What to Expect (disability)
Short-term Disability (STD)
Who is eligible for STD benefits?
Employees in the following Benefit Class are eligible to apply for Short-term disability benefits:
- Benefit Class 1: Permanent Full-time and Part-time employees
- Benefit Class 2: 1-year contract employees
- Benefit Class 4: Priests
There is no termination age for this benefit, providing that you continue to be: an insurable employee, actively at work, and meet the definition of disability.
Definition of Disability
This wage-loss benefit is available when eligible employees become disabled due to non-work-related injuries while insured and suffer a loss of earnings as a result. Disability means being unable to perform the essential duties of the employee’s occupation for your or any other employment due to illness or injury. Medical evidence must support this accordingly. The availability of work is not considered when assessing disability.
How is the STD benefit calculated?
The benefit is payable at 66.67% of weekly earnings. STD payments are paid weekly in arrears by the disability office. Weekly earnings are your annual earnings divided by the number of weeks you work and are paid for. Examples: 43 weeks (if the employee is a Teacher and/or Teacher Aide), 48 weeks (if a Principal), and 52 weeks for a 12-month employee.
- STD, which extends into summer periods (July 1st to August 31st), will stop on the last day of June for workers on a 10-month work schedule and resume in September if the disability continues. Workers on a 12-month schedule will have no interruption of payments. Sample benefit calculation (employee is a 10-month employee, earning $45,000/year):
- $45,000 (gross annual earnings) ÷ 43 (weeks worked) = $1,046.52 (gross weekly earnings)
- $1,046.52 (gross weekly earnings) x 66.67% (STD benefit amount) = $697.72 (STD benefit amount)
How long is the STD benefit available? For an approved STD claim, benefits are payable for a 15-week period. During this time, the disability office reserves the right to request updated medical information to support your claim. In such cases, the disability claimant is expected to keep in touch with their doctor to be sure such reports are sent promptly and do not delay the payment.
Non-taxable Benefits
This is a non-taxable benefit; therefore, a T4A will not be issued by the disability office for Income Tax purposes.
Satisfying the STD benefit waiting period
There is a 7 consecutive day waiting period from the last full day worked until the first day payable for disability. Statutory holidays are counted as part of the waiting period and are paid for by your employer. It is presumed you will use “sick days” according to your contract to remain at full pay during this waiting period.
If you apply for disability, you CANNOT use banked sick days in excess of the 7 consecutive days waiting period – even if you have them accumulated. This is a contractual stipulation with Canada Life that must be adhered to.
- If you have exhausted all of your sick days within the 7 consecutive days waiting period, then any days in excess of your sick days would result in time off without pay.
Claim Submission
The disability office must receive proof of claim within 90 days after the disability begins. Please refer to the Forms/Claim forms/Disability portion of our website to obtain the applicable Employee and Employer Statements.
- Within the Employee Statement, there is the Physician Statement that must be completed. The doctor must specify your diagnosis/prognosis and any other applicable information to support your claim.
Continuation of benefits & premium responsibilities
When you are on disability, all your benefits continue except for the Pension benefit. As an STD claimant, you are still responsible for paying your share of the benefit premiums.
Long-term Disability (LTD)
Who is eligible for LTD benefits?
Employees in the following Benefit Class are eligible to apply for long-term disability benefits, providing that they continue to be an insurable employee, actively at work, and meet the definition of disability:
- Benefit Class 1: Permanent Full-time and Part-time employees
- Benefit Class 4: Priests This benefit terminates at age 65 as you are then eligible to receive Old Age Security (OAS) benefits.
Definition of Disability
LTD continues to be a wage-loss benefit available when eligible employees become disabled due to non-work-related injuries while insured and suffer a loss of earnings. Medical evidence must support that during the first 24 months of payments, an employee will be considered disabled if unable to perform the essential duties of the employee’s occupation for your or any other employment due to illness or injury. The availability of work is not considered when assessing disability. After 24 months of payments, the employee will be considered disabled due to illness or injury if unable to perform the essential duties of any occupation for you or any other employer for which the employee is qualified or could reasonably become qualified based on education, training, or experience. The availability of work is not considered when assessing disability.
How is the LTD benefit calculated?
The benefit is payable at 67% of pre-disability monthly earnings. This means that there is a lapse of time for a period of 1 month after the last weekly STD payment is issued to the first LTD monthly payment.
- Your gross annual salary is divided by 12 (months) to calculate your monthly earnings. Please note that for Teachers and Principals, although you are paid over a 10-month period, your salary represents earnings incurred for a 12-month period.
- Unlike STD, LTD payments continue throughout the summer (July 1st to August 31st), so there is no break in coverage. Sample benefit calculation (employee is a 10-month employee, earning $45,000/year):
- $45,000 (gross annual earnings) ÷ 12 (months per year) = $3,750 (gross monthly earnings)
- $3,750 (gross monthly earnings) x 67% (LTD benefit amount) = $2,512.50(LTD monthly benefit amount)
Non-taxable benefit
- This is also a non-taxable benefit; therefore, a T4A will not be issued by the disability office for Income Tax purposes.
Satisfying the LTD waiting period
The waiting period before the employee can receive LTD payments is 119 days. Please note that the 119 days represents the 15-week benefit period for STD. Therefore, once you have exhausted the STD benefit, you are eligible for LTD benefits. Canada Pension Plan (CPP) Prolonged disability will prompt Great-West Life to ask you to apply for Canada Pension Plan (CPP) disability benefits. Your CPP income is deducted (direct offset) from your LTD benefit if approved.
Continuation of benefits & premium responsibilities
When approved for LTD benefits, benefit premiums for the Life, Optional Life (if you’ve applied and been approved), AD&D, STD, and LTD benefits are no longer due. However, you are still responsible for paying your share of the benefit premiums for the benefits not listed above (for example, Extended Health, Dental, and Critical Illness).
- The waiver of applicable benefit premiums takes place on the first of the month following approval of your LTD claim by the disability office.
Back-to-Work program in conjunction with STD and LTD Benefits
Short-term and Long-term disability insurance plays a valuable role in replacing income lost due to a disability. The best outcome, however, is the return of employees to productive employment. The goal of rehabilitation is to help make that return to employability happen as early and as smoothly as possible for both the employee and the employer.
Employees engaged in approved rehabilitative employment will have their earnings from rehabilitative employment coordinated with their disability benefits. The employer must only pay for the hours/days the employee is at work.
The disability office will be in contact with your local employer to obtain the following information for the period that the employee worked the previous week:
- Specific days that the employee worked
- Hours worked per day by the employee
- Earnings paid by the local Employer
The disability office will then calculate the appropriate disability benefit payment for you (the employee), based on your earnings through the school/parish. This process will continue until you return to work, FULL-TIME.
It’s important to understand that income from all sources can’t exceed 100% of net pre-disability earnings while on a back-to-work program. This 100% clause does not apply if you are solely on disability.
It is your obligation as an employee to ensure that there is clear communication with your local employer at all times in regards to when you are expected to return to work!
Pension contribution Suspension
Disability, Approved Leave of Absence (LOA) & Maternity Leave
Our Group Policy Contract with the pension department clearly states the following regarding your employer-matched contributions to the Registered Pension Plan (RPP):
“…if a Member is unable to work because of disability (Short-term disability, Long-term disability or WCB), leave of absence or temporary lay-off, all contributions will cease during such periods.”
The Member may continue to make Voluntary (not matched by your employer) contributions to the Plan while on disability.
For an expectant mother who goes on disability prior to her official Maternity Leave starting, the Pension contributions must be suspended as well. Only when the Maternity Leave officially starts can the employee request to have her RPP contributions reinstated.
An employee who is on a maternity/parental leave of absence may continue to participate in the CISVA, RPP. This is the only type of leave in which an employee may opt-out of the pension plan, and then resume contributions upon their return to work.
This information is reflected on Page 14 of the CISVA Registered Pension Plan booklet.
Vacation pay while on disability
An employee usually receives credit for service while on STD for the purposes of vacation and employment security. An employee usually does not receive credit for service while on LTD in regards to the Vacation Policy. In general, any vacation outstanding in respect of the employee at the expiry of the STD leave is paid out to the employee at the time they are accepted onto LTD.
LTD Plans or any type of disability insurance plans are considered Income Maintenance Plans/Wage Loss Replacement Plans.
Please refer to your employment contract to confirm if reference is made to your entitlement of vacation time or vacation pay.
Role of the disability office
Contact Information
Insured with Canada Life Assurance Company
Policy No. 335645 – Division 10
Canada Life Assurance Company
Langley Disability Management Office
2nd Floor, 8700 – 200 Street
Langley, BC V2Y 0G4
General Office Number: 604-455-2700
Toll-Free Number: 1-877-262-0749
Fax Number: 1-844-569-3131
Email Address: Langley.dmso@canadalife.com
Disability Claims Process - Summary
Disability comes in degrees. At any given time, there may be employees on the job who are at risk for absences and disability. You could be coping with the demands of teenagers or aging parents, trying to manage a medical condition, etc. Other employees could be attempting to return to their normal or work routine after an absence. Any of these situations could escalate into a disability.
The focus of the disability office is on creating opportunities to support recovery and the ability to enable you to return to work.
Employees on short-term disability (STD)
Once an employee is on short-term disability, the focus shifts to recovery and return. Statistics show the longer an employee remains on disability, the less likely they may return to work. Providing the right support for the right problem early on is critical.
Employees on long-term disability (LTD)
Employees facing a serious long-term disability need the most extensive level of support and intervention to realize their potential. By using the same Case Manager throughout, the disability office provides a seamless transition from Short to Long-term Disability and effective support for our employees.
Partnership Services:
- Health & Wellness Library – employees participating in our Extended Health or Dental benefits can access a wealth of information through the Canada Life website for plan members.
