Retired part-time employee benefits

The eligibility requirements for retiree optional extended life insurance, supplementary health and dental coverage are:

• Age 55 or older
• Held a continuing part-time position
• Have had part-time group insurance coverage for 10 continuous years prior to their date of retirement and
• Retired prior to July 1, 2004

Supplementary health and dental coverage is also provided to a retired staff member's spouse and unmarried dependent children, who normally reside with the retired staff member at his/her regular residence. Temporary absences to attend school will not make the dependents ineligible.

Dependents:

• Staff member's legal spouse, common-law spouse, or same-sex partner (common-law spouse or same-sex partner means an individual who has been residing with the staff member in a conjugal relationship for a period of not less than one year).
• Any unmarried natural child, adopted child or stepchild of the staff member or the insured spouse.
• Any child for whom the staff member or the insured spouse has been appointed legal guardian by a court of competent jurisdiction. Satisfactory proof of such guardianship must be provided to the insurer:
  • From birth but under 18 years of age
  • Up to 25 years of age, if a full-time student at a school, college or university
  • 18 years of age or over if incapacitated for a continuous period beginning before age 18, or while a full-time student and before age 25

Coverage

As an eligible retiring staff member, you may purchase optional extended life insurance up to an amount equivalent to your life insurance coverage in effect as of the date immediately preceding your retirement, rounded to the nearest unit. The amount of coverage in effect includes your basic life coverage (one times your salary) and any optional life coverage you may have elected.

At retirement, your basic life coverage is converted into units and rounded to the nearest unit. Your optional life coverage is equivalent to the number of units of optional life in effect as of your date of retirement. The total of your basic life and optional life units is then multiplied by the dollar value of one unit of optional life insurance as of your date of retirement. The resulting amount is the amount of your optional extended life insurance.

Example: Prior to retirement, if you were insured for:

1. One times your pre-retirement salary of $45,000, which the University of Manitoba paid for on your behalf; and
2. Ten units of optional life insurance which you paid for.

If you retire on April 1, 2004, at retirement, you may elect to continue your insurance up to an amount equivalent to the sum of:

1. One times your salary of $45,000. Your pre-retirement salary is converted to units and rounded to the nearest complete unit in effect at the date of retirement. In this example, on your retirement (April 1, 2004), the value of a unit was $10,290. Therefore, the number of units you would be insured for if you retired on April 1, 2004, would be equal to 4 ($45,000 ÷ $10,290).
2. Up to ten units of optional life insurance.

Under this scenario, the maximum number of units you could be insured for would be equal to fourteen, which is equivalent to $144,060 of insurance. Provided you continue to remit premiums, this amount of insurance will remain in effect until you reach age 71.

Benefit termination

Optional extended insurance terminates on the first day of the month before your 71st birthday.

Payment of premiums

Currently, there are two methods by which retirees can submit payment for required Optional Life premiums.

Retirees who retired prior to July 1, 2004 and who are in receipt of an annuity from the University of Manitoba can elect to have the required Optional Life premiums deducted directly from their annuity payments each month.

For those members retiring after July 1, 2004 or those retirees not in receipt of an annuity from the University, payment of Optional Life premiums will be via pre-authorized automated withdrawal (direct debit) from your Canadian bank account.

Beneficiary designations

Your designated beneficiary under the Optional Extended Life plan on the date of retirement will remain in force until you complete and file the required form to change your beneficiary. File your completed form with the Staff Benefits Office.

Your beneficiary designation can be changed at a later date subject to legal restrictions. It is important that the beneficiary designation be updated to reflect changes in personal circumstances.

The Supplementary Health Plan provides coverage for covered expenses, which are not insured by the Manitoba Health Services Commission (MHSC).

• Reimbursement for covered services incurred outside of Manitoba is provided on the basis that the staff member has maintained coverage under MHSC, whether or not such coverage has been maintained.
• There is a $17,500 lifetime maximum for covered expenses excluding hospital and ambulance.

