Local 112 Health & Welfare

Claims Payment Service

Plan Summaries

Select a benefit below to view the summary

Overall Deductible = $25 per family, per calendar year (not applicable to drugs, hospital, or vision benefits)

Member Life Insurance

$60,000 – reduced to $30,000 at age 70 and $15,000 at age 75

Dependent Life

Spouse -$10,000

Dependent Child – $5,000

Prescription Drugs

95% reimbursement with no deductible, subject to mandatory generic pricing, $7 dispensing fee cap, maximum $5,000 per person per calendar year

Deductible

No deductible

Basic Services

100% reimbursement, subject to Provincial Fee Guide

Major Restorative Services*

100% reimbursement, subject to Provincial Fee Guide

*Must have 12 months of continuous service with Participating Employer to be eligible for Major Dental

Orthodontia

50% reimbursement, to $3,000 lifetime maximum, for dependents up to age 18 only

Post-Retirement

Retired members age 60 or over 12 months dental coverage

Vision Care

100% reimbursement up to $400 every 24 months for persons 18 or older, every 12 months for persons under age 18.

Eye Exams

100% reimbursement for one eye exam every 24 months

Chiropodist/Podiatrist

100% reimbursement, $350 maximum

Psychologist/Psychotherapist/Social Worker

80% reimbursement, $350 combined maximum

Other eligible paramedical practitioners

80% reimbursement, $350 maximum per practitioner
Eligible practitioners include: acupuncturist, audiologist, chiropractor (and 1 chiropractic x-ray combined), massage practitioner, naturopath, osteopath (and 1 osteopathic x-ray combined), speech language pathologist

Orthotics & Orthopedic Shoes

100% reimbursement up to $400 (combined) every 24 months

Medical Supplies and Prosthetics

80% reimbursement. Subject to reasonable & customary amounts.

Hospitalization

100% reimbursement, semi-private hospital room accommodation

Member Accidental Death & Dismemberment

$60,000

Reduced to $30,000 at age 70

Reduced to $15,000 at age 75

Critical Illness

$5,000, list of 25 eligible conditions

Wage Indemnity* (Short Term Disability)

Payable from 1st day accident, 2nd day illness

Weeks 1-2 – Plan pays 75% of average weekly earnings, to maximum of $524

Weeks 3-6 – Plan pays 60% of average weekly earnings, to maximum of $524

Weeks 7-32 – Paid by Employment Insurance

* Must have 12 months of continuous service with Participating Employer to be eligible for Wage Indemnity

Maternity / Parental / Compassionate Leave Top Up*

Up to $100/week top up provided during periods member is receiving Employment Insurance benefits for maternity/parental leave (for up to 25 weeks) or for compassionate care leave (for up to 6 weeks)

*Must have 12 months of continuous service with Participating Employer to be eligible for Maternity/Parental/Compassionate Leave Top Up benefits.

Select a benefit below to view the summary

Overall Deductible = $25 per family, per calendar year (not applicable to drugs, hospital, or vision benefits)

Dependant Coverage = Dependents of part-time Members are eligible for prescription drugs, dental benefits, and eye exams only

Member Life Insurance

$30,000

Reduced to $15,000 at age 65

Dependent Life

Spouse -$5,000

Dependent Child – $2,500

Prescription Drugs

95% reimbursement with no deductible, subject to mandatory generic pricing, $7 dispensing fee cap, maximum $5,000 per person per calendar year

Deductible

No deductible

Basic Services

100% reimbursement, subject to Provincial Fee Guide
Includes diagnostics, preventive, restorative, endodontics, peridontics, prosthetic repairs, and surgical services

Major Restorative Services

Not covered

Orthodontia

Not covered

Vision Care

100% reimbursement up to $400 every 24 months

Eye Exams

100% reimbursement for one eye exam every 24 months

Paramedical Practitioners

100% reimbursement, $350 maximum for Chiropodist and Podiatrist only

Orthotics & Orthopedic Shoes

100% reimbursement up to $400 (combined) every 24 months

Member Accidental Death & Dismemberment

$30,000

Reduced to $15,000 at age 65