捆绑SM社区

Supplemental health

Opting out

Participation in the Supplemental Health Plan is听. Quebec legislation requires that you, your spouse and children听be covered under a private group health insurance plan providing at least drug coverage. The R茅gie de l'assurance maladie de Qu茅bec (RAMQ) requires employers to register eligible employees in their health plan and charge the necessary premiums.

To opt out of the听Supplemental Health Plan you must听provide written proof听of alternative health coverage (eg. Through your spouse, through membership in professional order or association) within 60 days of securing coverage.听Proof can be a letter from your spouse's employer or insurance carrier, written confirmation from a professional order or association, a photocopy of your spouse's insurance card detailing the type of coverage and effective date of coverage, etc.

Before opting out of the Supplemental Health Plan:

• 颁辞苍蝉耻濒迟听When you retire听for rules regarding eligibility for post retirement benefits;
• Note that you will only be able to re-join the Plan if you lose coverage under another private plan and provide written proof of loss of coverage.

To opt out, please use your Workday account. . Please include necessary documentation as requested.

Opting in

You may join the Supplemental Health Plan at a later date if you involuntarily lose coverage under another health plan (eg. spouse's plan) and provide written proof of loss of this coverage which includes the date of loss of coverage. You must enroll within 60 days of your loss of coverage. Since Quebec legislation requires that all employees under age 65 be covered under a private group health insurance plan,听if you have involuntarily lost coverage under another health plan,听you must join the 捆绑SM社区 Supplemental Health Plan.听

Dental

Opting out

Participation in the Dental Plan is听optional.听If you have joined the plan, you are expected to remain in the plan for as long as you are employed at the University.听You are permitted to opt out of the Dental Plan under the following circumstances:

• You provide written evidence that you have secured new coverage within the last 60 days under another group dental plan (eg. your spouse鈥檚 plan). (Note: You will not be able to rejoin the plan unless you lose this alternative coverage and provide written proof of involuntary loss of coverage.)
• You complete three (3) consecutive years of membership in the Dental Plan. You will not be permitted to rejoin the Plan within the same period of employment with the University.
• 驰辞耻听retire

Before opting out of the Dental Plan:

• Consult When you retire for rules regarding eligibility for post retirement benefits;
• Note you will only be able to re-join the Plan if you experience an involuntary loss of coverage under another private plan and provide written proof within 60 days of such event.

To opt out, please use your Workday account. . Please include necessary documentation as requested.

Opting in听

If you did not join the Dental Plan at enrolment, you will be re-offered the opportunity to join, by invitation, every 3 years, providing that you are actively at work and remain eligible.

If you opted out of the Dental Plan and wish to rejoin, you can rejoin the Dental Plan if you no longer have dental coverage under another dental plan and provide written proof of involuntary loss of coverage within 60 days of the event. If you miss the 60 days window, coverage will be in effect as of January 1st of the year following the year in which the life event occurred. If you wish to rejoin with family coverage, your spouse and dependents must also have lost this alternate coverage involuntarily and provide proof.

As of the date your employment is terminated, your benefit coverage with 捆绑SM社区 will end.

Life insurance

Conversion Privilege

A participant whose life insurance is cancelled on or prior to his 65th birthday due to termination of his employment or his group membership will be able to convert all or part of his life insurance to an individual life insurance policy without having to provide evidence of insurability in the 31 days following their termination.

The participant may choose to convert to one of the following types of insurance:

a) permanent,

b) term to age 65; or

c) one year term convertible into permanent or term to age 65 at the end of one year.

The amount that can be converted to an individual policy will include all amounts of Basic and Optional life insurance that the participant was covered for under 捆绑SM社区鈥檚 group policy, and will not exceed the lesser of:

a) The amount selected by the participant,

b) The amount for which the participant was insured immediately prior to the termination of his insurance;

c) The difference between the amount for which the participant was insured immediately prior to the termination of his insurance, and the amount for which he is eligible under a new group insurance policy;

d) $200,000 ($400,000 for participants living in the province of Quebec).

The individual insurance policy shall not include a disability benefit, nor an accidental death and dismemberment benefit, and the premium shall be based on the insurer鈥檚 rates in effect which apply to the type and amount of such policy, according to the participant鈥檚 sex and attained age.

The individual policy will only be issued if the insurer receives a written request to that effect, together with a deposit covering the monthly premium for a one year term policy within 31 days of the date of the termination of the participant鈥檚 insurance, and will take effect only at the expiration of that period.

Should the participant die during the period of 31 days following the termination of his insurance, the insurer shall pay an amount equal to that which he could have converted whether or not he made application for the individual policy.

