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Benefits for Research Staff Covered by
Section 45.1 of The Labour Standards Act

Introduction

This booklet contains a summary of
1. Basic Life Insurance,
2. Business Travel Accident Insurance,
3. Dental plan provisions, and
4. Formulary drug plan provisions.
These programs represent an important part of your total compensation package.
Eligibility
Research staff working at the University of Saskatchewan who do not meet the requirements for
full benefits but do meet the following eligibility requirements, which are set out in the Labour
Standards Regulations, are eligible for the coverage described in this booklet.
Qualifying Period
The initial qualifying period is 26 consecutive weeks of employment from your date of hire.
Commencement of Coverage
Your coverage begins after you have worked at least 390 hours during the initial qualifying period.
In order for coverage to begin, your grant holder must notify Human Resources once you have met
the eligibility requirements.
Please note that, notwithstanding any other plan provisions, you must be actively at work during
a month in order to be covered by the benefits plan for that month.


Summary of Benefit Coverage

Employment history:
 During the initial 26 week qualifying period: at least Benefit:
2 times annual basic earnings, adjusted to the next higher $1,000 (if not already a multiple of $1,000) subject to a maximum benefit of $500,000. 100% of Basic Dental Coverage, member only, $2,000 per person per calendar year, subject to the drug
Continuation of Coverage
Coverage under the Basic Life Insurance, Dental and Formulary Drug plans will continue while you are on:  paid vacation;  an approved leave of absence with pay; or  an approved leave of absence without pay for up to 36 months provided you pay the
Termination of Coverage
Your coverage under the Basic Life Insurance, Dental and Formulary Drug plans terminates on the earliest of the fol owing:  the date your employment terminates;  the date the policy terminates;  your retirement date;  the end of the period for which the last premium was paid;  the date you are no longer an eligible employee; or  if you are deceased.
Coverage wil also terminate during any period of lay-off or during a strike.

Cost of Coverage
Cost sharing of your benefits coverage wil remain consistent with that of the full-time group. You may be required to contribute to the cost of the plans by payrol deduction.
1. LIFE INSURANCE

Basic Life Insurance Plan
The Basic Life Insurance Plan provides a lump sum benefit to your beneficiary in the event of
Benefits
In the event of your death from any cause at any time or place while you are insured, your beneficiary or estate will receive:  2 times basic annual earnings, adjusted to the next higher $1,000 (if not already a multiple of $1,000) subject to a maximum benefit of $500,000. Death benefits may be paid in one lump sum or, if elected, under settlement options offered by
Beneficiary
When you become eligible for the Basic Life Insurance plan, your beneficiary designation will automatically be your estate. You may change your beneficiary at any time by completing a Change of Beneficiary form available upon request from Human Resources. Any nominations you make are revocable, unless prohibited by law or you stipulate otherwise. It is your responsibility to keep your beneficiary designation up-to-date.
Disability Provision
If you become total y disabled before your 65th birthday and are unable to work at your own or any other job, an application will be filed on your behalf to have your Basic Life Insurance continue without payment of premium until you recover, retire or on your normal retirement date. Application must be made before the end of your first year of disability. You will be required to submit medical proof of your disability. Any amount of insurance continued is subject to the terms of the group contract.
Conversion Privilege
If your Basic Life Insurance is reduced (e.g., because your hours are reduced) or terminated (e.g., because you retire or terminate employment), your coverage will be continued without cost for a 31-day conversion period. During this time, you may convert your coverage to an individual policy without providing medical evidence. For information on conversion, contact Human Resources for the insurance company agent’s name and phone number within the 31 In the event of your death, during the 31-day conversion period, the full amount of your coverage will be paid to your beneficiary or estate. In the event of your death, Human Resources will assist your beneficiary or executor in submitting a claim. Claims should be submitted as soon as possible.
Government Plans

Canada Pension Plan
A lump sum death benefit may be payable to your spouse or estate. In addition, a survivor’s pension may be payable to your spouse or an orphan’s pension may be payable to your
Workers’ Compensation
If your death is the result of a work-related accident, a lump sum death benefit wil be paid to your spouse. In addition, a specified monthly amount may be paid to your spouse or dependent
2. BUSINESS TRAVEL ACCIDENT INSURANCE

