Health and Welfare Plan
The current Collective Agreement requires that your Employer contribute $3.71 for every hour you work. Of that amount, $3.39 is deposited in your own Dollar Bank to pay for your own benefits, 3¢ is allocated to maintain Welfare and Pension Benefits for Members in receipt of Workers' Safety and Insurance Board (WSIB) benefits. The balance helps to pay for Welfare Benefits for Members who are unemployed due to shortage of work or disability as well as Retired Members. The current cost of your own Benefits is $366.00 per month so you can maintain your Benefits by averaging 108 hours of work monthly. These are the Eligibility Rules for obtaining and maintaining Benefits:
| Status | Requirement |
|---|---|
| Initial Eligibility | first day of the calendar month after your Dollar Bank reaches $732.00 |
| Staying Covered | every month you have at least $366.00 in your Dollar Bank, which is the amount that will be deducted from your Dollar Bank |
| Terminated | end of the month when the $366.00 deduction leaves you with a balance of less than $366.00 |
If you average more than 108 contributory hours monthly, the excess contributions remain in your Dollar Bank to a maximum of $4,392 which will keep you covered up to one year of complete unemployment under the current Eligibility Rules. If the reason you are not working is because you retired, your Dollar Bank will still keep you covered for all Benefits, not including the Disability Income Benefits.
You must complete a Member Information Card. You can get one from the Administration Office by calling: (905) 946-9700 or (800) 263-3564, or visiting:
Employee Benefit Plan Services Limited
45 McIntosh Drive
Markham,Ontario L3R 8C7
or E-Mail: ebps@mcateer.ca
The provided Health and Welfare Benefits depend upon your classification, of which there are three, namely:
1) Active Member working for a Contributing Employer and covered by your own Dollar Bank.
2) Previously covered as an Active Member, and now unemployed due to shortage of work or disability, and transfered to the Extended Benefit Program by Local Union 30.
3) Retired, in receipt of a Monthly Pension from the Sheet Metal Worker's Local Union 30 Pension Plan, and still a Member of Local Union 30.
Each of these classifications is covered for Death, Health and Dental Benefits. Classification 1) and 2) Members (above) are also covered for Disability Income Benefits.ACTIVE MEMBERS AND MEMBERS ON EXTENDED BENEFITS PROGRAM: RETIRED MEMBERS:
ACTIVE MEMBERS AND MEMBERS ON EXTENDED BENEFITS PROGRAM
Death Benefits:| For whom? | What Benefit? |
|---|---|
| Member | $50,000 Life Insurance |
| Member | $25,000 Accidental Death and Dismemberment |
| Member's Spouse | $900 per month Survivor Income |
| Member's Spouse | $2,000 Life Insurance |
| Child(ren) of Member | $600 per month Survivor Income |
| Member's Child | $1,000 Life Insurance |
NOTE: For Members who were disabled on October 1, 2003,
the Life Insurance will remain at $25,000 until they recover
and return to work or are available for work.
Disibility Income (Active Members Only):
If, while insured, you suffer a disability that is not covered by WSIB, you are entitled to receive a benefit as long as you are and remain totally disabled right up to your attainment of Age 65. Please pay attention to the definition of "totally disabled", as set out later, because that will determine your eligibility to receive a Benefit. There are two Plans, one covering the more common shorter disabilities, supplemented by another Plan that takes over if the disibility is lengthy. Here are the Plans:
| Benefit | The Details |
|---|---|
|
Short Term Plan $445 per week, |
Benefits commence with the 1st day of total disability due to a non-occupational accident, or the 8th day of a non-occupational illness, and continue while you remain disabled to a maximum of 26 weeks per disability. To qualify, the nature and extent of your disability must be such that you are unable to perform each and every duty of your usual occupation for wage or profit while receiving a Benefit. It is essential that you consult a physician without delay, because the commencement of your Benefit will be measured from the first day on which you consult a physician. For example, if you are disabled due to a non-occupational illness there is a 7 day waiting period before Benefits commence, and those 7 days will be counted starting with the first day you consult a physician. If you are receiving Benefits under this Plan, recover for at least one day and are again disabled due to a wholly different cause, you are entitled to a new 26 weeks' Benefit. However, if you recover and within 26 weeks are again disabled due to the same, or essentially the same, cause you are entitled to receive 26 weeks' Benefit minus the number of weekly Benefits already paid for that disability. Both of these examples of recovery/relapse assume that you are still insured at the time of the relapse. |
