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As an
employee of Edmonton Catholic Schools, group insurance benefits are
available to you. The cost of the group insurance benefits is shared
between employees and Edmonton Catholic Schools.
Introduction
As an employee of Edmonton
Catholic Schools, group insurance benefits are available to you.
The cost of the group insurance benefits is shared between
employees and Edmonton Catholic Schools.
The plan benefits are
provided through:
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Alberta
Health and Wellness |
Ph: (780) 422-1212
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(Formerly Alberta
Health Care) |
Fax: (780) 422-0102
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10025 Jasper Avenue
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Edmonton, Alberta |
Web Site:
www.health.gov.ab.ca |
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Alberta Health &
Wellness is provided for employees and their dependents.
More information concerning your provincial health care
plan can be obtained by visiting the Alberta Health & Wellness
web site at
www.health.gov.ab.ca |
Eligibility
Teacher on a
temporary, probationary, or continuous contract working a minimum of .2
F.T.E./8 hours per week are eligible for coverage by the group insurance
plan along with their "dependents". The coverage
commences on the first day of employment provided the employee is
actively at work.
Life Insurance,
Accidental Death & Dismemberment, and Extended Disability coverage is a
condition of employment it cannot be waived. You
may, however, opt out of other benefits such as Dental, Extended Health
Care, Vision & Hearing Aid Care , and Alberta Health and Wellness only
if you have coverage through your spouse.
Dependents
The term
"dependent" means your spouse, either legal or common-law*; and
unmarried children (of either your legal spouse or your common-law
spouse) who reside with you in a regular parent-child relationship and
who are:
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Under 21 years of age; or
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Under 25 of age and attending a college or university full-time; or
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Mentally or physically handicapped, entirely dependent upon you for
support and maintenance and covered under the group insurance plan
prior to age 21.
*Common-law spouse
means a person is publicly represented as your spouse, and has resided
with you for two years.
Group insurance plan
coverage for dependents you have when you join the plan commences on
your effective date. Group insurance coverage for
dependents you acquire after you join the plan is effective on the date
of birth for new born children, the date of marriage if we have been
advised prior to the marriage, or the date we are advised of the
marriage. You must, however, notify Benefits/Human
Resource Services within 31 days to add your spouse and each dependent
child to avoid the late applicant restrictions.
Termination of Group Insurance Plan Coverage
Group
insurance plan coverage for you and/or your dependent(s) ends:
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when you and/or your dependents are
no longer eligible (e.g. you are no longer working, or your
dependents reach the maximum age); or
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if you are a
non-retired employee, on the June 30th immediately
following attainment at age 65 (Extended Disability Benefit
terminates on the last day of the month following the month in which
the employee reaches age 65), or
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if you are a
retired employee, at the end of the month in which you have your 65th
birthday.
Most
group insurance plan coverage may be continued during:
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temporary lay-off, strike or lockout
to the end of the month following the month in which you
stopped working.
Retired
Employees
Retired employees and their
dependents are eligible to be covered by the group insurance plan if
they are at least 50 years old with 5 or more years of cumulative
employment with Edmonton Catholic Schools.
You must apply for group insurance coverage before retiring and
must remain a resident of Canada.
You may, by choosing Option
1, continue the same group insurance plan coverage you had before
retiring (except for extended disability which is not available to
retired employees), or choose Option 2 which is a reduced level of
benefits, or discontinue group insurance plan coverage completely.
The employee will pay the full cost of group insurance plan
benefits.
Note:
Should you decide to discontinue group insurance you may still convert
your life insurance to an individual policy at market rates.
Claims
Claim forms for Extended Health Care,
Dental, and Vision & Hearing claims, are available at your work location
or can be printed from the ASEBP's web site at
www.asebp.ab.ca.
Claims must be submitted within 18 months of the date the expense
is incurred. Claims more than 18 months old will not be paid.
Prescription medication claims will be
processed electronically within seconds if you show your ASEBP direct
bill payment identification card to your pharmacist.
For expenses not covered by the plan, the Pharmacist can request
additional payment from you. If you purchase
medication that cannot be direct billed (either in or outside Alberta),
please submit a completed ASEBP Extended Health Care claim form along
with the original receipt.
For Dental claims, an ASEBP claim form or
an Alberta Dental Association's standard claim form is acceptable.
Employees must include their Social Insurance Number as their
identification number on dental claims only. Your
Dentist may also submit a claim using the Electronic Data Information
(EDI) system. The EDI system expedites reimbursement
to the covered member or dentist by automatically verifying eligibility
and coverage amounts.
ASEBP recommends that you submit a dental
pre-determination well in advance for any proposed treatment if the
estimated cost is $500 or more. Pre-determinations can be submitted on
the ASEBP's Dental claim form, an Alberta Dental Association's standard
claim form, or by electronic submission. Clearly mark any mailed
submissions as "pre-determinations".
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