Benefits include:

• Semi-private hospital, no deductible, 70 per cent coverage.
• Medically necessary emergency ambulance service, no deductible, 70 per cent coverage.
• Prescription drugs are covered by the Prescription Drug Cost Assistance Act of Manitoba (Manitoba Pharmacare program). There is a $150 deductible with a 40 per cent reimbursement up to $1,000 and 70 per cent reimbursement thereafter up to the lesser of your Manitoba Pharmacare deductible or $1,050.
• Medical benefits (55 per cent coinsurance up to the first $500 of expense and 70 per cent thereafter) such as:
  • Charges for services of registered graduate nurses and/or licensed practical nurses both in hospital and in the home when medically necessary and prescribed by a physician, subject to a maximum reimbursement of up to but not more than $3,500 per individual in any twelve-month period. Home Care is not covered.
  • Professional ambulance service (in excess of that covered under the Ambulance Benefit) if medically necessary and prescribed by the attending physician, to return the patient to the point of departure in Canada, including one economy airfare for the patient plus additional economy airfare for an accompanying licensed practical nurse or registered nurse (excluding a family member) and a stretcher, cast or life support medical equipment when required. It is provided, however, that no benefit shall be payable for such additional airfare expenses if the person is returning from a trip made for the purpose of undergoing medical treatment outside the area of departure.
  • Transportation charges to return a deceased insured or deceased dependant to the retired staff member's resident city, subject to reimbursement not exceeding $1,000.
  • Services of qualified and licensed physiotherapists, podiatrists, and chiropractors.
  • Rental of a wheelchair, or hospital bed.
  • Prosthesis and surgical support garments as identified in the group policy.
  • Splints, braces, crutches and casts.
  • Dental services for the treatment of a fractured jaw or of accidental injury to natural teeth within six months following the accident.
  • For insulin-dependent diabetes, diabetic equipment limited to blood glucose monitoring machines and blood-letting devices subject to reimbursement not exceeding $350 per lifetime.
  • Insulin, insulin syringes and Clinitest or similar home chemical testing supplies for diabetics (excluding supplies used with blood glucose monitoring machines).
  • Post-mastectomy external breast prostheses, one per calendar year.
  • Post-mastectomy support brassieres, one per calendar year following single mastectomy, or two per calendar year following bi-lateral mastectomy.

Out-of-county coverage

The Supplementary Health Plan specifically excludes coverage for expenses incurred outside of Canada.

Benefit termination

Supplementary Health is provided for your lifetime, provided monthly premiums are maintained.

Submitting supplementary health claims
(Canada Life - Plan Number 44870GH):

Some things to remember about submitting your claim are:

• Send in your claim to Canada Life for your Healthcare expenses.
• If your spouse has coverage, your expenses should be sent to the insurer for any additional payment.

For your spouse's claim:

• Send in your claim to your Spouse's insurer.
• Send the claim to Canada Life for any additional payment under the Supplementary Health Plan.

For dependent children:

• Health claims are processed first through the plan of the parent whose birthday is first in the calendar year.
• Other parent's plan.

Payments are based on the Manitoba Dental Association Fee Guide in effect at the time the services are provided.

Reimbursement Percentages for Covered Services:

• 50 per cent reimbursement for basic coverage
• 50 per cent reimbursement for major coverage
• 50 per cent for orthodontic procedures per eligible dependent child.

Maximums:

• The annual maximum per calendar year for Basic and Major coverage is $700.
• The lifetime maximum for orthodontic coverage per eligible dependent child is $700.

Benefit termination

Dental coverage is provided for your lifetime.

Submitting dental claims
(Blue Cross - Plan Number #67075)

Blue Cross Dental Claim forms can be obtained from the Staff Benefits Office, the Human Resources Office, or downloaded from our website.

There are parts of the form to be completed by you and your dentist. The completed form can then be sent directly to Blue Cross.

If the dental procedure is covered under the supplementary health plan with Canada Life (such as accidental injury to natural teeth), then a special Canada Life dental claim form should be obtained from the Staff Benefits Office. The form must be completed by you and your dentist, and returned to Canada Life.

Please note that the dental benefits are assignable if your dentist provides this option of payment. In this case, the insurer will pay the dentist directly for any benefit covered under the terms of the plan and you would be required to pay the balance directly to the dentist. If your dentist does not accept assignment of benefits,  you must pay your dentist, and the insurer will pay any benefits due to you.

If you have any questions about your claim please call Blue Cross at 1-204-775-0151 or 1-800-873-2583 if you are outside of Winnipeg, but within Manitoba. Please have your employee number handy.

