| Covered Services |
5
employees minimum |
| xxx |
xxxx |
|
Prescription Drugs (100 %) with drug card
|
Unlimited coverage
|
Semi-Private Hospital (unlimited coverage)
(100%)
|
No daily maximum
|
|
Ambulance (100 %)
|
Included
|
|
Accidental Dental (100 %)
|
No maximum per year
|
|
Private Duty Nurse (R.N. & R.N.A.)(100%)
|
$10,000/year
|
|
Medical Supplies, Aids & Appliances (100%)
|
$300 per year
|
|
Specialists (100%)
|
$500 per specialist per year
|
| xxx |
xxx |
(Chiropractor, Chiropodist, Naturopath,
Osteopath, Podiatrist, Registered Massage
Therapist, Physiotherapist/Occupational
Therapist, Speech Pathologist) |
xxx |
| xxx |
xxx |
|
Psychologist (100%)
|
$500 per year
|
|
Hearing Aids (100%)
|
$500 per 3 years
|
|
Life Insurance
|
Optional
|
|
Disability Insurance
|
Optional
|
|
Emergency Travel Health Insurance (100%) |
$1,000,000 - 60 day maximum stay per trip |
| xxx |
xxx |
| Dental Coverage (no deductibles): |
xxx |
| xxx |
xxx |
| Preventative Services (80 %)
|
6 month recall examinations, cleanings, X-rays, pit
and fissure sealants.
|
| Restorative Services (80 %)
|
fillings, extractions, denture relining, rebasing and
repairs, etc.
|
| Periodontal Services (80 %)
|
Scaling
|
| Endodontic Services (80%)
|
included
|
| 12 month maximum
|
$1,500 per person per year
|
| xxx |
xxx |
| Monthly Rates per employee |
Single |
Couple |
Family |
| xxx |
$98.67* |
$197.68* |
$261.11* |
| xxxxxxxxx |
xxxxxx |
xxxxxx |
xxxxxx |
Monthly Rates per employee
for same as above coverage
with 100% reimbursement |
xxxxxxxxx |
xxxxxxxxx |
xxxxxxxxx |
| Dental Coverage |
$112.03* |
$224.39* |
$294.49* |
| xxxxxx |
xxxxxx |
|
*Vision Care Option Add: $5.80 single $11.60 couple $15.29 family
(Includes glasses, contacts and frames) |
| xxxxxx |
xxxxxx |
|
|
| xxxxxx |
xxxxxx |