| Employment Insurance Integration Effective January 1 2007
$435 per week |
Your Plan’s Weekly Disability Benefits are co-ordinated with Human Resources and Social Development Canada (HRSDC) Employment Insurance Sickness Benefit. Your Plan will pay Benefits during the Employment Insurance (EI) waiting period. This is currently two calendar weeks. EI will pay benefits for a maximum of 15 weeks. If you are still disabled after 15 weeks, your plan will continue payments to you if you provide your Plan with medical statements which support you total and continuous disability. The Plan’s Weekly Income Benefit is $445 per week. EI’s current maximum weekly benefit is $435. If you are unable to work due to disability, you should immediately file a claim for the Plan’s Weekly Disability Income Benefit as well as for IE. It is important that you apply for EI Sickness Benefits, not EI Regular Benefits. If you are already in receipt of EI Regular Benefits when you became disabled, you should notify HRSDC of your disability and switch to Employment Sickness Benefits. If you are still disabled after EI’s benefits are completed, the claim will be refunded to the Welfare Plan for further Weekly Income benefit payments, if eligible. The maximum period of benefits for Weekly Income is 26 weeks including any weeks paid by EI. (Example – The Plan will pay the first 2 weeks; EI will pay (if eligible) the next 15 weeks and the Welfare Plan will pay the remaining 9 weeks. (if eligible). You will be required to provide claim information while in receipt of EI Sickness Benefits. |
| Disability Due To Motor Vehicle Accident Effective January 01, 2007 |
Effective January 01, 2007 no Benefit is payable for an illness or injury caused or contributed to by Any Motor Vehicle Accident |
|
Long Term Plan $1,500 monthly |
This Benefit takes over when your short term Benefits are exhausted, and continues as long as you are totally disabled, right up to your 65th birthday.You will be deemed "totally disabled" if you are unable to perform each and every duty of your usual occupation during the 130 weeks starting with the onset of your disability - that is, 26 weeks under the Short Term Plan plus 104 under this Plan. Thereafter, you are deemed "totally disabled" if the nature and extent of your disability is such that you are unable to perform the duties of any occupation for which you are suited, having due regard for your education, traing and experience. In the event that your disability is compensable by the Workplace Safety and Insurance Board (WSIB), the Monthly Benefit of this Plan will be reduced, dollar-for-dollar, by the amount you are entitled to receive from WSIB, or would receive if you applied for WSIB. |
Supplementary Health and Dental Benefit
Prescription Drugs
100% of the ingredient cost and up to $8.50 for the professional dispensing fee of a pharmacist with respect to generic drugs dispensed for the treatment of illness or injury on the written prescription of a medical doctor or dentist; 70% of the ingredient cost and up to $8.50 for the dispensing fee with respect to brand name drugs similarly dispensed (100% of the ingredient cost if there is no generic equivalent to the brand name drug); 100% of the dispensing fee for compounds prepared by a pharmacist.
Major Medical Plan
100% of medical supplies as well as services of certain paramedical practitioners. Limitations are outlined in your Member Booklet. Out-of-Ontario emergency medical care and hospital care are covered.
Vision Care
$240 per 24 month period, per person. Effective July 1, 2005 there is an additional $50 per 24 month benefit for refractions, if not covered by OHIP, for eligible claimants.
Chiropractic Care
Effective July 1, 2005 The Benefit Plan will reimburse the amount charged up to the Recommended Fee as per the current Fee Schedule of the Ontario Chiropractice College, for eligible claimants.
Dental
| Fee Guide | Annual Maximum |
|---|---|
| 2007 - Ontario | $2,000 |
Please note the Annual Maximum is for the Member and each of his/her dependants. For example, if the Member has a Spouse and two dependant children - they each can have up to $2,000 in approved dental services each year.
The list of dental expenses covered is in your Member Booklet - We recommend you check your coverage before you go to the dentist.
To qualify, you must:
- Be and remain a Member in Good Standing, Sheet Metal Workers Local Union 30, and
- Be in receipt of a Monthly Pension from the Sheet Metal Workers Local 30 Pension Plan, and
- Have been covered by the Sheet Metal Workers Local 30 Health and Welfare Plan as an Active Member and/or an Extended Benefit Program Member for at least 60 months (in the aggregate, and not necessarily consecutively) during the 120 months immediately preceding the date of your retirement, and
- Agree to have deducted from your Monthly Pension the amount required for Health and Welfare Benefits as set by the Trustees.
