmaximumbenefitof$500/24monthsforadultsoverage25and$500/12monthsforchildrenunder25.
–Physiotherapy-Annualmaximumbenefitof$500
–HearingAid-maximuminany5yearperiod-$350.
LOBLAWS
•Chiropractor–10additionalvisitsbasedonareimbursementoftheOHIPratesandafterthe10OHIPentitledvisitsarecompleted.
MAkINg A CLAIM Great Food
•Obtainclaimformfromyouremployer.Completethisformmakingsureitcontainsallrequiredinformation.Attachyourreceiptstotheclaimformandsendittothebenefitofficeforpayment.
LOBLAWS
•DrugcardusedataLoblawCompaniespharmacy;ORcompleteclaimformwithin90daysofthedateof purchase and submit to the benefit payment officeforreimbursement.
DENTAL CAREDEDUCTIbLE Great Food
•$25/calendaryear/familymemberforallcoveredexpensestoamaximumof$50/calendaryear/family.
LOBLAWS
•$50foreachOrthodontictreatmentplan.
AMOUNT PAyAbLE Great Food Afterdeductiblepaid:
•100%ofRoutinetreatment;
•80%ofMajortreatment;and
•50%ofOrthodontictreatmentfordependentchildrenwhoareatleast6butnotmorethan18atthetimetreatmentcommences.
•TheamountsarebasedontheOntarioDentalAssociationFeeGuideineffectonthedatetreatmentisrendered.
LOBLAWS
•ChargesperArt.10.02ofAppendix“D”asfollows:: –100%ofchargescoveredinPart“A”;
–90%ofchargescoveredinPart“B”;and
–50%ofchargescoveredafterdeductibleispaidinPart“C”(Orthodontictreatment)foreligible employees and dependent children underage20.
–BenefitsprovidedunderParts“A”and/or“B”excludethatportionofanychargewhichisinexcessoftheprevailingScheduleofFeesoftheProvincialDentalAssociationintheProvinceofresidence.
MAxIMUM AMOUNT PAyAbLE
Great Food •Routine/MajorMaximumcoveredexpenses-$2,000/
family member in any employee year; and
•OrthodonticMaximum-$2,000percourseoftreatment.
LOBLAWS
•$2,000/eligiblefamilymember/24monthBenefitperiodforParts“A”&/or“B”;and•Alifetimemaximumof$1,000forPart“C”.
13
DENTAL CARE CONTINUEDLIMITATIONS Great Food
•Sometreatmentsnotcoveredbytheplansuchascosmetictreatment,wherecoveredelsewhere,etc.CheckyourcollectiveagreementunderAppendix“J”forfulldetails.
LOBLAWS
•Sometreatmentsnotcoveredbytheplansuchascosmetictreatment,wherecoveredelsewhere,etc.CheckyourcollectiveagreementunderAppendix“D”Article10forfulldetails.•Benefitscontinuefor3monthsafterthelastofthemonthyouterminatedduetoretirementorlay-off.
COORDINATION OF bENEFITS
Great Food •SeeNote#1atthebottomofthistable.
LOBLAWS
•Coverageissubjecttothe“CoordinationofBenefitsProvision”underAppendix“D”,Article15oftheCollectiveAgreement.;
MAkINg A CLAIM Great Food •Obtainadentalformfromyouremployerforyourdentisttocompleteifhe/sheisnotsetuptosendyourclaimelectronicallytoyourinsurancecompany.
LOBLAWS •Obtainadentalformfromyouremployerforyourdentisttocompleteifhe/sheisnotsetuptosend your claim electronically to your insurance company.
VISION CAREbASIC COvERAgE Great Food
•$200maximumforeyeglassesorcontactlensesina24-monthperiod.Thiscanincludeupto$60ofthecostofaneyeexamination.•Thereisanexceptionaroundreplacementoflost,stolenorbrokenglasses.
LOBLAWS
•$200maximumina24-monthperiodforopticalappliance(andtheirrepair)prescribedforcorrectionofvision•PrescribedOpticalapplianceasaresultofasurgicalproceduretoamaximumtotallifetimeeligibleexpenseof$200.•Eyeexaminationbyanoptometristonceevery24monthsoronceevery12monthsforadependentchildunder18.•Coverageissubjecttothe“CoordinationofBenefitsProvision”underAppendix“D”,Article15ofthecollectiveagreement.
CONTACT LENSES COvERAgE
Great Food •Contactlensesforspecialconditionswithalifetimemaximumof$450.
LOBLAWS •Contactlensesforspecialconditionswithalifetimemaximumof$150.
MAkINg A CLAIM Great Food •Obtainformfromyouremployerandsubmitit
for payment together with your receipt from your optometristandyoureyewearorvisioncorrectionapplianceprovider.
LOBLAWS
•Obtainformfromyouremployerandsubmititfor payment together with your receipt from your optometristandyoureyewearorvisioncorrectionapplianceprovider.
Note#1:ThereisanextensiveCo-ordinationofBenefitsprovisionintheGreatFood/RealCanadianSuperstoreAppendixifyouoroneofyourdependentsisentitledtobenefitsforthesameexpenseunderotherplans.CheckwiththeunionifyouhaveanyquestionsaboutthisCoordinationofBenefitsissueasitmayaffecthowmuchyoucanclaimunderoneormorebenefitplans.
Note#2:TheCoordinationofBenefitsprovisionforLoblawsisnotedspecificallyundereachbenefitplan.
Ifyouareleavingthecompany,someGreatFood/RealCanadianSuperstorebenefitpackagesallowyoutoapply(withinacertaintimeperiod)foranindividualpolicywiththebenefitproviderwithoutproofofinsurabilityaslongasthegrouppolicyisineffectatthetimeyouapply.Ifyouareleaving,reviewyourcollectiveagreementunderAppendix“J”formoredetailsorcontacttheunion(1-800-637-5936).
14