2008 BENEFIT CHANGES
The following are changes to
our benefits that will take effect on
October 1, 2008:
• Chiropractic care- annual maximum
increased $15 to $465
• Psychologist- annual maximum
increased $25 to $625
• Vision care (available every 24
months)- increased $20 in each
category:
o Single vision: from $200 -
$220
o Bifocal: from $255 - $275
o Multi-focal: from $325 to
$345
o Contacts: from $210 to $230
• Eye examination coverage
increased $20 to $85.
• New vehicle purchase plan- See below
Starting January 1, 2009
The prescription drug co-pay for
actives and retirees will increase to
10% per prescription with a maximum
cap per year.
2009 - $250/Family/Year
2010 - $270/Family/Year
2011 - $290/Family/Year
For retirees over 65
and are on the Ontario drug plan
the first $100 that the government
takes will still be reimbursed to you
through your Green Shield plan,
minus the 10 percent co-pay.
Effective January 1, 2009 the
maximum rate of coverage for long
term care will be $1,543.95 per
month for new entrants.
Current
residents of long term care facilities
will be exempt from this and will
continue at the previously capped
semi-private rate. If a member of
your family is strongly considering
entering a long term care facility it
may be advantageous to do so
before January 1, 2009 to take
advantage of the current coverage
of $1,725 per month.
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New Vehicle Discount Program!
During 2008 negotiations, the parties discussed an employee automotive discount purchase program.
The parties agreed to implement an automotive discount program consisting of the following features:
- $2,600.00 discount for eligible retirees from the Retiree New Vehicle Purchase Plan price on eligible vehicles.
- Applicable to ONE (1) purchase or lease made on or after October 1, 2008 and during the term of the 2008 Collective Agreement only.
- Eligible vehicles are new vehicles assembled in North America eligible under the Employee/Retiree New Vehicle Purchase Plan.
- Eligible retirees are retirees (or their surviving spouses) who are receiving a normal, early (regular or special), or disability retirement benefit at the time of the purchase or lease.
- The $2,600.00 New Vehicle Discount Program is NOT combinable with the $35,000.00 Car Voucher Program.
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World Access
Canada -
Name Change

Please be advised of the following for Out of Province Coverage:
June 5, 2008
World Access Canada - Name Change
Effective June 1, 2008 World Access will be known as Mondial Assistance.
The immediate impact will be:
All Call Centre and Claims staff will answer OP questions in the same manner as now except they will refer plan members to Mondial Assistance as of Monday June 2.
World Access will continue to answer their phones as follows: "Green Shield Canada Travel Assistance" when the calls come in on the Green
Shield Canada line. If calls come in on their general line they will answer: "Mondial Assistance - formerly World Access." All of their claim forms and explanation of benefits (EOB's) will now refer to Mondial Assistance. An insert communication explaining the change will be included. This will continue for six months.
Going forward, there will not be any changes required to Green Shield Canada ID cards since they refer to 'Green Shield Canada Travel Assistance Group.'
The Mondial/WAC phone number will not change.
If there are booklets with a reference to WAC they will be changed as new ones are requested.
Green Shield Prepaid Services |
Green Shield has removed natural health products from the
formulary as of April 1/08
What are Natural Health Products (NHPs)?
Vitamins and minerals
Herbal remedies
Homeopathic medicines
Traditional medicines (such as traditional Chinese medicines)
Probiotics
Other products like amino acids and essential fatty acids
How are NHPs regulated?
Because NHPs were not strictly regulated, some of them were assigned
DINs and were therefore included in some GSC drug plans.
Under new regulations, NHP products which had previously been assigned
DINs are now to be assigned NPNs (Natural Product Numbers) rendering
them ineligible for reimbursement because they are no longer classified
as drugs.