Business Travel Accident Insurance Benefits
In the event of your accidental death while travelling on University business, your estate will The Plan will also pay you a lump sum benefit in the event of accidental loss of limbs while travelling on University business. These benefits are detailed in the Specific Loss Accident Indemnity section of the policy. Business Travel does not include everyday travel to and from
Aircraft Coverage
You are covered while travelling on University business when flying as a passenger on a scheduled airline or any other aircraft, provided the aircraft has a standard airworthiness certificate and is not owned or operated by the University.
Limitations
This policy has an overall maximum of $2,000,000 for any one accident, regardless of the number of University employees involved. If this limit is not enough to pay the full amount for each employee, a proportionate share of the $2,000,000 will be paid to each.
3. DENTAL PLAN

Benefits
The Dental Plan will reimburse you for:  100% of basic dental services, to a maximum of $2,000 per year. Dependants are not covered for dental benefits. Reimbursement for dental benefits is based on the usual and customary charges established for general practitioners by the college of Dental Surgeons in the member’s province of residence. If alternative dental procedures would provide professionally adequate results, reimbursement will be based on the lowest cost alternative.
Basic Services


Clinical Oral Examination: Complete oral examination of new patient (limited to once in a
three year period per dentist). Recall oral examination (limited to two in a calendar year). Emergency oral examination (limited to two in a calendar year). Specific oral examination (limited to two in a calendar year). Analysis of mixed dentition (limited to one per lifetime).
Radiographs (x-rays): Periapical, Sialography, Posteo-anterior and lateral skull and facial bone.
Use of radiopaque dyes. Full mouth series (including bitewings), Panoramic (limited to one of either type in every three calendar years). Cephalometric (limited to five in two calendar years). Occlusal (limited to two in a calendar year). Bitewing, Temporomandibular joint (limited to four
Tests and Laboratory Examinations: Pulp vitality tests. Histological tests. Cytological tests. Lab

Preventive Services: Polishing (limited to two units in a calendar year). Scaling (limited to eight
units in a calendar year). Fluoride treatment (limited to two treatments in a calendar year). Oral hygiene instruction/plaque control (limited to once every calendar year). Pit and fissure sealants (posterior permanent teeth). Space maintainer appliances, maintenance and repairs. Interproximal disking of teeth. Protective appliance (limited to one in a calendar year).
Basic Restorative Services: Caries, trauma and pain control. Amalgam (metal) and tooth
coloured (plastic) restorations. Full coverage prefabricated restorations (metal and plastic). Repairs to inlays, onlays or crowns. Removal of inlays, onlays, crowns or veneers. Recementation/rebonding of inlays, onlays, crowns or veneers. Retentive pins.
Periodontic Services: Non-surgical services – application of displacement dressings,
management of oral infections, desensitization. Adjunctive periodontal services – provisional splinting or ligation, occlusal adjustment/equilibration, root planing (limited to eight units in a calendar year), topical application of antimicrobial agents.
Basic Prosthodontic Services – Removable: Denture repairs and additions – denture repairs,
additions to partial dentures, denture cleaning and polishing (limited to once in a calendar year). Denture reline and denture rebase – reline and rebase of complete and/or partial denture (limited to one upper and one lower denture reline in two calendar years, and one upper and one lower denture rebase in two calendar years). Other basic prosthetic services – tissue conditioning, soft liner (limited to twice in a two calendar year period).
Basic Prosthodontic Services – Fixed: Repairs. Replace broken prefabricated attachable
facings. Removal of fixed bridge. Repair of fixed bridge. Recementation.
Oral Surgery: Extractions – erupted teeth, impacted teeth, residual roots, surgical exposure of
teeth, surgical movement of teeth including transplantation of erupted or unerupted teeth, surgical repositioning of teeth and surgical enucleation of unerupted teeth and fol icle. Remodeling and recontouring oral tissues – alveoplasty, gingivoplasty and/or stomatoplasty. Surgical excisions, incisions and sequestrectomy. Other oral surgery services – replantation of avulsed teeth, repositioning of traumatical y displaced teeth, frenectomy/frenoplasty, antral
Adjunctive General Services: Neuroleptanalgesia. Conscious sedation. Consultation and/or
participation during autopsy (other than forensic). Office or institutional visit.
General Exclusions and Limitations