For retiree optional extended life insurance, supplementary health, and dental coverage:

• age 55 or older, and
• held a continuing part-time position and
• have had part-time group insurance coverage for 10 continuous years prior to their date of retirement and
• retired after July 1, 2004.

Supplementary health and dental coverage are also provided to a retired staff member's spouse and unmarried dependent children, as defined, who normally reside with the retired staff member at his/her regular residence. Temporary absences to attend school will not make the dependents ineligible.

Dependents:

• Staff member's legal spouse, common-law spouse, or same-sex partner (common-law spouse or same-sex partner means the individual who has been residing with the staff member in a conjugal relationship for a period of not less than one year).
• Any unmarried natural child, adopted child or stepchild of the staff member or the insured spouse.
• Any child for whom the staff member or the insured spouse has been appointed legal guardian by a court of competent jurisdiction. Satisfactory proof of such guardianship must be provided to the insurer:
  • From birth but under 18 years of age.
  • Up to 25 years of age, if a full-time student at a school, college or university.
  • 18 years of age or over if the child is incapacitated for a continuous period beginning before age 18, or while a full-time student and before age 25.

Coverage

As an eligible retiring staff member, you may purchase Optional Extended Life Insurance up to an amount equivalent to your Life Insurance coverage in effect as of the date immediately preceding your retirement, rounded to the nearest unit. The amount of coverage in effect includes your Basic Life coverage (one times your salary) and any Optional Life coverage you may have elected.

At retirement, your basic life coverage is converted into units and rounded to the nearest unit. Your optional life coverage is equivalent to the number of units of optional life in effect as of your date of retirement. The total of your basic life and optional life units is then multiplied by the dollar value of one unit of optional life Insurance as of your date of retirement. The resulting amount is the amount of your optional extended life insurance.

Example: Prior to retirement, if you were insured for:

1. One times your pre-retirement salary of $45,000, which the University of Manitoba paid for on your behalf; and
2. Ten units of optional life insurance which you paid for.

If you retire on July 1, 2004, at retirement, you may elect to continue your insurance up to an amount equivalent to the sum of:

1. One times your salary of $45,000. Your pre-retirement salary is converted to units and rounded to the nearest complete unit in effect at the date of retirement. In this example, on your retirement (July 1, 2004), the value of a unit was $10,620. Therefore, the number of units you would be insured for if you retired on July 1, 2004 would be equal to 4 ($45,000 ÷ $10,620).
2. Up to ten units of optional life Insurance.

Under this scenario, the maximum number of units you could be insured for would be equal to fourteen, which is equivalent to $148,680 of insurance. Provided you continue to remit premiums, this amount of insurance will remain in effect until you reach age 71.

Benefit termination

Optional extended insurance terminates on the first day of the month before your 71st birthday.

Payment of premiums

Currently there are two methods by which retirees can submit payment for required Optional Life premiums.

1. Retirees who retired prior to July 1, 2004 and who are in receipt of an annuity from the University of Manitoba can elect to have the required Optional Life premiums deducted directly from their annuity payments each month.
2. For those members retiring after July 1, 2004 or those retirees not in receipt of an annuity from the university, payment of Optional Life premiums will be via pre-authorized automated withdrawal (direct debit) from your Canadian bank account.

Beneficiary designations

Your designated beneficiary under the Optional Extended Life Plan, at date of retirement will remain in force until you complete and file the required form to change your beneficiary. File your completed form with the Staff Benefits Office.

Your beneficiary designation can be changed at a later date subject to legal restrictions. It is important that the beneficiary designation be updated to reflect changes in personal circumstances.

• The Supplementary Health plan provides coverage for covered expenses, which are not insured by the Manitoba Health Services Commission (MHSC).
• Reimbursement for covered services incurred outside of Manitoba is provided on the basis that the staff member has maintained coverage under MHSC whether or not such coverage has been maintained.
• There is a $17,500 lifetime maximum for covered expenses excluding hospital and ambulance.