Application process

Members who wish to exercise their conversion privileges must contact hr.hr [at] mcgill.ca听to obtain the required form. Members must proceed as soon as possible, as the application process must be sent to the carrier, with the deposit within 31 days of the termination of their coverage.

Supplemental Health and Dental Plans

Health and dental claims

You have 90 days to submit any outstanding health and dental claims for charges incurred before your termination date. You will no longer have access to Manulife鈥檚 Secure Site听once you leave the university, therefore all claims must be submitted by mail using the following forms: Health Claims and Dental Claims. If you need to print out a summary of your claims for income tax purposes, please proceed in the week following your last day at work, otherwise, you will have to contact Manulife directly.

Personal health and dental insurance coverage

If you are a member of the 捆绑SM社区 supplemental health or dental plan, you have 90 days to听 subscribe to a personal health and dental insurance coverage without completing a health questionnaire with Manulife under the 鈥�.鈥� coverage. If you are interested in learning more about this plan or wish to apply, please visit .

听

Drug coverage

At age 65, Quebec residents are automatically registered for the Public Prescription Drug Insurance Plan administered by the R茅gie de l鈥檃ssurance-maladie de Qu茅bec (RAMQ). You will therefore need to determine if you want to remain in the RAMQ Drug plan or elect the 捆绑SM社区 Age 65+ Drug plan.

Options: RAMQ Drug Plan vs. 捆绑SM社区 Age 65+ Drug plan

Option A - Remain in the RAMQ Drug Plan: Under this option, you are reimbursed under the Public Plan for drugs covered by RAMQ. The current reimbursement level is 67% and may vary in the future according to provisions determined by RAMQ. For non-RAMQ drugs covered by the 捆绑SM社区 drug formulary, you remain covered under the 捆绑SM社区 Supplemental Health Plan and receive reimbursement at 80%.

Option B - Opt out of the RAMQ Drug Plan: Under this option, you elect coverage under the 捆绑SM社区 Age 65+ Drug Plan where RAMQ and non-RAMQ drugs are covered at 80%. However, as permitted by RAMQ, the premium rate will be adjusted to reflect the experience of the group. As a result, if you elect this plan, you will pay a premium, in addition to the Supplemental Health plan premium, as described below. This additional premium will start being deducted from your paycheck in the pay period following your 65^th birthday.

Please note that whichever plan you choose for RAMQ drug coverage, the Supplemental Health Plan will still cover your other eligible expenses (such as: eligible drugs not covered by the RAMQ formulary, certain health practitioners, medical supplies and services and travel insurance) for you and your eligible dependents, if you have family coverage, in accordance with the terms of the Supplemental Health plan.

Annual contribution for 2024

听

(1) This amount represents the current total premium, between $0 and $744听per person (depending on net family income) and the maximum amount paid for drugs covered per year of $1,196听per person (after which you are reimbursed at a 100%). The annual premium is paid when you file your income tax return with Revenue Quebec.

(2) The out-of-pocket maximum is $400 for single coverage and $800 for family coverage after which, expenses are reimbursed at 100%.

How do the two options compare?

The RAMQ Drug Plan (Option A) is likely to be more advantageous to you because it costs significantly less than the 捆绑SM社区 Age 65+ Drug Plan (Option B), as indicated in the previous table.

Why does it cost me less to remain with the government鈥檚 Drug Plan?

The contribution required under the government鈥檚 Drug Plan is much lower than the required contribution for the 捆绑SM社区 Age 65+ Drug Plan since it is subsidized by the Quebec government. In fact, the annual contribution for the same coverage under the 捆绑SM社区 Age 65 + Drug Plan represents the actual cost to provide equivalent coverage. This amount will be revised each year, based on claims paid to participants in preceding years. Please note that the annual contribution for RAMQ drugs covered under Option B is payable, as described above, in addition to your current contribution for coverage of other eligible expenses under the Supplemental Health Plan.

What do I need to do?

Option A 鈥� RAMQ Drug Plan:

You have nothing to do to if you elect coverage under the RAMQ Drug Plan since you are automatically registered at age 65. However, you will need to advise your pharmacist that you are covered under the RAMQ drug plan.

Also, if you have dependents covered under the Supplemental Health Plan, you will need to contact the RAMQ to ensure they are also registered for coverage under the RAMQ Drug Plan, even if they are under age 65. However, if your dependents are under age 65 and have access to private drug coverage elsewhere (e.g. employer), they must join that plan.