The following services are not covered:
 Services covered by the Canada Health Act, Saskatchewan Medical Care Insurance Act, or Saskatchewan Hospital Services Plan as of July 1, 1991 whether such services continue to be  Medical examinations or routine general checkups required for the use of a third party.  Charges for rest cures, convalescent care, custodial care, rehabilitation services in a hospital for the chronically ill or a chronic care unit of a general hospital, or charges incurred by the participant when, in the opinion of Sun Life, proper treatment should be in a chronic care unit or institution for the chronically ill.  Charges relating to elective services obtained by a participant outside his province of residence when his provincial government health care programs have not accepted liability for those items normal y covered in the participant’s province of residence.  Any services and supplies to which the participant is entitled under any Workers’ Compensation statute or any other legislation.  Charges which normally would not be made if the participant were not covered by this plan.  Services for cosmetic purposes or conditions not detrimental to one’s health.  Any services and supplies normally available without cost, or at a nominal cost, under any government statute on the effective date of this plan.  Mileage and/or delivery charges to or from a hospital, physician, dentist or other provider of  Services in connection with an injury or disease resulting from riot, insurrection or war, whether war be declared or not. This includes any condition caused directly or indirectly by  Any item or service not listed as a benefit in this plan.  Medications restricted under federal or provincial legislation which are prescribed and/or  Registration charges or non-resident surcharges in any hospital.  Services required as a result of attempting to commit a criminal act.  Services performed by an unqualified practitioner.  Charges for missed appointments or the completion of claim forms.  Services which are normally paid for directly or indirectly by the employer.  Dental implants and/or services performed in conjunction with implants.
Pre-treatment Plan
If your dentist recommends any dental procedure that is expected to cost over $500, you should have your dentist complete a pre-treatment plan. Submit this plan to the insurer, and you wil be advised of the benefits payable for the course of treatment.
Claim Procedures

Claims must be submitted within 90 days of the end of the calendar year of receiving the service or supplies. If you have a dental expense that is either fully or partial y covered by the plan, you can submit your claim in one of three ways.
Electronic Submission:
Many dentists choose to submit claims electronically on behalf of their
patients and wil agree to have the reimbursement made directly to the dentist’s office. This means you won’t need to complete a claim form. However, you should remember that having the reimbursement paid directly to your dentist does not discharge your obligation to the dentist should the reimbursement be less than the dentist’s fee.
Online:
Sign up to my Sun Life at www.mysunlife.ca and enter your access ID and password. If
you do not have an access ID, click on Register now and follow the steps. You will need your member ID (your university employee number) and contract number (150798). Once you have logged in, sign up for direct deposit. You can submit claims online and have your payment deposited directly into your bank account, usual y within 24 to 48 hours from the time your claim has been processed. When your claim has been processed, Sun Life will send you an e- mail to notify you about the status of your claim.
Mail:
All eligible expenses can be claimed by mailing your claim submissions. Complete Sun
Life’s “Dental and Health Spending Account Claim Form”, enclose the original receipts and mail it to the address below. Be sure to keep a copy of the claim form and receipts for your records. • Policy Number - the University’s group policy number is 150798. • Member ID – the ten digit displayed on your wallet card.
ALL MAIL CLAIM FORMS ARE TO BE FORWARDED TO:

BENEFIT PERIOD

Each benefit period covers one calendar year. Limits apply on
Benefit Period
Each benefit period covers one calendar year. LIMITS APPLY ON A CALENDAR YEAR BASIS.
4. FORMULARY DRUG COVERAGE