- Medical Coordination – provides medical support and expertise from the first report of illness or injury, continuing through treatment.
- Vocational Rehabilitation, Consulting – provides return-to-work planning, education and job search assistance and helps employees adjust on a personal and vocational level.
- Exchange – a unique communication process that uses facilitated meetings to bring the employee and the employer together early, to work through issues affecting the employer’s return to work.
- STD and LTD Case Management – progressive case management services designed to ensure claims are handled according to the terms of your plan.
- At-Work Services – provides vocational or medical rehabilitation and related services while the individual is still at work, to help the employee remain on the job.
Process Summary:
Every claim submitted to Canada Life will be unique but will follow through a management approach that offers the following key-value points:
- Timely information gathering and initial assessment
- A team approach to management, quarterbacked by a single Case Manager
- Regional claim management
- Vocational Rehabilitation consultants who focus on the non-medical elements of case management
- Medical Coordinators who can add value where medical attention or interpretation is a barrier to return to work
At the heart of the management team is the Case Manager. This person is responsible for a claim from inception until the employee returns to work, or otherwise is no longer eligible for benefits.
Initial Claim Review:
Before a claim decision can be made, the Case Manager must review the claim to gain insight into its complexity and validity. This includes gathering information about the claim and verifying plan parameters and assessment criteria.
Information Gathering:
The first information gathered by the Case Manager will be the claim form and the physician’s statement. If the documentation is straightforward and complete, then the claim decision can be made quickly and accurately. On the other hand, if the information is not straightforward or incomplete, it is examined more closely.
Canada Life may call employees to obtain information about their condition and treatment. Then, if additional information is needed, more specific questions can be directed to the employee’s physician.
Claim Assessment & Decision:
Once the claim has been initially reviewed, the Case Manager can then assess the claim and determines if it satisfies the plan provision. If the claim is accepted the management of the claim begins. If the claim is declined, then the employee is advised concerning the reasons for the declination. Information is also provided on additional medical facts needed for further review or on how to appeal the decision should the employee disagree with the discussion.
Initial Assessment:
In making an initial assessment of a claim, the disability office reviews all of the information gathered pertaining to the claim. This initial assessment will give direction to the claim, and assist in determining the plan for further handling of the claim.
- Maximize Return on Investment
In order to maximize return on investment, the Case Manager must make sure that straightforward claims are paid accordingly, and only investigate the more complex claims further.
- Plan provisions
In order for a disability claim to be accepted, the disability must be covered in the CISVA plan provisions; therefore, the Case Manager must check the plan provisions before moving forward with the claim assessment.
- Limitations and Exclusions
Limitations are provisions that may result in a claim terminating (temporarily or permanently) if certain criteria have not been satisfied. Exclusions, on the other hand, are initial requirements that, if not met, will result in a claim being declined (i.e., a pre-existing condition).
Decision-Making Tools Available:
The Case Manager uses many tools when deciding on a claim. These tools are important in making the right decision in a timely matter.
- Manuals
At Canada Life’s disability offices, they have created proprietary manuals to assist in assessing and managing disability claims.
- Normal Convalescence Periods
Industry-recognized reference materials are used to establish a normal recovery period for disabilities. These reference materials and the knowledge of Medical Coordinators and Medical Board Consultants allow the disability office to determine duration period information. This also enables the Case Manager to make appropriate plans for the employee to return to work.
Medical Consultants:
The Case Manager determines when it is appropriate to use the services of a Medical Consultant. The medical consultant interprets the medical test results and other clinical information. The Case Manager then compares the medical restrictions to the employee’s job abilities to assess if the employee is medically able to do their job.
Appeal:
If a claim is declined or disputed, the employee has the right to an appeal; this right to appeal is outlined to the employee in the decision letter. The review process requires the employee to submit additional information. The employee may also appeal by providing detailed reasons why the claim should be reassessed. Upon receipt of the additional information, the employee will be provided with the results of our reassessment.
Disability Management (Accepted Claims):
The management of a disability claim is the most detailed part of the disability claim process. In order to manage such detailed claims, Case Managers frequently use the following tools:
- Medical Coordination
- Rehabilitation
- Reviews
The overall objectives to the management of a claim are to:
- Maximize non-medical management via Vocational Rehabilitation Consultants
- Include Vocational Rehabilitation and Medical Coordination in detailed claims
- Have the Case Manager act as the “Gate Keeper”, responsible for the management of the claim from inception until the return to work
- Use other supplemental disability tools to help manage the claim
Disability Management Tools:
Case Managers can use many different tools to manage a disability claim. These tools are in place for the Case Manager to get the employee back to work as soon as possible. The main disability management tools are as follows:
- Vocational Rehabilitation Referral
- Medical Coordination
- Disability Reviews
- Medical Consultants
- Independent Medical Exam
- Functional Capacities Evaluation
- Fraud Investigation
- Activity Investigation
Rehabilitation:
Experience has shown that early initiation of rehabilitation is an integral part of effective, comprehensive disability management; therefore, the possibility of rehabilitation is immediately considered in claim assessment. If appropriate, a telephone interview will be conducted to assist in developing rehabilitation plans and programs for the employees.
Seamless STD/LTD transition:
The disability office strives for a seamless disability approach allowing for an easier transition between Short Term and Long Term disability benefits. The assigned Case Manager is responsible for referrals to Medical Coordination and Vocational Rehabilitation and the claim assessment. Individual claim attention provides consistent and proactive management of the claim and a personal touch in what is often a difficult time for the employee.
Financial Management:
Alternate sources of income, such as CPP, WCB, and auto insurance, act as significant sources of savings for disability benefits. The disability office ensures that any employee entitled to these alternate insurance benefits is notified of their potential entitlement.
Canada Life advises the following individuals to pursue a claim with CPP benefits:
- People with degenerative, chronic, or terminal conditions.
- Where there is no indication that a person is medically capable of any work (i.e., If it appears improvement is unlikely, benefits may continue until age 65),
- Or where the person is over age 60 and not expected to recover from their medical condition and be able to perform any work.
The possibility of auto insurance benefits is considered whenever disability results from a motor vehicle accident. If alternate benefits are denied, the disability office will assume liability provided other contract requirements have been satisfied.
Benefits:
Once a claim has been approved, the employee is entitled to disability benefits. The following point needs to be taken into consideration to claim payments:
Methods of payment:
Canada Life currently supports two methods of payment – Direct Deposit and Cheque Payment. To process an electronic fund transfer, Canada Life requires bank identification and account number for each disability claimant. If the employee chooses cheque payment, the disability office sends the cheque directly to the employee.
Termination & Appeal:
Termination of the claim is the final step in the disability claims process. A claim is considered terminated once an employee has returned to work or no longer meets the CISVA plan provisions. For those employees who have received Long Term Disability benefits for more than two years, the employee will receive 30 days’ notice before the termination of benefits; for those whose Long Term Disability benefits are terminating due to a change in the definition of disability. The disability office will advise employees of their decision as early as possible. If a claimant feels their claim has been terminated prematurely, they are entitled to an appeal.
Maternity
Introduction
Federal and provincial legislation protects an employee’s right to take maternity leave and outlines the employer’s role in administering benefits during such a leave. The Catholic Independent Schools of Vancouver Archdiocese’s maternity leave policy is accountable to employment-related legislation and at no time reflects rights that are less than those provided by federal or provincial legislation.
The information provided within this document complies with the following governing bodies:
1. Employment Insurance (EI) EI website
2. Employment Standards Act (ESA)
3. Human Resources & Social Development Canada (HRDC)
| This document provides details of benefit plans, but it is not a legal document. In the event of a conflict between the contents of this guide and the actual plans & contracts or regulations (as outlined by any applicable governing bodies), the provisions outlined in the latter will apply. |
Overview of Benefits
Maternity benefits (as defined by EI)
Maternity benefits are only available to the person away from work because they’re pregnant or have recently given birth and cannot be shared between parents.
The person receiving maternity benefits may also be entitled to parental benefits.
If the actual date of birth is different from the expected date of birth, you must provide this date as soon as possible after your child’s birth. Please contact EI at 1-800-206-7218 from 8:30 am to 4:30 pm and press “0” to speak to a representative. This way, they will be able to determine the most advantageous maternity period to receive the maximum maternity benefits you are entitled to.
Eligibility: (Please refer to the EI website for the most recent and updated information)
The information below should be used as a guideline. We encourage you to apply for benefits and let a Service Canada agent determine if you’re eligible.
You need to demonstrate that:
| BENEFIT NAME | MAXIMUM WEEKS | BENEFIT RATE | WEEKLY MAX |
|---|---|---|---|
| Maternity (for the person giving birth) | up to 15 weeks | 55% | up to $650 |
- you’re pregnant or have recently given birth when requesting maternity benefits
- you’re a parent caring for your newborn or newly adopted child when requesting parental benefits
- your regular weekly earnings from work have decreased by more than 40% for at least one week
- you accumulated 600 insured hours* of work in the 52 weeks before the start of your claim or since the beginning of your last claim, whichever is shorter
- Standard parental benefits
- Extended parental benefits
- Standard parental: within 52 weeks (12 months)
- Extended parental: within 78 weeks (18 months)
Terminology
Maternity Leave
Refers to the federally legislative leave provided to the biological mother at the time of the birth of a child. Maternity Employment Insurance (EI) benefits are payable to the birth mother for a maximum of 15 weeks.
Supplemental Unemployment Benefit (SUB) – aka maternity “top-up” benefit
Refers to the supplemental wage-loss support paid to only teachers and principals of the CISVA by the local school as the difference between the Employment Insurance payable and 75% of gross salary.
Waiting Period
Refers to the one week before Employment Insurance benefits begin payment. Generally, this period is the first week of the EI claim.