Drugs not on the RAMQ list may be claimed to Manulife

For information about the Quebec Public Prescription Drug Insurance Plan, contact the RAMQ by phone at (514) 864-3411 or visit the

Option B 鈥� 捆绑SM社区 Age 65+ Drug Plan:

Should you want to elect the 捆绑SM社区 Age 65+ Drug Plan, you will need to contact the Shared Services Unit in Human Resources by email at hrhr [at] mcgill.ca or by phone at 514-398-4747 as well as deregister from the RAMQ Drug Plan by calling RAMQ.

It is important to note that if you choose to remain covered under the RAMQ Drug Plan, you cannot opt to join the 捆绑SM社区 Age 65+ Drug Plan at a later date. To this effect, you can elect the 捆绑SM社区 Age 65+ Drug plan up to the date you will be turning 65 after which, your decision to remain in the RAMQ Drug Plan becomes irrevocable. If you elect the 捆绑SM社区 Age 65+ Drug Plan, you may choose to opt-out and join the RAMQ Drug Plan at any time.

*Note that neither the Supplemental Health Plan or the Age 65+ Drug Plan cover coinsurance or deductibles not paid by under the government drug plan

Temporary residents,听or non-Quebec residents

If you are a temporary resident, verify with 听, or call them at (514) 864-3411, to see if you are eligible to maintain your prescription drug coverage. If you are not eligible for drug coverage through the provincial plan,听please contact the Human Resources Shared Services Unit either by hrhr [at] mcgill.ca (email), or at (514) 398-4747 for any questions regarding your coverage options.

If you live in a province outside of Quebec,听you will need to register for drug coverage under the drug plan provided by your province of residence.听Please consult your province's provincial health care plan for further information.

Deductibles and portions not reimbursed under a provincial drug plan are not eligible for reimbursement under the 捆绑SM社区 Supplemental Health Plan.

Supplemental health

Whether you are a resident of Quebec or another Canadian province,听you may continue your coverage under the 捆绑SM社区 Supplemental health Plan for eligible expenses other than basic drug coverage.

These other eligible expenses include hospitalization in a semi-private room, the services of various licensed health practitioners, medical services and supplies, emergency medical travel insurance, and may include eligible prescription drugs not covered by a provincial drug plan.听

Life insurance

Basic听

• Coverage reduces to: 陆 x salary to a maximum of $50,000 while still actively at work, to a maximum of $30,000 at retirement.
• 捆绑SM社区 pays 100% of the cost of this coverage.

Optional

• Option to maintain insurance bought before age 65 to a maximum of $100,000.
• You pay for the amount you elect. Refer to the听Rate Summary听sheet for cost of coverage.

Disability plans

Short-Term Disability (STD)

While you are actively at work, your coverage will remain unchanged.

Long-Term Disability (LTD)

Coverage ends.听Premiums are no longer charged as of age 64.5.

Dental

Your dental coverage continues unchanged.

Process

The HR Shared Services Unit must be notified of your upcoming retirement.

If you are eligible (see below) for post retirement benefits, the HR Service Centre will send you correspondence explaining the changes to your coverage at retirement. This will include a Continuation of Benefits form.听You will be asked to complete this form, indicating whether or not you wish to continue your benefits post retirement.

Eligibility for post retirement benefits

In order to be eligible for post-retirement benefits, employees are required to meet all of the following criteria:

• Minimum age of 55
• Minimum of 10 years of continuous service prior to date of retirement.
• Minimum of 10 consecutive years of participation in the benefit plans within one's current period of employment.听You may only continue those plans in which you had a minimum of 10 consecutive years of participation.

Not eligible?

If you are听under age 65听and do not meet the eligibility criteria for post-retirement benefits, you may convert your听life insurance policy up to a comined maximum of $400,000 ($200,000 for members outside of Quebec) into an individual policy.听You must听apply for coverage directly with the insurance carrier and pay the required premium听within 31 days of your retirement.听If you die during this 31-day period, your beneficiary will receive the full value of your coverage, regardless of whether you apply for the conversion or not.

The application form is available from the HR Shared Services or听online.听The "Policyholder" section of the form must be completed by the HR Shared Services Unit before it can be sent to the insurance carrier.

Supplemental health

You may elect to continue the coverage you had prior to retirement.听Your eligible dependents will also continue to be covered.

Cost of coverage

If you meet the eligibility requirements for post-retirement benefits, cost sharing for the Supplemental Health Plan will be set at 30% for the University and 70% for the retiree.

Residency requirements

You (and your eligible dependents) must be a resident of Canada听with provincial health care听in order to continue coverage under the 捆绑SM社区 Supplemental Health Plan.

• If you move to another province in Canada, your health coverage will continue.
• If you move permanently outside of Canada, your coverage under the 捆绑SM社区 Supplemental Health Plan will end as you are no longer eligible for provincial health care.