The Trustees have made available 3 Optional Plans so that Retirees can choose the Option that best suits their needs. Here are the Options:
| BENEFIT | THE DETAILS |
|---|---|
| $10,000 Life Insurance | Payable on the death of the Retired Member. |
| Prescription Drug Plan | If the Claimant, who could be either the Member or a Dependant, is under Age 65 the Plan will pay a portion of the cost of a drug or other medication that was dispensed on the written prescription of a medical doctor or dentist. The portion of the cost the Plan will pay is as follows: up to $8.50 for the pharmacist’s professional dispensing fee (100% of the dispensing fee cost for compounds); 100% of the ingredient cost of generic drugs; 70% of the ingredient cost of brand name drugs (100% if there is no generic equivalent). If the Claimant is Age 65 or older, the Plan will pay only for Prescription Orders that are not covered by Ontario's Prescription Drug Plan for Seniors. Ontario's Plan covers almost every such Prescription Order for persons legally entitled to reside in Ontario on/after their 65th birthday subject, at least for the present, to an Annual Deductible of $100 per person and the payment of a Dispensing Fee after the Deductible is satisfied. Our Plan does not pay these Deductibles nor Dispensing Fees. |
| Major Medical Plan | Subject to a Lifetime Maximum of $50,000 per person, this Plan covers the cost of many services and supplies ordered by a medical doctor, as well as the services of certain paramedical practitioners such as chiropractors. Also included is the cost of medical and surgical treatment by a medical doctor, and hospital care, if the treatment is rendered outside Canada and is in response to an unexpected event that would be regarded as an emergency. This Plan has an Annual Deductible of $100 per person. |
| Vision Care | The Plan pays up to $50 per person per 24 month period to defray the cost of prescription lenses and frames. Effective May 1, 2005 there is an additional $50 per 24 month benefit for refractions, if not covered by OHIP, for eligible claimants. |
| Chiropractic Care | Effective May 1, 2005 The Benefit Plan will reimburse the amount charged up to the Recommended Fee as per the current Fee Schedule of the Ontario Chiropractic College, for eligible claimants. |
| Dental Plan | The Plan will pay up to $1,000 per person, annually, after applying a $100 Deductible per person per year, to defray the cost of eligible dental services. |
This is the same as Option A, except there is no benefit whatever for Prescription Drugs.
This Option provides only the $10,000 Life Insurance Benefit.
CHOOSING AN OPTION
When you retire, you remain covered by the Active Members Welfare Plan (except Disability Income) for as many months as your Dollar Bank will keep you covered. If you are eligible to subscribe to the Retired Members Welfare Plan, you can choose to enrol in your choice of one of the three Options, and the Benefits of your chosen Option become effective immediately following the termination of your Active Members' Benefits. You have a limited ability to change your Option at any time in the future by moving to an Option providing fewer Benefits. For example, if you choose Option A you can move to either Option B or Option C at any time - all you have to do is give the Administrator written advance notice. The best way to do that is to complete another Retired Members Welfare Plan Application Card. Changing from Option A to Option B might be attractive to a Member if he and his Spouse have both turned Age 65; but we recommend utmost care in making that change because dropping our Prescription Drug Plan means you are permanently out of that Plan. By the same token, any Member who declines all of the Options will have no opportunity in the future to get any kind of Benefits through this Plan.
Eligible Dependants
These Benefits cover the Member, as well as his Spouse and unmarried children under Age 22. The definition of "Spouse" is:
- That person to whom the Member is married pursuant to a religious or civil ceremony that is recognized in the province of Ontario as a binding contract of marriage; or
- That person (whose sex is opposite to that of the Member, and) with whom the Member has lived in a conjugal relationship for at least 36 consecutive months, or that shorter period of time if the Member and that person are the natural or adoptive parents of a child, and whom the Member has publicly held out to be his "Spouse"; or
- That person whose sex is the same as that of the Member, who has lived with the Member in a conjugal relationship for at least 36 consecutive months, and whom the Member has held out publicly to be his "Spouse" or "Partner".
- Important Note about the Life Insurance Benefit – If (due to total disability) you are approved for Waiver of Premium when you retire, you are only eligible for Options A and B and coverage under these Options will exclude the Life Insurance Benefit. Your Life Insurance entitlement is the amount you are eligible for under Waiver of Premium.
- Collect receipts for services provided
- Complete a Claim Form
- Promptly mail or hand-deliver the Form and supporting evidence (bills and receipts) to the Administration Office:
Employee Benefit Plan Services Limited
45 McIntosh Drive
Markham,Ontario L3R 8C7
Telephone: (905) 946-9700 0r (800) 263-3564
Fax: (905) 946-2535
- All of the Welfare Plan's Benefits are provided through a Contract of Insurance The Insurer (Manulife Financial) is legally bound to pay the cost of Claims provided that they are received by the Administration Office in a timely fashion. The Insurance Contract contains the following deadlines:
DEADLINES FOR SENDING CLAIMS Benefit Deadline Life Insurance Within one year of death Accidental Death and Dismemberment Within one year of death or loss Survivor Income Within one year of death Dependant Life Insurance Within one year of death Short Term Disability Within 90 days from onset of disability Long Term Disability Within 12 months of onset of disability Health Within 12 months of service Dental Within 12 months of service Please refer to your Member Booklet for more details.
The Income Tax Act, Canada requires that T-4 Supplementaries (T4A) be issued in or about February of each year, disclosing the amounts paid by the Welfare Trust Fund in the prior calendar year, as follows:
ACTIVE AND EXTENDED BENEFIT PROGRAM MEMBERS Benefit Tax Status Member's and Dependants Life Insurance, Survivor Income Benefit Plan Administrator issues a T-4A for Premium paid Disability Income Insurer will issue a T-4A for Benefits paid to Members All other Benefits Not taxable RETIRED MEMBERS Life Insurance Administrator will issue a T-4A only to Members subscribing to Option C in an amount equal to the Premium paid, minus that part of the Premium paid by the Member All other Benefits Not taxable