If both parents share parental benefits, only one waiting period needs to satisfy. If a 1-week waiting period has been met for maternity benefits, the waiting period for parental benefits will be waived.
Employment Insurance
Standard parental benefit is 55% of average insurable weekly earnings, up to a maximum amount. In 2023, the maximum amount is $650 a week.
Extended parental benefit is 33% of average insurable weekly earnings, up to a maximum amount. In 2023, the maximum amount is $390 a week.
Employment Standards Act
Labour standards legislation provides minimum entitlements for employees on maternity leave and states that an employee is entitled to unpaid maternity leave. While on leave, the individual continues to be an employee. Upon return to work, the employer must reinstate the employee in the prior position or to a comparable alternate position.
Salary increments are to be paid to the employee upon return to work as employees continue to accrue increments on the salary scale grid while on maternity leave.
Pension and Benefits
The Employment Standards Act (ESA) also requires that a member of a pension plan is required to make member contributions under the plan (as the pension plan of the Catholic Independent Schools of Vancouver Archdiocese). The member who takes a Maternity leave may continue to participate in and accrue benefits under the pension plan for the duration of the approved leave. Employer contributions will also continue during this leave unless the member elects in writing (please refer to the Waiver section found on the Maternity Leave contract) not to participate in the pension plan for the duration of the approved leave.
Under the Employment Standards Act (ESA), Group Insurance benefits also continue accordingly.
Employment Insurance (EI)
Who is eligible?
The information below should be used as a guideline. We encourage you to apply for benefits and let a Service Canada agent determine if you’re eligible. You need to demonstrate that:- you’re pregnant or have recently given birth when requesting maternity benefits
- you’re a parent caring for your newborn or newly adopted child when requesting parental benefits
- your regular weekly earnings from work have decreased by more than 40% for at least one week
- you accumulated 600 insured hours* of work in the 52 weeks before the start of your claim or since the start of your last claim, whichever is shorter
How, and where to apply?
To receive maternity, parental, or sickness benefits, you must submit an EI application online or in-person to your Service Canada Centre. You should apply as soon as you stop working, even if you receive or will receive money when you become unemployed. You must request your Record of Employment (ROE) from your last employer. If you have your ROE from your last employer, apply immediately. If you did not receive your last ROE, submit your application along with proof of employment — for example, pay stubs. If one or more ROE covering periods prior to your last employment are missing, you must still submit your claim for benefits. Generally, an ROE must be issued within five (5) calendar days of the interruption of earnings or the date the employer becomes aware of the interruption.When to apply?
According to the EI website: “You can start receiving maternity benefits as early as 12 weeks before your due date or the date you give birth. You can receive these benefits more than 17 weeks after your due date or the date you gave birth, whichever is later. A maximum of 15 weeks of benefits is available. When you apply for maternity benefits, you can also apply for parental benefits. This will save you time later.” Source: EI maternity and parental benefits: Apply – Canada.ca What information/documents are needed to apply?- Your Social Insurance Number (SIN). If your SIN begins with a 9, you need to supply proof of your immigration status and work permit.
- Record of Employment (ROE) from each job held over the last 52 weeks. If you do not have your ROE after 14 days from your last day of work, you must submit proof of employment such as pay stubs;
- personal identification such as your driver’s license, birth certificate, or passport if you are applying in person;
- your complete bank information, as shown on your cheque, bank statement, or voided personalized blank cheque from your current account;
- a medical certificate indicating how long your incapacity is expected to last if you are claiming sickness benefits;
- the expected or actual date of birth of your child, if you are claiming maternity benefits;
- your newborn’s date of birth, or, when there is an adoption, your child’s date of placement, if you are claiming parental benefits. In the case of an adoption, you also need to provide the name and full address of the agency handling the adoption;
- your detailed version of facts if you have quit or have been dismissed from any job in the last 52 weeks;
- details regarding your most recent employment: Your total salary before deductions, your salary before deductions for your last week of work – from Sunday to your last day worked, the gross amount received or to be received, such as vacation pay, pension, pay in lieu of notice or lay off and other monies.
This is how EI calculates your weekly benefit amount:
- Add your insurable weekly earnings from your best weeks based on information provided by you and your Record of Employment
- Divide that amount by the number of best weeks based on where you live
- Then multiply the result by 55% for maternity and standard parental benefits or by 33% for extended parental benefits
You may be eligible to receive the family supplement if:
- your annual net family income is $25,921 or less
- you have at least one child under 18
- you or your spouse receive the Canada Child Benefit
Supplemental Unemployment Benefit (Aka: Maternity “Top-Up” Benefit)
| Note: | (1) ALL CISVA employees are eligible for this benefit |
| (2) this benefit is only available to the biological mother | |
| (3) this benefit is not payable during the period the eligible employee may be receiving post-delivery, Short- term disability benefits (for a 4 or 6 week period) |
Formula:
|
| 1. CISVA employee delivers and experiences wage-loss during the said year (Sept. 1 – June 30) | |
| Regular gross salary: | $49,082.00 |
| Gross weekly salary: $49,082 divided by 52 weeks | = $943.88 |
| 75% of gross weekly salary | = $707.91 |
| Gross EI benefit (max is $650) | = $519 |
| The amount payable as “top-up” per week (75% Weekly salary – EI benefit) | = $188.91 |
Registered Pension Plan (RPP)
As required by legislation, pensionable service for a member in the Registered Pension Plan (RPP) of the CISVA will continue to accrue during the approved Maternity leave provided the member indicates in writing that she will continue to make contributions under the plan. Employer contributions to the RPP will also continue during this time.
It is the employee’s responsibility to ensure that they always adhere to the Canadian Income Tax Act regulations. The most that an individual can contribute to their RPP is the lesser of 18% of “earned income” for the current year, to the Annual Contribution Limit set by Revenue Canada.
For your purposes, generally speaking, earned income includes a taxpayer’s income (earned while the taxpayer was resident in Canada) from the following:
- income earned from employment reported on a T4 slip (including maternity top-up payments for eligible CISVA employees)
Group Insurance Benefits
During maternity leave, the employee shall be entitled to the following benefits providing (1) she was normally entitled to such benefits and (2) she pays her share of premiums:
- Life insurance, Accidental Death & Dismemberment, Short-term and Long-term disability
- Extended Health, Dental and Critical Illness benefits
- Pension
- Medical Service Plan (MSP)
Post-delivery, Recovery Benefit (Maternity STD Benefits)
What are post-delivery, recovery benefits?
What are post-delivery, recovery benefits?
Our Short-term Disability (STD) plan covers the part of maternity leave that the biological mother would not work due to pregnancy and childbirth health-related reasons. While a woman is on maternity leave, there may be a period during which she may be unable to work due to the physical demands of pregnancy and childbirth. As a result, there is now the provision of disability coverage during the recovery portion of maternity leave for eligible employees:
Our STD plan has expanded its benefits for a disability following childbirth in the following format:
- Childbirth by regular delivery: 4-week benefit
- Childbirth by c-section: 6-week benefit
Who is eligible to receive this benefit?
This continues to be an STD benefit. Therefore, the expansion in the STD benefit is made available to all eligible employees (expectant mothers) who are eligible to apply for STD benefits. The employee would need to be actively participating in either one of the following two benefit classes:
Benefit Class 1: Permanent Full-time and Part-time employees
Benefit Class 2: 1-year contract employees
There is no termination age associated with STD benefits providing you continue to be: an insurable employee, actively at work, and meet the definition of disability.
When is this benefit payable?
Even though this benefit is available to eligible employees for 4 or 6 weeks (as of the date of birth of the newborn), our group STD plan still retains a seven consecutive-day waiting period. As a result, the post-delivery recovery benefit is payable for the following two periods:
* If the employee is currently on STD benefits due to pregnancy-related complications, it’s likely that the STD waiting period has been satisfied. In these cases, this benefit is now payable as of the newborn child’s birth date.
| Type of Birth | Benefit Period | * STD Waiting Period | Payable Benefit |
| Regular delivery | Four weeks | Seven consecutive days | Three weeks |
| C-section delivery | Six weeks | Seven consecutive days | Five weeks |
How are these claims assessed?
These claims are assessed in the same manner as any other STD claim.
- The employee must be enrolled in the applicable benefit class.
- The employee must meet the definition of disability.
- The benefit is payable at 66.67% of weekly earnings.
- STD payments are paid weekly in arrears by the disability office.
- There is a seven consecutive day waiting period from the newborn’s date of birth until the first day payable for disability.
- The Short-term disability claim forms must be completed in full:
- The Employee Statement (including the Attending Physician’s Statement)
- The Employer Statement
- These forms must be completed in full and returned to the Benefits Administration Office for coordination with the disability office.
Sample benefits calculation
Sample benefit calculation (employee is paid over a ten-month/43-week period, earning $55,000/year):
This is a non-taxable benefit to the employee. Therefore, no T4A will be issued.
- The baby was born on January 5th
- The baby is born by c-section.
- In this example, STD benefits are payable for a 6-week post-delivery period.
| The employee is eligible for STD benefits from January 5th to February 16th. (43-week formula) | |
| – Regular gross annual salary: | $55,000.00 |
| – Gross weekly salary: $55,000 divided by 43 weeks | = $1,279.07 |
| – STD benefit applied at 66.67%. Benefit payable weekly, in arrears. | = $853.00 |
What if the employee was already on STD for pregnancy-related complications?
If the employee was previously approved for STD benefits, the post-delivery recovery benefit extends the existing claim. STD benefits will continue for 4 or 6 weeks after the newborn’s date of birth (depending on the type of delivery).
Contractually, does this mean that the employee's official maternity leave is extended?
No, the employee’s official maternity leave is not extended beyond the agreed period specified in the employee’s Maternity Leave Contract.