If you are under 65

If you continue to reside in Quebec, you are obliged to remain covered under the 捆绑SM社区 Supplemental Health Plan, unless you have alternative private health insurance and provide听proof听of this alternate coverage. For further details, please refer to:

• the RAMQ听website
• the RAMQ pamphlet听Prescription Drug Insurance when retiring

If you reside in another Canadian province,听you must adhere to that province's provincial health care plan.

If you are 65 and over

Please see the section听When you turn 65听for further details.

Emergency Travel Assistance

See听Emergency travel assistance/Retirees听for information on travel insurance coverage for retired employees.听

Dental

• Employees hired prior to January 1, 2010:听You may elect to continue the coverage you had prior to retirement. Your eligible dependents will also be covered.
• Employees hired as of January 1, 2010: Dental coverage will not be part of the post-retirement package. Therefore, employees hired as of January 1, 2010 will not be entitled to continue their dental coverage post-retirement.

Cost of coverage

• Employees who retired on May 31, 2016 or earlier:听The cost of coverage is shared 50-50 between you and the University.听听
• Employees hired before January 1, 2010 AND who retire after May 31, 2016:听If you meet the eligibility requirements for post retirement benefits (see above), you will be responsible for 100% of the cost of the coverage.

Residency requirements

You must reside in Canada to remain eligible for the Dental Plan. Dental expenses will be reimbursed according to the Quebec Fee Guide for General Practitioners if you move to another province in Canada.

Coverage at age 65

There are no changes to coverage at age 65.

Disability plans

Short term disability听ends at retirement.

Long term disability听contributions are no longer charged as of age 64.5.

Life insurance - continuation of coverage

At retirement, several changes occur to life insurance coverage:听

New plan

Basic

• Pre-retirement coverage reduces to 陆 x salary to a maximum of $50,000 until age 65, and will reduce further to $30,000 thereafter.
• 捆绑SM社区 pays 100% of this coverage.

Optional

• Option to maintain insurance bought before retirement to $100,000.
• You pay for the amount you elect.
• Refer to the听Rate Summary听for information on the cost of this coverage.听

Old plan

If you are insured under the Old Life Insurance Plan, you may maintain your coverage prior to retirement up to a maximum of $100,000. The cost of the coverage is shared between you and 捆绑SM社区. You can switch from the Old Plan to the New Plan at any time, and contact the Human Resources Shared Unit for any questions at 514-398-4747 or hrhr [at] mcgill.ca.

Supplemental health and dental

Continuation of benefits听- spouse & dependent children

If you die before retirement:

• If you were听under age 65听and you had family health and/or dental coverage, your spouse and eligible dependent children can continue this coverage under the plan for up to three (3) months. The University will pay both shares of the benefit cost.
• If you were听65 and over听and you had family health and/or dental coverage, your spouse (and eligible dependent children) can choose to continue this coverage under the plan, provided they pay their share of the benefit cost. The coverage for eligible dependent children will cease once they no longer meet the eligibility criteria.听If your spouse chooses to continue coverage, they will be registered with benefits under their own 捆绑SM社区 ID number.听Once notified of your death, a Human Resources representative will contact them with all the necessary details.
• If at age 65 you elected coverage under the 捆绑SM社区 Age 65+ Drug plan, this coverage will cease and your dependents will need to register under the RAMQ Drug Plan.

If you die after retirement

• Regardless of your age, if you had family health and/or dental coverage, your spouse (and eligible dependent children) can choose to continue this coverage under the plan, provided they pay their share of the benefit cost.听 The coverage for eligible dependent children will cease once they no longer meet the eligibility criteria. If your spouse chooses to continue coverage, they will be registered with benefits under their own 捆绑SM社区 ID number.听
• If you were age 65 and over at retirement and had elected coverage under the 捆绑SM社区 Age 65+ Drug plan at age 65, this coverage will cease and your dependents will need to register under the RAMQ Drug Plan.

Once notified of your death, a Human Resources representative will contact them with all the necessary details.

Claiming outstanding health and/or dental expenses

• Health and/or dental expenses incurred prior to your death must be submitted to the insurance carrier听within 90 days after your death.
• Plan member certificate number:听Your 捆绑SM社区 ID number needs to be indicated in this section of the form.
• Signing the claim form: Your spouse听or the executor of the Estate can sign the claim form.

For information please contact the Human Resources Shared Services Unit at 514-398-4747 or听hr.hr [at] mcgill.ca.

Life insurance

The life insurance benefit will be paid out to the beneficiary(ies) you have duly designated in Workday. You can confirm your designated beneficiaries on Workday by logging in with your 捆绑SM社区 email address and password.