Benefits include:

• Semi-private hospital, no deductible, 70 per cent coverage.
• Medically necessary emergency ambulance service, no deductible, 70 per cent coverage.
• Prescription drugs that are covered by the Prescription Drug Cost Assistance Act of Manitoba (Manitoba Pharmacare program). There is a $150 deductible with a 40 per cent reimbursement up to $1,000 and 70 per cent reimbursement thereafter up to the lesser of your Manitoba Pharmacare deductible or $1,050.
• Medical benefits (55 per cent coinsurance up to the first $500 of expense and 70 per cent thereafter) such as:
  • Charges for services of registered graduate nurses and/or licensed practical nurses both in hospital and in the home when medically necessary and prescribed by a physician, subject to a maximum reimbursement of up to but not more than $3,500 per individual in any 12-month period. Home Care is not covered.
  • Professional ambulance service (in excess of that covered under the Ambulance Benefit) if medically necessary and prescribed by the attending physician, to return the patient to the point of departure in Canada, including one economy airfare for the patient plus additional economy airfare for an accompanying licensed practical nurse or registered nurse (excluding a family member) and a stretcher, cast or life support medical equipment when required. It is provided, however, that no benefit shall be payable for such additional airfare expenses if the person is returning from a trip made for the purpose of undergoing medical treatment outside the area of departure.
  • Transportation charges to return a deceased insured or deceased dependant to the retired staff member's resident city, subject to reimbursement not exceeding $1,000.
  • Services of qualified and licensed physiotherapists, podiatrists and chiropractors.
  • Rental of a wheelchair or hospital bed.
  • Prosthesis and surgical support garments as identified in the group policy.
  • Splints, braces, crutches and casts.
  • Dental services for treatment of a fractured jaw or of accidental injury to natural teeth within six months following the accident.
  • For insulin dependent diabetes, diabetic equipment limited to blood glucose monitoring machines and bloodletting devices subject to reimbursement not exceeding $350 per lifetime.  
  • Insulin, insulin syringes and Clinitest or similar home chemical testing supplies for diabetics (excluding supplies used with blood glucose monitoring machines).
  • Post-mastectomy external breast prostheses, one per calendar year.
  • Post-mastectomy support brassieres, one per calendar year following single mastectomy, or two per calendar year following bi-lateral mastectomy.

Out-of-county coverage

The Supplementary Health Plan specifically excludes coverage for expenses incurred outside of Canada.

Benefit termination

Supplementary Health is provided for your lifetime, provided monthly premiums are maintained.

Submitting supplementary health claims
(Canada Life - Plan Number 44870GH)

Some things to remember about submitting your claim are:

• Send in your claim to Canada Life (GWL) for your healthcare expenses.
• If your spouse has coverage, your expenses should be sent to the insurer for any additional payment.

For your spouse's claim:

• Send in your claim to your spouse's insurer.
• Send the claim to GWL for any additional payment under the supplementary healthcare plan.  

For dependent children:

• Health claims are processed first through the plan of the parent whose birthday is first in the calendar year.
• Other parent's plan.

Payments are based on the Manitoba Dental Association Fee Guide in effect at the time the services are provided.

Reimbursement percentages for covered services:

• 50 per cent reimbursement for basic coverage
• 50 per cent reimbursement for major coverage
• 50 per cent for Orthodontic per eligible dependent child.

Maximums:

• The annual maximum per calendar year for basic and major coverage is $700.
• The lifetime maximum for orthodontic coverage per eligible dependent child is $700.

Benefit termination

Dental coverage is provided for your lifetime, provided monthly premiums are maintained.

Submitting dental claims
(Blue Cross - Plan numbers: Full-time group #67060; Part-time group #67085)

Blue Cross Dental Claim forms can be obtained from the Staff Benefits Office, the Human Resources Office or downloaded from our website.

There are parts of the form to be completed by you and your dentist. The completed form can then be sent directly to Blue Cross.

If the dental procedure is one covered under the Supplementary Health Plan with Canada Life (such as accidental injury to natural teeth), then a special Canada Life dental claim form should be obtained from the Staff Benefits Office. The form must be completed by you and your dentist, and returned to Canada Life.

Please note that the dental benefits are assignable if your dentist provides this option of payment. In this case, the insurer will pay the dentist directly for any benefit covered under the terms of the plan and you would be required to pay the balance directly to the dentist. If your dentist does not accept assignment of benefits, you must pay your dentist, and the insurer will pay any benefits due to you.

If you have any questions about your claim, please call Blue Cross at 775-0151 or 1-800-873-2583 outside of Winnipeg, but within Manitoba. Please have your employee number handy.