The employee will not receive one year and four weeks (due to childbirth by regular delivery) of maternity leave. The employee will not receive maternity leave for one year and six weeks (due to birth by c-section).
The post-delivery recovery (STD) benefit is simply payable within the current period of the approved maternity leave.
What happens with the maternity benefits offered through Employment Insurance (EI)?
EI, maternity leave, must start no later than the expected or actual week of childbirth; however, an employee can start their maternity leave up to 8 weeks before the scheduled delivery date. If the employee chose to start the maternity leave early, they would still be eligible for the STD paid post-delivery period.
STD benefits would be payable for the post-delivery period (4 weeks for normal, uncomplicated delivery and six weeks for a Cesarean section – less the seven-day waiting period).
Please note that EI Benefits are not payable when STD benefits are paid. As our group benefits plan benefits from an EI reduced rate (since we offer disability benefits), EI will “offset” any payment you receive through STD benefits. EI reduces its benefit in the amount paid under the group disability plan. Therefore, employees will not receive full payable benefits under EI and the STD benefit.
Once the STD benefit is exhausted, EI will pay the employee (providing that the employee is eligible for EI benefits).
Maternity/Parental benefits are limited to a combined period of 52 or 78 weeks. If the employees receive post-delivery STD benefits (4 or 6 weeks minus the one-week waiting period), EI’s payable benefit is cut back.
Note: if the employee starts maternity EI benefits before the DOB of the child, the local Employer will need to make a note on the employee’s Record of Employment (ROE) that the employee may be eligible for post-delivery STD benefits. After that, EI will follow up accordingly with the employee.
How is the top-up benefit managed while an employee is receiving STD benefits?
| Note: | (1) ALL CISVA are eligible for this benefit |
| (2) this benefit is only available to the biological mother |
- The STD benefit is considered the first payor in providing a wage-loss benefit as it’s a system-wide benefit to eligible employees.
- EI is the secondary payor; however, EI will suspend any EI payments while the claimant receives STD benefits.
- As the CISVA has an EI-reduced plan, EI will “offset” the STD benefit from the EI calculation.
- Top-up is also contingent on EI’s approval of the claim.
- The employee receives more than 75% of weekly earnings due to the difference in calculations using the 43-week formula (STD) versus the 52-week formula (EI).
(A) Example of a top-up calculation:
Jane Doe – Teacher within the CISVA
- Jane’s baby is born on January 1st
- 6-15 week top-up benefit. Payable:
- To all CISVA employees
- EI has approved maternity leave
- In this example, we’ll say that Jane would have been eligible for a top-up for 15 weeks (per her doctor’s recommendation).
| Jane is eligible for top-up from January 1st to April 14th (52-week formula – EI’s formula) | |
| – Regular gross annual salary: | $71,407.00 |
| – Gross weekly salary: $71,407 divided by 52 weeks | = $1,373.22 |
| – 75% of gross weekly salary | = $1,029.92 |
| – Gross EI benefit (max is $650) | = $650 |
| – Amount payable as “top-up” per week (75% Weekly salary – EI benefit) | = $379.92 |
| The amount that the employee would receive as a combined taxable income through EI and the top-up benefit ($650 + $379.92 = $1,029.92) | $1,029.92 |
(B) Example of an approved STD post-delivery, recovery benefit:
ane Doe – Teacher within CISVA
- Jane’s baby is born on January 1st
- The baby is born by c-section.
- In this example, STD benefits are payable for a 6-week post-delivery period (minus the seven-day waiting period).
| Jane is eligible for STD benefits from January 1st to February 11th (43-week formula – STD formula) | |
| – Regular gross annual salary: | $71,407.00 |
| – Gross weekly salary: $71,407 divided by 43 weeks | = $1,660.63 |
| – STD benefit calculated at 66.67% of the gross weekly earnings. This is a non-taxable benefit to the employee. | = $1,107.00 |
Canada Pension Plan Disability
Introduction
The Canada Pension Plan (CPP) has been in effect since 1966. It is a national plan based on contributions from workers and employers in Canada. It is best known for its retirement pension, but also provides survivor, death and disability benefits to CPP contributors and their families.
The CPP Disability program is the largest long-term disability insurance program in Canada. Its primary role is to replace a portion of income for CPP contributors who cannot work because of a disability that is both severe and prolonged (as defined by the CPP legislation).
What is CPP disability
CPP Disability is part of the Canada Pension Plan (CPP). It is designed to provide financial assistance to CPP contributors who are unable to work because of a severe and prolonged disability.
Benefits are paid monthly to eligible applicants and their dependent children. The monthly disability benefit payment includes a fixed amount, plus an amount based on how much and for how long the contributor paid into the Plan. Payments are adjusted once a year in January if necessary, to reflect changes in the cost-of-living index.
How do I qualify for CPP disability benefits?
To qualify you must:
- be under 65,
- have earned a specified minimum amount and contributed to the CPP while working for a minimum number of years, and
- have a severe and prolonged disability as defined by the CPP legislation.
Introduction
The CPP defines “disability” as a condition, physical and/or mental, that is “severe and prolonged”. “Severe” means that you have a mental or physical disability that regularly stops you from doing any type of work (full-time, part-time or seasonal). “Prolonged” means your disability is likely to be long term or is likely to result in your death.
When should I apply?
(YOU MUST APPLY FOR ALL CPP BENEFITS!)
You should apply when you develop a serious long-term or terminal medical condition that prevents you from working regularly at your own or any other job.
How do I apply?
You must complete a written application. For an application kit, visit http://www.esdc.gc.ca/en/cpp/disability/index.page and print a copy. It will tell you what you need to provide so CPP can determine whether you meet the eligibility requirements.
The Disability kit includes an Application form, General Information and Guide, Questionnaire, Consent for Service Canada to Obtain Personal Information form, Medical Report and Child Rearing Provision form. Each form must be completed and forwarded to your nearest Service Canada office (see Returning the Form).
- Application For Disability Benefits
- Questionnaire for Disability Benefits
- Consent for Service Canada to Obtain Personal Information / Physician’s copy
- Consent for Service Canada to Obtain Personal Information / Service Canada’s copy
- Medical Report
- Child Rearing Provision form
- Information sheet for the Child Rearing Provision
What happens if I die before applying for CPP disability benefits?
CPP disability benefits cannot be paid unless an application is received before the contributor dies. Surviving spouses or common-law partners and dependent children may, however, apply for a CPP death benefit, survivor’s pension, and children’s benefit.
When will my disability benefits start?
Your benefits start four months after the date you become eligible. You may be entitled to benefits dating back a maximum of one year from the date you apply.
Can I volunteer, go to school or work while receiving CPP disability benefits?
Yes. You can:
- volunteer or attend school, participate in training or upgrade your skills without affecting your CPP disability benefits;
- work – you can earn up to a limited dollar amount without having to report these earnings to the CPP. To verify what amount CPP has designated as a limit on an annual basis, please contact them directly.
Do my CPP benefits affect the amount I receive from Great-West Life's disability programs?
Yes, they will. If you receive disability payments covering the same period of time from both the CPP and the Short-term and/or Long-term disability program, you may be asked to pay back some or all of your CPP disability benefits to the Great-West Life disability office.
If you have questions about how your CPP benefits might affect other benefits you are receiving, you should contact the disability office of Great-West Life at 604-455-2700 or 1-877-262-0749.
Are my CPP payments taxable?
Yes. CPP payments are taxable income. If you wish, Social Development Canada can deduct income tax each month. If you do not request monthly tax deductions, you may have to pay income tax in quarterly instalments. For more information, contact the tax services office of the Canada Revenue Agency at www.cra.gc.ca.
Retirement
All about Retirement
Retiree benefits are available to plan members aged 55+ and leaving employment permanently (retirement):
Dental: Single, Couple, or Family coverage
Extended Health: Single, Couple, or Family coverage
The cost is calculated to equal the employer and employee premiums plus a $3.00 monthly administration fee.
- No upper age limit. Renewable yearly.
- No medical exam is required.
- Dental Coverage is the same as an active employee. (Please refer to the retiree booklet for details. Canada Life will pay the cost based on the provincial Dental Fee Guide)
o Preventive coverage 100% preventive covered costs with no deductible
o Maintenance coverage 100% maintenance covered costs with no deductible
o Major restorative coverage 50% of Major restorative covered costs with no deductible, $1,000 maximum limit per person in a calendar year
o Orthodontic coverage 50% orthodontic covered cost with no deductible, $3,000 maximum limit per person in a lifetime
- Extended Health Coverage is the same as an active employee except for emergency travel insurance. (Please refer to the retiree booklet for details)
o Prescription Drugs
o Hospital accommodation
o Laser eye surgery, eye examinations, prescription eyeglasses, or contact lenses
o Medical services and equipment – for additional detail, please refer to the retiree booklet
o Ambulance services
o Dental accident
|
Coverages |
Plan maximum & frequency |
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Acupuncture |
$500 per calendar year(s) |
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The following 2 coverages combine to: |
$500 per calendar year(s) |
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Athletic Therapist |
Athletic Therapist, Physiotherapy, Combine to: $500 per calendar year(s), Occupational Therapist is included. |
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Physiotherapy |
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The following 2 coverages combine to: |
$500 per calendar year(s) |
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Chiropractor |
|
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Chiropractor X-Rays |
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The following 2 coverages combine to: |
$500 per 4 calendar year(s) |
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Hearing Aid Repair or Adjustment |
Hearing Aid Repair or Adjustment, Hearing Aids, Combine to: $500 per 4 calendar year(s), Hearing aid batteries are not covered. |
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Hearing Aids |
|
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Massage Therapy |
$500 per calendar year(s) |
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Naturopath |
$500 per calendar year(s) |
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Orthopedic Shoes |
1 occurrence(s) per calendar year(s). You may be eligible for more services than those shown in your maximum. Please contact a customer service representative for assistance. |
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Orthotic Appliances |
$300 per 2 calendar year(s) |
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The following 2 coverages combine to: |
$500 per calendar year(s) |
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Osteopath |
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Osteopath X-Rays |
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The following 3 coverages combine to: |
$500 per calendar year(s) |
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Podiatrist |
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Podiatrist Surgery |
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Podiatrist X-Rays |
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The following 3 coverages combine to: |
$1,000 per calendar year(s) |
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Psychologist Office Visit |
Psychologist Office Visit, Psychologist Testing, Social Worker, Combine to: $1,000 per calendar year(s), Registered Clinical Counsellors are covered for BC residents. |
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Psychologist Testing |
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Social Worker |
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Speech Therapy |
$1,000 per calendar year(s) |
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Other Coverage |
|
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Accidental Dental |
Covered |
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Travel Assistance |
Covered |
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Employee and Family Assistance Program |
Covered |
o Out-of-Province/Country coverage is limited to $500,000.00 per covered person.
o Family and Employee Assistance Program
- You enroll and pay the Benefits Administration Office directly.