Benefits
The Formulary Drug Plan will reimburse you and each of your eligible dependants for:  100% of formulary drugs, $2,000 per person per calendar year, subject to the drug formulary.
Eligible Dependants
Al dependents must be residents of Canada and be eligible under the provincial government health care programs in their province of residence.
Your Spouse – legal or common-law spouse provided your common-law spouse is publicly
represented as your spouse and you have cohabited for one year.
Dependent Child – means an unmarried natural, adopted, or stepchild who is dependent upon
2) Under 26 years of age and attending a Col ege or University full-time, 3) Or physically or mentally incapable of self-support and became incapable to that extent while entirely dependent on the member for maintenance and support under
Covered Formulary Drugs
The Plan reimburses prescribed formulary drugs which:  have been approved by the Federal Drug Information Division, Health Protection Branch, for  have been assigned a drug identification number in Canada,  are listed in the current Saskatchewan Prescription Drug Plan Formulary,  have been prescribed by a physician or dentist and dispensed by a licensed retail pharmacy or  are not normally available over the counter.
Exclusions and Limitations
Anti-smoking drugs are limited to a six month supply, once per lifetime. Benefits wil not be payable for charges in connection with the fol owing:  non-formulary drugs,  vitamins, dietary aids, experimental drugs, fertility drugs, Rogaine, and any other drug required  Services covered by the Canada Health Act, Saskatchewan Medical Care Insurance Act, or Saskatchewan hospital Services Plan as of July 1, 1991 whether such services continue to be provided pursuant to legislation.  Medical examinations or routine general checkups required for the use of a third party.  Charges for rest cures, convalescent care, custodial care, rehabilitation services in a hospital for the chronically ill or a chronic care unit of a general hospital, of Sun Life, proper treatment should be in a chronic care unit or institution for the chronically ill.  Charges relating to elective services obtained by a participant outside his province of residence when his provincial government health care programs have not accepted liability for those items normally covered in the participant’s province of residence.  Any services and supplies to which the participant is entitled under any Workers’ Compensation  Charges which normal y would not be made if the participant were not covered by this plan.  Services for cosmetic purposes or conditions not detrimental to one’s health.  Any services and supplies normally available without cost, or at a nominal cost, under any government statute on the effective date of this plan.  Mileage and/or delivery charges to or from a hospital, physician, dentist or other provider of  Services in connection with an injury or disease resulting from riot, insurrection or war, whether war be declared or not. This includes any condition caused directly or indirectly by any armed forces.  Any item or service not listed as a benefit in this plan.  Medications restricted under federal or provincial legislation which are prescribed and/or  Registration charges or non-resident surcharges in any hospital.
 Services required as a result of attempting to commit a criminal act.
 Services performed by an unqualified practitioner.
Claim Procedures
All prescription benefits are on a reimbursement basis. Claims must be submitted within 90 days of the end of the benefit plan year. If you have a medical expense that is either fully or partially covered by the plan, you can submit your claim in one of two ways.
Online
Sign up to my Sun Life at www.mysunlife.ca and enter your access ID and password. If you do not
have an access ID, click on Register now and follow the steps. You will need your member ID (your
university employee number) and contract number (150798). Once you have logged in, sign up for
direct deposit. You can submit claims online and have your payment deposited directly into your
bank account, usual y within 24 to 48 hours from the time your claim has been processed. When
your claim has been processed, Sun Life will send you an e-mail to notify you about the status of
your claim.

Mail

All eligible expenses can be claimed by mailing your claim submissions. Complete Sun Life’s “Extended Health Care and Health Spending Account Claim Form”, enclose the original receipts and mail it to the address below. Be sure to keep a copy of the claim form and receipts for your • Policy Number - the University’s group policy number is 150798 • Member ID – your university employee number
ALL MAIL CLAIM FORMS ARE TO BE FORWARDED TO:

Benefit Period

Each benefit period covers one calendar year. LIMITS APPLY ON A CALENDAR YEAR BASIS.
Reimbursement for prescribed drugs will be made at the lowest priced interchangeable brand as
listed in the Saskatchewan Drug Formulary, even if “no substitution” is prescribed by the attending
physician.
Co-ordination of Benefits
If a covered person has similar benefits through any other policy or arrangement, the amount
payable through this plan shal be co-ordinated so that total payment from all sources will not
exceed the actual expenses incurred.
Conversion Option
If your coverage ceases because of termination of employment or termination of membership in the class of employees eligible for coverage under this policy, you may apply within 31 days of the termination date of this policy to convert to a group conversion plan available through Sun Life at that time. The conversion option is also extended to dependents. In the event of loss of coverage due to a change in status, or your death, a spouse or dependent child may apply within 31 days of the change to convert to one of the programs available to individuals through Sun Life at that time. The information in this booklet is important to you and your family and should be kept in a safe place. We suggest you familiarize yourself with the contents of the booklet and refer to it whenever you make a claim for group benefits. You may call Human Resources if you need This description is intended as a summary of the benefit plans sponsored by the University of Saskatchewan. In the event of any misunderstanding or discrepancy, benefits wil be paid according to the terms of the official plan documents and applicable legislation. The Dental Plan and the Formulary Drug Plan is underwritten by Sun Life, Policy No. 150798 The Basic Life Insurance Plan is underwritten by Sun Life, Policy No. 101798.

Source: http://working.usask.ca/documents/findmybenefits/benefitplans/research/researchptbenefitplansummary.pdf

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