The Full Benefit Plan
Each Dependent Child: $5,000
or the maximum payment provided under EI*, whichever is greater
*not to exceed 85% of pre-disability earnings
Benefit Commences: 1st day for accident 4th day for illness
Maximum Duration: 52 weeks for any one Disability
Benefit Commences: after 52 weeks of continuous total disability
Maximum Duration: to age 65
$1,000,000 maximum per lifetime
$25 (Single) $50 (Family) calendar year deductible (applies only to drugs)
Out of Country – 100% reimbursement, 60 days max, $5 Million max
Terminates at age 75
100% reimbursement on Basic Services
100% reimbursement on Major Services
$3,000 Dental maximum per family member per calendar year
Orthodontia 75% reimbursement, $3,000 maximum every 24 months per eligible child
Immediate, confidential help for any concern
1-800-268-5211 (English) or 1-800-363-3872 (French)
The Mini Plan
Each Dependent Child: $5,000
NOTE: All coverage terminates automatically at age 65, except for those Employees who remain actively at work under the Quality Control Council of Canada (Q.C.C.C.) Agreement.
QCCC National Post-Retirement Health Benefits
Eligible Retired members will be covered immediately following normal retirement age, provided a Group Insurance Enrollment Card has been completed and submitted to the Administrator and all other requirements are met.
Learn more here
To set up your claims payments to be directly deposited into your bank account, click here
Q.C.C.C. Members will initially become covered for the Full Benefit Plan on the first day of the month following the month in which 120 hours are earned, provided the employer makes the appropriate contributions to the Plan.
Example: 120 hours earned in April provide coverage for May.
If an Employee working under the Q.C.C.C. Agreement earned less than 120 hours or is not a Union Member, and the employer has not contributed on his/her behalf for the Full Benefit Plan, then please refer to the last section of the HEALTH BENEFIT PLAN BOOKLET regarding the Mini Plan.
For continued coverage after initial qualification, the Employee must earn at least 90 hours per month. If a lapse in coverage occurs, the Employee must re-qualify with 120 hours.
NOTE: An enrolment card must be completed and forwarded to the Administrator’s office before any claims payment will be made. If dependents or a beneficiary changes, a revised card must be completed. The signed original enrolment card must be submitted to the Administrator – faxes or copies are not acceptable.
Once an eligible Member qualifies for the Full Benefit Plan and has submitted a completed enrolment card to the Administrator, a wallet card will be mailed to the Member (2 cards if there is dependent coverage). This card serves as the pay-direct prescription drug card for a pharmacy to submit a claim via ASSURE for prescription drugs. This card also shows the group (policy) number and client ID (certificate number) for a dentist to submit a dental claim to the Plan on behalf of the covered Member or dependents. PLEASE NOTE: the dentist should not send the dental claim via ASSURE. Dental claims must be sent to D.A. Townley for processing, either by email to email@example.com or by fax to 1-604-299-8136.
Office Personnel will be initially covered the first of the month following the date of becoming a permanent employee*, provided he/she is actively at work on that day.
Employees absent from work on their effective date, with the exception of statutory holidays or paid vacations, will become effective on the date they return to active full-time work.
Eligible dependents are:
Spouse: The legal spouse of the Employee, or, in absence of a legal spouse, the common-law spouse of the Employee.
*The cohabitation period required for a Common-Law Spouse is a minimum of a continuous 12-month period. Completion of the Common-Law Declaration form is required when adding a Common-Law Spouse, in addition to completing a new Benefit Plan Application for Enrolment and Beneficiary Designation form and a new Pension Plan Application for Enrolment and Beneficiary Designation.
Dependent Children: A person who is unmarried, dependent on an Insured Employee for financial support, and who is:
- a) a natural child of an Employee,
- b) a legally adopted child of an Employee,
- c) a foster child of an Employee or
- d) a step-child who lives with the Employee;
- and unless otherwise shown in a benefit, under:
- a) 21 years of age,
- b) unmarried children age 21 or over are also eligible provided they depend wholly on the Employee for support and maintenance and are full-time students in an educational institution;
- and a developmentally or physically disabled Dependent Child.
Employee & Family Assistance Program
For immediate and confidential assistance for you and/or your family members, 24 / 7 / 365.
Please refer to the BOOKLET for this specific benefit.
Substance Abuse Rehabilitation Assistance
It is recognized that there will be circumstances where counselling alone is not enough to properly deal with alcohol or chemical dependency. The cost of obtaining the proper assistance can be more than you or your family is able to afford. If you or a family member suffers from alcohol or chemical dependency, the Plan may be able to offer you assistance with the cost of treatment. Please contact the PLAN ADMINISTRATOR to determine if you meet the required eligibility for coverage.