If you want to join the retiree plan, please complete the following forms.
Pension
Essential info
REGISTERED PENSION PLAN (RPP)
Policy No. 35169
Managed by Group Retirement Services (GRS), a division of Canada Life Assurance Company
GRS ACCESS LINE: 1-800-724-3402
WEBSITE: www.grsaccess.com
Note: Our Registered Pension Plan (RPP) is a separate policy from the remainder of the Canada Life benefits. Therefore, you must ensure that the appropriate documentation is completed for any pension changes. Please contact your Benefit Representative for the applicable documents. All originals are forwarded directly to the Benefit Administration Office for processing & record maintenance.
Please call the GRS ACCESS LINE directly if you have lost your PIN, user Access ID and/or Password.
| This site is for general information purposes only and is not intended to provide you with any personalized, financial, insurance, legal, accounting or tax advice. You should not rely on this site as a substitute for independent research or for personal advice from an appropriate professional advisor. |
History
- The Registered Pension Plan (RPP) began in September 1980. Purpose was to encourage and assist employees to build a supplemental retirement fund that would complement the Canada Pension Plan (CPP) and Old Age Security (OAS) programs of the federal government.
- The following rates illustrate the gradual increase to our RPP:
| Annual Reporting Period: Sept. 1 to Aug. 31 | EMPLOYER MATCHED CONTRIBUTION (Current Definitions) | ||||
| New & Current Employees | New & Current Employees | In the 15th Year of Service | In the 20th Year of Service | In the 25th Year of Service | |
| 1980-1984 | 1.50% | 1.50% | |||
| 1984-1986 | 2.00% | 2.00% | |||
| 1986-1988 | 2.50% | 2.50% | |||
| September 1988 – Approved CISVA (Teacher) Compensation Package Introduces the “Grandfathered” Contribution tier? | Grandfathered Tier | ||||
| 1988-1991 | 3.00% | 3.00% | 5.00% | ||
| 1991-1993 | 3.50% | 3.50% | 5.50% | ||
| 1993-1999 | 4.00% | 4.00% | 6.00% | ||
| 1999-2000 | 4.50% | 4.50% | 6.50% | ||
| 2000-2001 | 5.00% | 5.00% | 7.00% | ||
| 2001-2002 | 5.50% | 5.50% | 7.50% | ||
| 2002-2003 | 6.00% | 6.00% | 8.00% | ||
| September 2003 – Approved CISVA (Teacher) Compensation Package recognizes Employee’s in the 21st year of service. New contribution tier is introduced accordingly. | |||||
| 2003-2005 | 3.00% | 6.50% | 7.00% | 9.00% | |
| 2005-2009 | 3.00% | 7.00% | 8.00% | 9.00% | |
| September 2009 – Approved CISVA (Teacher) Compensation Package amends contribution requirement from “in the 21st year of service” to “in the 20th year of service.” | |||||
| 2009-2010 | 3.00% | 7.00% | 8.00% | 9.00% | |
| September 2010 – Approved CISVA (Teacher) Compensation Package dissolves “Grandfathered” tier and establishes new, “in the 25th year of service” category. | |||||
| 2010-2011 | 3.00% | 7.00% | 8.00% | 9.00% | |
| September 2011 – Approved CISVA (Teacher) Compensation Package recognizes Employee’s in the 15th year of service. New contribution tier is introduced accordingly. | |||||
| 2011-2012 | 3.00% | 7.00% | 7.50% | 8.00% | 9.00% |
| 2012-2013 | 3.00% | 7.00% | 7.50% | 8.00% | 9.00% |
| September 2016 – New contribution tier is introduced accordingly | |||||
| 2016-2017 | 3.00% | 7.00% | 8.00% | 9.00% | 9.00% |
Who is eligible to participate in the Registered Pension Plan
If you are a permanent full-time or part-time employee, working a minimum 20-hour work-week, you may join the Registered Pension Plan (RPP) as of your first day of employment. For those individuals who are required to satisfy a probation period, you may join the RPP on the first day after you satisfy your probation period.
If you are a permanent part-time employee working less than 20 hours a week, you may join the RPP on the first day after you complete two years of continuous employment with your employer, provided you have earned 35% of the Year’s Maximum Pensionable Earnings (YMPE) in each of the two consecutive years.
The following eligible Benefit Classes allow for participation in the RPP:
- Benefit Class 1: Permanent FT/PT Employees
- Benefit Class 2: One Year – Contract
- Benefit Class 4: Priests (Prince George and Kamloops only)
- Benefit Class 100: Pension only
Current Contributions Levels
The following contributions are available to CISVA employees:
Contribution levels are based on the following percentages of gross annual earnings:
- 3% – new or existing employees
- 7% – new or existing employees
- 8% – employees in their 15th year of service
- 9% – employees in their 20th year of service
- Archdiocese of Vancouver
- Catholic Independent Schools of Vancouver Archdiocese
- Catholic Independent Schools of Kamloops Diocese
- Catholic Independent Schools of Prince George
- Diocese of Kamloops
- Diocese of Prince George
What is the maximum that someone can contribute to the Registered Pension Plan?
The total of all employer and employee contributions (including Voluntary RPP contributions) to an RPP are limited to the lesser of the current year’s contribution limit (as set by Revenue Canada) and 18% of the employee’s pensionable earnings for the year.
Note: for 2023, Revenue Canada has set the pensionable contribution limits to $30,780.
Illustration:
- Employee earns $71,407 per calendar year
- Employee contributes to the RPP at 7% which is matched by the Employer
- Therefore, total contributions to the RPP are 14% = $9,996.98 ($71,407 x 14% = $9,996.98)
- Employee is allowed to contribute 18% of their annual gross earnings
- $71,407 x 18% = $12,853.26
- $12,853.26 is the maximum the employee can contribute to the RPP for the tax year 2017
- $2,856.28 ($12,853.26 – $9,996.98 = $2,856.28) is the most that the employee could contribute to their Voluntary RPP to maximize their pensionable contributions.
Defined Contribution Plan
The Archdiocese of Vancouver, in association with Canada Life, provides a Defined Contribution Plan for our employees. A Defined Contribution Plan (also known as a money purchase plan) is similar to a Group RRSP. The employer and employee contribute to an account in the employee’s name (based on a percentage of the employee’s income) and the employee is responsible for making investment decisions with respect to their own portion of the contributions, choosing from the investment funds available within the Archdiocese of Vancouver, RPP plan.
While the value or percent of income going into a plan is known; the final benefit is not known. Retirement income from the plan is based on the total value of the accumulated employee/employer contributions and the investment income earned by the time the employee retires. The value of the plan will vary, depending on years of investment, market performance and the selected investments.
When an employee leaves the company or retires, the benefit from the plan is the balance in the employee’s account, providing that funds are fully vested.
Is it beneficial to join the Registered Pension Plan?
Saving for retirement is always a good goal, and being part of a pension plan helps you achieve that goal. Even if you don’t intend to work within the Archdiocese of Vancouver until you retire, you will never receive less than twice your contributions as a benefit while employed within our organization.
Joining your Group RPP is a great way to start and offers you advantages such as:
- Easy, convenient and disciplined with direct contributions from your paycheque. Plus, these contributions are deposited before income tax is calculated, so you get immediate tax savings.
- Very favourable investment management fees
- No fees for annual service, set-up, transfers between funds, or redemption
- A wide variety of world-class investment managers
- Flexible guaranteed compound interest accounts
- Customized member statements with personalized rate of return and Smart messages
- Freedom to change your investment instructions at any time at no cost
- Access to excellent retirement planning software
- 100% immediate return on investment due to Employer matched contributions
Is membership in the pension plan automatic?
No. It is not a condition of employment by the Archdiocese of Vancouver that an employee joins our RPP. However, you cannot opt-out once you join the pension plan. Please make an informed decision.
How can I get information about a pension plan so that I can decide whether or not I would like to join?
As a prospective employee and/or an existing employee wanting to join our RPP, the CISVA provides some tools to assist you with your decision. Within the CISVA Benefit Plan portion of our website, please refer to the following sections for an overview of our pension plan:
Registered Pension Plan
Can my pension plan have different requirements for plan membership, contributions, or plan options for men and women?
No! Sex discrimination by any RPP is prohibited by the Pension Benefits Standards Act (PBSA).
Are part-time or on-call/casual employees eligible to join the pension plan?
Permanent or part-time employees who meet the minimum eligibility requirements of working 20 hours per week may join the plan.
Casual, on-call or seasonal employees are not entitled to the pension plan.
Employees who work less than 20 hours a week may be eligible to join the RPP providing that the following criteria is met:
- An employee for whom a pension plan is maintained is, on application, eligible to become a member of the pension plan after completing 2 years of continuous employment with the employer, with earnings of not less than 35% of the Year’s Maximum Pensionable Earnings (dollar amount set by Revenue Canada) in each of 2 consecutive calendar years.
- Employees who meet this legislated criterion are placed in Benefit Class 100.
Your Rights and Obligations
Pension plans are closely regulated by federal and provincial legislation. As a member of a pension plan, you have certain legislated rights including the right to receive an annual statement from the plan and a right to examine official plan documents. Please note that under our pension plan, bi-annual statements are issued: one in September, the other in March.
You also have obligations – most importantly to inform yourself about your pension plan and the decisions you need to make as a member.
What if I go on a maternity/parental leave of absence?
To maintain your pension benefits you will be responsible for making your required contributions for each month you are on this specific type of leave. You will receive an invoice for your benefits from your immediate employer (school or Parish). If you do not receive an invoice, please contact your immediate employer to address this issue.
If you want to opt-out of the RPP while on maternity/parental leave, please ensure that a copy of your Maternity Contract is forwarded to the Benefit Administration Office. For audit purposes, you will need to complete the Pension waiver on Page 2 of this contract. Please note that contributions will be reinstated once you return to active employment.
What if I’m absent from work as a result of a disability (STD, LTD or WCB)?
If you are temporarily away from work as a result of a disability (Short-term disability, Long-term disability or Worker’s Compensation), you are unable to participate in the employer-matched portion of the pension plan. Contributions will cease as of the first day following the month of disability. Voluntary pension contributions may continue during the period of your disability.
Contributions will be reinstated once you return to your pre-disability employment status.
What happens when I return from a leave of absence or lay-off?
Upon return to active employment, please advise your Benefit Representative accordingly and your benefits will be automatically reinstated and deductions will resume as normal. It is imperative that you check your pay stub to ensure your required pension contributions have been deducted. If the contributions have not been deducted, please advise your employer immediately.
Can I retire before age 65?
Yes. You are entitled to start receiving early retirement benefits as soon as the age of 55 and have been a member of the plan for at least two years. The amount you receive each month, however, may be reduced to compensate for the fact you will likely receive pension payments for a longer period.
Can i keep working and contributing past normal retirement age?
Yes, you may continue working if your employer permits you to do so. If you continue working, you will continue to earn pension benefits. Your pension payments must commence no later than the end of the calendar year in which you turn 71.
What does "locked-in" mean?
Vested pension benefits, resulting from contributions made to the pension plan after 1992, may not be withdrawn as a lump sum, and must be used to provide retirement income.
When are my pension benefits vested?
Legislation requires that pension benefits become vested once the member has completed two years of continuous plan membership. Once vested, the member is vested for all periods of plan membership without regard to whether the contributions or periods of employment were before or after January 1, 1993.
Automatic vesting after September 30, 2015.
What are my options if my membership in the plan terminates?
You may leave the benefits in your employer’s pension plan, and start receiving the pension once you get to the age at which you are eligible to commence receiving payments. This option is valuable as it may allow you to participate in future benefit improvements under the plan.
If you quit or lose your job before your pension is vested, you can get back any money you paid into the plan, with interest. You may not be entitled to money your employer has paid into the plan on your behalf.
If, however, you quit or lose your job after your pension is vested you have the option to transfer the value of your vested entitlement out of the pension plan. If you opt to transfer your benefits out of the plan, you can transfer them to your new employer’s plan, as long as your new employer’s plan will accept the transfer. You also have the option to transfer the value of your benefits to a locked-in RRSP, to a life income fund (a “LIF”), or to an insurance company to buy an annuity.
The portion of the benefits resulting from employment before 1993 may be received in a lump sum, by a terminating plan member, if the pension plan does not require that these be locked-in.
If I transfer my benefits out of the pension plan how long do they remain locked-in?
Your benefits will always be locked-in, meaning that the money must only be used for the purposes of providing a stream of retirement income.
If I transfer benefits out of the pension plan, when can I start receiving monthly payments?
If you transfer the money to a locked-in RRSP, in order to start receiving payments it must be further transferred to a life income fund (a “LIF”), used to purchase an annuity, or transferred to another pension plan. In the case of a LIF and an annuity, the payments can start when you reach the age at which you could have started receiving payments under the pension plan the money was transferred out of (age 55 under most plans). If you transfer the money to another pension plan the money becomes subject to the provisions of the new plan.
Management Fees
The Investment Management Fee (IMF) that Canada Life charges the Pension Plan for the default Continuum TDF (current default) and Continuum Target Risk Fund (previous default, but still on our list of offerings) is 0.45%. In addition, there is a small amount for expenses, bringing up the total IMFOE (Investment Management Fee & Operating Expense) to 0.49%, still way below the management fees of retail providers like banks, credit unions, and finance companies, etc.
My spouse and I are separated. Is he/she entitled to any of my pension benefits?
Pensions are a “family asset” under the province’s Family Relations Act. The division of family assets, including pension credits, comes under that legislation. Part 6 of the Family Relations Act provides detailed procedures for valuing and dividing a pension after a marriage breakdown.
Dental
Essential info
Essential info
Insured with Canada Life Assurance Company Policy No. 56565 – Division 10 Toll-free number: 1-800-957-9777 (Select prompt 1 for language preference = English) (Select prompt 3 for benefit selection = Dental inquires)| This site is for general information purposes only and is not intended to provide you with any personalized financial, insurance, legal, accounting, tax, medical or other professional advice. You cannot rely on this site as a substitute for independent research or personal advice from a representative of the CISVA or any other appropriate professional or medical advisor. You must contact Canada Life directly to confirm eligibility for any eligible benefits under the Dental Plan. |
General
General
- Which employees are eligible for coverage under the CISVA, Dental Plan?
- Basic information about the Dental Plan
- How much of our dental costs are paid by our plan?
- Pre-authorizations
- What general expenses are covered in our Dental Plan?
- Dentists can charge anything they want!
- What is the coordination of benefits?
Which employees are eligible for coverage under the CISVA, Dentalcare Plan?
The eligibility requirements are as follows as defined in our Group Policy Contract:
- You must be an Insurable Employee 2. You must be Actively at Work 3. You must be in the appropriate Benefit Class
Please refer to the Definitions and General Terms section of your benefit booklet for further clarification. Further details on the Benefits Class structure can be found on the CISVA website: CISVA Benefit Plan Overview / Basic Elements of Our Plan
Basic information about the dental plan
Dental Care coverage pays for eligible expenses that you incur for dental procedures provided by a licensed dentist, denturist, dental hygienist and anaesthetist while this group plan covers you. For each dental procedure, we will only cover reasonable expenses. We will not cover more than the fee stated in the current Dental Association Fee Guide for general practitioners in the employee’s province of residence on the date that the treatment is received.
Payments will be based on the current guide at the time the treatment is received. If services are provided by a board qualified specialist in endodontics, prosthodontics, oral surgery, periodontics, paedodontics or orthodontics whose dental practice is limited to that speciality, then the fee guide used will be the specialist’s fee guide as set by the applicable governing authority.
The dental benefit year is from January 1 to December 31.
How much of our dental costs are paid by our plan?
There is no deductible for covered dental costs.
| Plan A: Basic treatment | 100% coverage of dental fee guide No annual limit |
| Plan B: Major treatment | 50% coverage of dental fee guide $1000 per person, per calendar year maximum |
| Plan C: Orthodontia | 50% coverage of dental fee guide $3,000 lifetime maximum per insured person (Coverage is available for both adults & children) |
Pre-authorizations are recommended for anything over $500.00
Pre-authorizations
Pre-authorization is required for dental claims estimated to cost $500 or more. If you or a dependent requires dental treatment that the dentist estimates will cost $500 or more, a Pre-Treatment description (including x-rays) and fee estimate must be obtained from the dentist and submitted to Canada Life directly for approval before treatment is commenced. If the treatment program is approved, you will be notified, and reimbursement will be based on the applicable fee guide.
It is strongly recommended to obtain a preauthorization with regards to extensive dental procedures performed. This is to prevent unexpected costs.
What general expenses are covered in our Dentalcare plan?
Please refer to the Booklets section of the CISVA website. The available booklets are reflective of the appropriate Benefit Class that pertains to you. Dental benefits are detailed according to your class status. Please ensure that you are referring to the correct benefit booklet.
Dentists can charge anything they want!
The Fee Guide forms the basis of what insurance companies will pay for dental treatments. The Fee Guide is only a guide for what dentists may charge for any particular treatment. Dentists may set their own fees. Specialists usually charge higher fees than those in the Fee Guide.
For more detailed information on the Fee Guide, please contact the BC Dental Association (www.bcdental.org).
What is the coordination of benefits?
If you or your dependents are covered under more than one benefit plan (for example, your spouse’s plan), you can claim up to 100% of an eligible expense (as per the dental fee guide) by coordinating your benefits under both plans. Here’s how:
- The plan that covers you as a plan member pays first. Then, the plan that covers you as a dependent pays any remaining eligible balance. Your spouse’s claims should go to his or her plan first, and then any remaining balance should be sent to your plan.
- Dependent children are covered first by the plan of the parent whose birthday falls earlier in the calendar year. In other words, if your birthday falls in January and your spouse’s birthday is in March, you should submit your children’s claims to your plan first.
Your first benefit plan will send you an explanation of how much of your claim has been covered. You will need to send that explanation, along with copies of your expense receipts, to the second benefit plan to claim any remaining balance that’s eligible.
Is oral pathology covered under dental?
Yes. Oral pathology is the specialty of dentistry concerned with a wide range of abnormalities and diseases. An oral pathologist is therefore concerned not so much with the teeth as with diagnosis, treatment, and study of disorders of the mouth, jaw, and soft tissues.
Orthodontic Services
Orthodontic Services
Orthodontic Services will be reimbursed at 50% of the cost with a lifetime maximum benefit of $3,000 per person. Coverage for ongoing treatment requires that the member continues to be eligible for benefits and that a dependent continues to meet the definition of a dependent as outlined in the Definitions section of your benefit booklet. At the start of the orthodontic treatment, the dentist or orthodontist will prepare a written outline of the proposed treatment. This is called a treatment plan. The treatment plan will outline the amount of your initial deposit plus your pro-rated monthly fees. Canada Life must have a copy of this in the patient’s file before they can reimburse for orthodontic claims.| IMPORTANT: if you wanted to pay for the entire cost of the orthodontic treatment, outright, Canada Life would not reimburse you for the entirety of the orthodontic expenses. Orthodontia is regarded as an ongoing treatment (claim); therefore; you cannot be reimbursed for a service that is not yet fully completed. |
- The member’s plan and ID numbers
- Patient’s full name
- Patient’s birth date
- Information on coverage under any other dental care plans. Refer to the narrative on the coordination of benefits (COB).
Claim submissions
Claim submissions
- Where do I mail my claims to?
- Where can I get blank claim forms?
- Is there a claiming deadline for submitting my claims?
- What can I do if I disagree with the amounts paid for my claims, or some claims are declined?
Where do I mail my claims to? Most general practitioners provide a service to their patients by submitting any incurred dental claims electronically to Canada Life for assessment. In such cases, you don’t need to concern yourself with submitting a paper claim. However, this is a service that is provided to you; your dentist is not obligated to submit your claim electronically. It is your responsibility to verify if this service is provided to you by your dentist. IMPORTANT: dental specialists (i.e., endodontists, prosthodontists, oral surgeons, periodontists, paedodontists or orthodontists) rarely ever submit incurred dental claims electronically to Canada Life. The reason is typical because when you receive services rendered by one of these professionals, it is generally to satisfy an immediate dental need. You would not be considered a long-term, ongoing, regular patient; therefore, the service of submitting claims electronically is typically not offered. Under these circumstances, please submit your dental claim to the following address:
| Send to: Canada Life Assurance Co. PO Box 3050 Station Main Winnipeg, MB R3C 0E6 |
- On the CISVA website, refer to the Claim forms/Dental Plan section. This document already includes the plan name, plan number and division number.
- Select Dental
- Open the document and complete accordingly
- Log onto the Canada Life GroupNet for Members: http://groupnet.greatwestlife.com.
- If you have not already done so, please register yourself as a new user.
- Select Form & Cards from the toolbar
- Double-click on Claim forms. The claim form is pre-populated; therefore, all of your personal information will automatically download onto your claim form.
- Log onto Canada Life’s website: www.greatwestlife.com.
- On the left side of the page, refer to Clients & Plan Members.
- Select Client Services
- Select GO under A group benefits plan member?
- Select Forms from Basic Forms & Resources
- Double-click on the first bullet called, Standard claim forms
- Select the second bullet called, Dentalcare Claim Form (M445D)
- Complete the form accordingly
- On the left side of the page, refer to Clients & Plan Members.
What is Member Portal?(Accessing your benefits any time)
What is Member Portal? (Accessing your benefits any time)
Access for your group benefits information has never been easier with Canada Life’s GroupNet for Plan Members (aka Member Portal). Register once and you’ll connect to a world of secure, user-friendly services – available online, any time! Available features are as follows:- Sign up for direct deposit claim payments – claim paid directly into your bank account.
- Access expanded coverage information quickly and easily.
- View your claim status and Explanation of Benefits for the past 24 months
- Check your Extended Healthcare balance and the date that you would next be eligible for a particular benefit.
- Check when you’re covered for new glasses or contacts.
- Complete and print personalized claim forms
- Access the Health & Wellness Site that includes:
- In-depth information on diseases, conditions, drugs and treatment options
- Interactive health and wellness tools, including the Personal Health Risk Assessment
- visit http://groupnet.greatwestlife.com
- have the following information ready:
- Plan number (No. 335645) and your employee Identification number (available on the front of your last benefit statement or your wallet certificate – little green card)
Extended Health Care
Essential info
Insured with Canada Life Assurance Company
Policy No. 335645 – Division 10
Toll-free number: 1-800-957-9777
(Select prompt 1 for language preference = English)
(Select prompt 4 for benefit selection = Extended Health inquires)
| This site is for general information purposes only and is not intended to provide you with any personalized financial, insurance, legal, accounting, tax, medical or other professional advice. You cannot rely on this site as a substitute for independent research or personal advice from a representative of the CISVA or any other appropriate professional or medical advisor. You must contact Canada Life directly to confirm eligibility for any eligible benefits under the Extended Healthcare Policy. (Sept. 26/07) |
General
Which employees are eligible for coverage under the CISVA, Extended Healthcare Plan? The eligibility requirements are as follows as defined in our Group Policy Contract:
1. You must be an Insurable Employee 2. You must be Actively at Work 3. You must be in the appropriate Benefit ClassPlease refer to the Definitions and General Terms section of your benefit booklet for further clarification. Further details on the Benefits Class structure can be found on the CISVA website: CISVA Benefit Plan Overview / Basic Elements of Our Plan. What general expenses are covered in our Extended Health plan? Please refer to the Booklets section of the CISVA website. The available booklets are reflective of the appropriate Benefit Class that pertains to you. Extended Healthcare benefits are detailed according to your class status. Please ensure that you are referring to the correct benefit booklet. How much of our health costs are paid by our plan? In-Canada expenses = 80% of eligible expenses, up to any benefit plan maximums. There is a $25.00 annual employee/family deductible that must be satisfied before reimbursement. Out-of-Country, unforeseen expenses = 100% of eligible expenses up to the specified benefit plan maximum that is reflective of your benefit class. The annual deductible is not applied to any Out-of-Country expenses. Please refer to your benefit booklet for any annual maximums that may apply for a particular benefit. If there is no financial limit set on a particular benefit, then Canada Life will reimburse eligible expenses up to the reasonable & customary charge. What are Reasonable & Customary (R&C) charges? Most benefit plans include coverage for Reasonable and Customary charges for dental and medical services. Generally, this is the lowest of the following:
- Representative pricing in the area where the treatment is provided.
- Prices are shown in the applicable professional association fee guide and the maximum prices established by law.
Drugs
How do I know if our plan covers a prescription from my doctor?
There is provision for various prescription drugs which legally require a prescription when prescribed by a physician, dentist, Nurse Practitioner or Pharmacist. The legally prescribed drug(s) must have a Drug Identification Number (DIN).
Prescribed drugs purchased over-the-counter are not eligible for reimbursement!
IMPORTANT: Please contact Canada Life directly to confirm if coverage is available for your legally prescribed drug.
Prior Authorization Drugs
Certain prescription drug claims need to be approved by Canada Life before they can be considered for reimbursement. The Prior Authorization process helps Great-Wets Life ensure that appropriate drug coverage is provided, and that prescribed drugs are considered a reasonable treatment for your condition.
If you want to be considered for coverage for one of the drugs listed below, you must contact Canada Life and request the Request for Information form for the appropriate drug. Send the form to Canada Life before, or along with, your first claim for the drug to be reviewed.
Where do I submit my eligible prescription drug claims?
Assure will process all eligible prescription drug claims.
The Assure Card is an electronic payment system that provides on-the-spot claims submission of prescription drug claims at almost any pharmacy in Canada. It’s a convenient, easy-to-use alternative to submitting claim forms. Plan members continue to pay 100% of the drug costs upfront; however, you present your Assure Card when having prescriptions filled. The pharmacist uses the card to confirm eligibility, drug coverage and remit your eligible drug claim directly to Assure for processing.
If/when a manual claim is required, please complete the attached claim form. Please note that you continue to use the same policy number (335645) and 9-digit identification number as your other extended health claims.
All other extended health claims will continue to be assessed directly by GWL.
| • Alertec/Xyrem | • Amevive/Raptiva |
| • Botox/Myobloc | • Cerezyme |
| • Enbrel | • Flolan/Remodulin/Revatio/Tracleer/Thelin |
| • Fludara/Fludarabine | • Forteo |
| • Gleevec | • Growth Hormones (Humatrope/Nutropin/Genotropin/Protropin/Saizen) |
| • Herceptin | • Humira |
| • Iressa | • Kineret/Orencia |
| • Myozyme | • Oncology drugs (Avastin/Erbitux/Camptosar/Irinotecan Hydrochloride/Velcade/Taxotere/Alimta/Mabcampath/Nexavar/Abraxane/Femara/ Sprycel/Sutent/Temodal) |
| • Pulmozyme | • Remicade |
| • Replagal/Fabrazyme | • Rituxan |
| • Sativex | • Sensipar |
| • Serostim | • Somavert |
| • Tarceva | • Thyrogen |
| • Tysabri | • Xolair |
| • Zavesca | |
Medical Equiptment & Out-of-Control Coverage
Pre-determination of Benefits:
There are times in which you may be in a position which requires you to purchase an expensive item – i.e., a wheelchair, CPAP machine, prosthetic devices, etc. For items over $500, Canada Life may coordinate your claim directly with the service provider. For this to be accomplished, a pre-determination of benefits (pre-authorization) must be established.
This is a process that occurs before any services are performed, in which the provider outlines a proposed course of treatment and estimated costs. Canada Life will then specify the dollar amount and services that would be considered, if covered, by the CISVA Extended Healthcare plan. Canada Life requires the following information when submitting a pre-determination of benefits:
- letter from the doctor outlining diagnosis & prognosis, confirming necessity for the specified equipment;
- estimate from the service provider detailing the required equipment and applicable costs;
- a note from yourself (the employee) confirming and authorizing Canada Life to coordinate the claim directly with the service provider; therefore, reimbursing them directly;
- Extended Health claim form must be attached. Please indicate that this is a pre-determination which is why there will not be a purchase date on the invoice.
- Alopecia Totalis
- Alopecia – areata, congenitalis, leprotica, medicamentosa, neurotica, scarring alopecia
- Burns
- Cancer – chemotherapy
- Lupus
- Psuedopelade Broque – form of Alopecia Areata
- Scleroderma
Paramedicals(Physiotherapy, Massage therapy, etc...)
Overview & financial benefit breakdown
Where provincial registration exists, the paramedical practitioner must be registered in the province where the service is given. If the practitioner is not registered with the applicable governing authority, then your claim will be rejected accordingly.
For your reference, we have included the applicable breakdown of expenses per covered benefit as confirmed by Canada Life (as of November 23, 2020). Please note that eligible expenses are not to exceed the maximum payable amount listed within the Calendar Year Maximum.
|
Paramedical Practitioner |
BC Reasonable & Customary per Hour charges |
SK Reasonable & Customary per Hour charges |
Year Max (per covered person) |
|
Acupuncturist |
$95 |
$75 |
$500 |
|
Chiropodist or Podiatrist |
$110 |
$85 |
$500 |
|
$110 |
$85 |
||
|
Podiatrist Surgery |
$500 |
$500 |
$500 |
|
Chiropractor |
$65 |
$55 |
$500 |
|
Massage Therapy |
$121 |
$89 |
$500 |
|
Naturopath |
$165 |
$160 |
$500 |
|
Osteopath |
$130 |
$125 |
$500 |
|
Physiotherapy or Occupational Therapist |
$95 $75 |
$90 $75 |
$500 |
|
Psychologist or Registered Clinical Counsellor |
$200 |
$180 |
$1000 |
|
$195 |
N/A |
||
|
Speech Therapy |
$150 |
$128 |
$1000 |
Resource information for confirming Paramedical practitioner’s designations Physiotherapy Association of BC Phone: (604) 736-5130 Fax: (604) 736-5606 www.bcphysio.org
Massage Therapists Association of BC Phone: (604) 873-4467 Fax: (604) 873-6211 www.massagetherapy.bc.ca
College of Psychologists of BC Phone: (604) 736-6164 www.collegeofpsychologists.bc.ca
College of Naturopathic Physicians of BC Phone: (604) 688-8236 www.cnpbc.bc.ca
BC Chiropractic Association and BC College of Chiropractors Phone: (604) 270-1332 Fax: (604) 278-0093 www.bcchiro.com
British Columbia Association of Speech-Language Pathologist & Audiologist Phone: (604) 420-2222 Fax: (604) 736-5606 www.bcaslpa.ca
College of Traditional Chinese Medicine Practitioners and Acupuncturists of BC Phone: (604) 738-7100 Fax: (604) 738-7171 www.ctcma.bc.ca
Is a referral from a doctor required for the use of physiotherapy, massage, acupuncture, etc., treatments?
If you are a resident of British Columbia, no, you do not require a referral from your doctor. The doctor’s referral was a requirement that had to be met for MSP as they had previously covered a portion of the user fees. However, since MSP no longer covers these expenses, Canada Life has not enforced this requirement to supply a referral from your doctor (again, providing that you are a BC resident).
Please note that the invoice provided by your paramedical practitioner’s office must indicate the following:
- The name of the claimant
- Date the service was rendered and that the expense was paid in full
- The receipt must reflect the practitioner’s designation (qualification) and their registration number.
- Address of paramedical practitioner’s office
Claim submissions
Where do I mail my claims to?
Please note that you also have the option of submitting your claims electronically to GWL via GWL’s E-Claims (aka Member Portal).
Is there a claiming deadline for submitting my claims?
Yes. Canada Life must receive proof of claim no later than June 30th of the year following the date that you incurred your expense.
Example: you purchased a custom-made orthotic for yourself in August 2007. You have until June 30, 2008, for Canada Life to have received your claim.
Confirmation of this deadline will be found in the tail-end section of the Extended Healthcare portion of your benefit booklet under the section entitled, Submitting a claim.
Can my claims be sent directly to Canada Life Assurance?
Generally, the answer is no. Our Extended Healthcare plan has been created as a reimbursement policy only. Therefore, you pay the initial expense upfront, and Canada Life will assess your claim accordingly.
In those cases where a pre-determination has been submitted and approved by Canada Life in advance, then your service provider can coordinate payment directly with Canada Life on your behalf.
Where can I get blank claim forms?
The following 3 methods are ways in which you can obtain a Healthcare Expense Statement claim form:
| Send to: Canada Life Assurance Co. PO Box 3050 Station Main Winnipeg, MB R3C 0E6 |
- On the CISVA website, refer to the Forms / Claim forms section. This document already includes the plan name, plan number and division number.
- Select Claim Forms/Extended Health Care
- Open the document and complete accordingly
- Log onto the Canada Life GroupNet for Members: http://groupnet.greatwestlife.com.
- If you have not already done so, please register yourself as a new user.
- Select Form & Cards from the toolbar
- Double-click on Claim forms. The claim form is pre-populated; therefore, all of your personal information will automatically download onto your claim form.
- Log onto Canada Life’s website: www.greatwestlife.com.
- On the left side of the page, refer to Clients & Plan Members.
- Select Client Services
- Select GO under A group benefits plan member?
- Select Forms from Basic Forms & Resources
- Double-click on the first bullet called, Standard claim forms
- Select the second bullet called Healthcare Claim Form (M635D)
- Complete the form accordingly
- On the left side of the page, refer to Clients & Plan Members.
What is Member Portal?(Accessing your benefits any time)
Access for your group benefits information has never been easier with Canada Life’s GroupNet for Plan Members (aka Member Portal).
Register once and you’ll connect to a world of secure, user-friendly services – available online, any time! Available features are as follows:
- Sign up for direct deposit claim payments – claim paid directly into your bank account.
- Access expanded coverage information quickly and easily.
- View your claim status and Explanation of Benefits for the past 24 months
- Check your Extended Healthcare balance and the date that you would next be eligible for a particular benefit.
- Check when you’re covered for new glasses or contacts.
- Complete and print personalized claim forms
- Access the Health & Wellness Site that includes:
- In-depth information on diseases, conditions, drugs and treatment options
- Interactive health and wellness tools, including the Personal Health Risk Assessment
- visit http://groupnet.greatwestlife.com
- have the following information ready:
- Plan number (No. 335645) and your employee Identification number (available on the front of your last benefit statement or your wallet certificate – little green card)
- Your date of birth
- Date of birth of one of your dependents (if applicable)
- Your postal code
- Your e-mail address
- follow the registration instructions to choose your own user name and password (do not include your middle name)
Late Application
Essential info
Insured with Canada Life Assurance Company
Policy No. 335645 – Division 10
Toll-free number: 1-800-957-9777
(Select prompt 1 for language preference = English)
(Select prompt 4 for benefit selection = Extended Health inquires)
| This site is for general information purposes only and is not intended to provide you with any personalized financial, insurance, legal, accounting, tax, medical or other professional advice. You cannot rely on this site as a substitute for independent research or personal advice from a representative of the CISVA or any other appropriate professional or medical advisor. You must contact Canada Life directly to confirm eligibility for any eligible benefits under the Extended Healthcare Policy. (Sept. 26/07) |
General
Which employees are eligible for coverage under the CISVA, Extended Healthcare Plan?
The eligibility requirements are as follows as defined in our Group Policy Contract:
1. You must be an Insurable Employee 2. You must be Actively at Work 3. You must be in the appropriate Benefit ClassPlease refer to the Definitions and General Terms section of your benefit booklet for further clarification. Further details on the Benefits Class structure can be found on the CISVA website: CISVA Benefit Plan Overview / Basic Elements of Our Plan. What general expenses are covered in our Extended Health plan? Please refer to the Booklets section of the CISVA website. The available booklets are reflective of the appropriate Benefit Class that pertains to you. Extended Healthcare benefits are detailed according to your class status. Please ensure that you are referring to the correct benefit booklet. How much of our health costs are paid by our plan? In-Canada expenses = 80% of eligible expenses, up to any benefit plan maximums. There is a $25.00 annual employee/family deductible that must be satisfied before reimbursement. Out-of-Country, unforeseen expenses = 100% of eligible expenses up to the specified benefit plan maximum that is reflective of your benefit class. The annual deductible is not applied to any Out-of-Country expenses. Please refer to your benefit booklet for any annual maximums that may apply for a particular benefit. If there is no financial limit set on a particular benefit, then Canada Life will reimburse eligible expenses up to the reasonable & customary charge. What are Reasonable & Customary (R&C) charges? Most benefit plans include coverage for Reasonable and Customary charges for dental and medical services. Generally, this is the lowest of the following:
- Representative pricing in the area where the treatment is provided.
- Prices are shown in the applicable professional association fee guide and the maximum prices established by law.
What is a Late Application?
Some employees with extended health and dental coverage can waive their coverage through us.
They cannot automatically join the plan if they are not losing the coverage but can join the extended health and dental plan as late applicants.
The approval is not automatic and is based on the employee and their dependents’ medical insurability.
What are the required forms?
As a Late Applicant, you must complete the following forms:
The employer or employee must submit the completed, signed forms to the Benefits Administration Office.
DO NOT send the forms directly to Canada Life.
Limitations and Restrictions
Dental coverage for an approved late applicant will be limited.
- Once approved, the employee and dependents have limited coverage of $250 for the first 12 months after the approval date.
- Approval for extended health coverage is not guaranteed.
- Canada Life will approve the application based on the employee and the dependents’ medical insurability.