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More Information on
ODB antibiotic drug delisting
| NOT A BENEFIT |
LISTED BRAND |
|
(Dispensed for
ODB
recipients) |
|
|
| Amoxicillin 250mg Capsule |
Novamoxin 250mg Capsule |
|
|
| |
|
| Amoxicillin 500mg Capsule |
Novamoxin 500mg Capsule |
|
|
| |
|
| Amoxicillin 25mg/mL Oral liquid |
Novamoxin 25mg/mL
Oral liquid |
|
|
|
|
| Amoxicillin 50mg/mL Oral liquid |
Novamoxin 25mg/mL Oral liquid |
|
|
| |
|
Cefaclor 250mg
Capsule |
Apo-Cefaclor 250mg Capsule |
|
|
|
|
Cefaclor 500mg
Capsule |
Apo - Cefaclor 500mg Capsule |
|
|
| |
|
| Cephalexin 250mg Tablet |
Apo-Cephalex 250mg Tablet |
|
|
| |
|
| Cephalexin 500mg Tablet |
Apo-Cephalex 500mg Tablet |
|
|
| |
|
| Cloxacillin 250mg Capsule |
Novo-Cloxin 250mg
Capsule |
|
|
|
|
| Cloxacillin 500mg Capsule |
Novo-Cloxin 500mg
Capsule |
|
|
| |
|
| Cloxacillin 25mg/mL Oral liquid |
Novo-Cloxin 25mg/mL
Oral liquid |
|
|
| |
|
Penicillin V-K 60mg/mL
oral liquid |
Novo-Pen-VK-500
60mg/mL O/L |
|
|
| |
|
Penicillin V-K
300mg Tablet |
Novo-Pen-VK-500
300mg Tablet |
|
|
| |
|
Cefaclor 25mg/mL
Oral liquid |
Apo-Cefaclor 25mg/mL
Oral liquid |
|
|
| |
|
Cefaclor 50mg/mL
Oral liquid |
Apo-Cefaclor 50mg/mL
Oral liquid |
|
|
|
|
Cefaclor 375mg/5mL
Oral liquid |
Ceclor 375mg/5ml
Oral liquid |
|
|
| |
|
Cephalexin 125
25mg/mL
Oral liquid |
Novo-Lexin 25mg/mL
Oral liquid |
|
|
|
|
Cephalexin
50mg/mL
Oral liquid |
Novo-Lexin 50mg/mL
Oral liquid |
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******************************************
Ontario Drug Benefit (ODB) stops paying for over 30 antibiotic generic
products
January 18, 2008
Ever since the introduction of Ontario's Transparent Drug System for
Patients Act, 2006, the landscape continues to change, creating a 2-tier
system between the private and public sector. Increases in the prices of
generics, combined with off-loading expenses to private payors and plan
members, are increasing the costs to Canadian employers and their
employees.
The most recent change occurred this week when the Ontario Ministry of
Health announced the ODB would no longer pay for over 30 highly utilized
antibiotic generic products.
The issue
On January 1, 2008, generic manufacturers raised their prices by 20-90%
for 5 classes of antibiotics, including Amoxicillin, Penicillin V,
Cephalixin, Cloxacillin and Cefaclor.
In response to the significant price increases, the ODB Program changed
the benefit status of over 30 highly utilized, first line antibiotic
generic products from "General Benefit" to "Not-a-Benefit". A drug
classified as "Not-a-Benefit" is not paid for by ODB, but is still
listed on the ODB formulary and considered eligible for
interchangeability with other listed products.
However, one generic drug product for each strength and dosage form,
from each affected class of antibiotics, remains listed as a "General
Benefit" and is covered by ODB.
What does this mean?
All Ontario residents over the age of 65, including retirees and "active
at work" employees, will no longer have coverage through ODB for these
commonly prescribed antibiotics.
Providers may be attempting to transfer the full cost of the claim to
the private payor as would be the usual practice for drugs that are not
covered by ODB.
Because only one antibiotic generic product remains listed as a "General
Benefit" and is covered by ODB, it has compounded the issue since many
pharmacies do not carry the lone generic product that is covered.
Pharmacies that carry the covered products are exhausting their
supplies.
Patients have the option to pay out-of-pocket for the non-covered drug,
wait for the drug supply to come in for the sole covered drug in that
class, or have the prescription changed to a covered drug in another
class.
What has Green Shield Canada done?
Upon receiving the notice of these changes from the Ministry of Health,
Green Shield Canada immediately updated the eligibility status of these
drugs.
Green Shield Canada will diligently monitor this situation and will
provide information on any further developments.
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**********************
Government Benefits 2008
| Canada Pension Plan and Quebec Pension Plan |
CPP |
QPP |
| 1. Contribution Rate |
4.95% |
4.95% |
| 2. Year's maximum pensionable earnings |
$44,900 |
$44,900 |
| 3. Basic exemption |
$3,500 |
$3,500 |
4. Maximum premiums for employees
Maximum premiums for self-employed |
$2,049.30
$4,098.60 |
$2,049.30
$4,098.60 |
| 5. Benefits (maximum for new recipient) |
$884.58 |
$884.58 |
| 6. Lump Sum Death Benefit (max.) |
$2,500 |
$2,500 |
| 7. Disability (max.) |
$1,077.52 |
$1,077.52 |
| 8. Dependent children's benefit |
$208.77 |
$66.29 |
| 9. Surviving spouse 65 and over (max.) |
$530.75 |
$530.75 |
10. Surviving spouse under 65 (max.)
Surviving spouse 55-64 (max.)
Surviving spouse under 55 (max.) |
$493.28
-
- |
-
$745.77
$745.77 |
Old Age Security
(effective Jan. 1, 2008 - adjusted quarterly) |
| 1. Old Age Security |
- |
$502.31 |
| 2. Guaranteed income supplement (max.) |
single |
$634.02 |
| 3. Maximum spouse's allowance (Age 60-64) |
- |
$921.00 |
| 4. Maximum widowed spouse's allowance (Age 60-64) |
- |
$1,020.91 |
********************************
Calcium Supplements
Calcium supplements are no longer a benefit.
Health Canada has removed the DIN #'s
They are now labelled as a natural health product not a drug.
Anyone who has repeats on their prescriptions should buy the product off the shelf.
If they use their prescriptions they will be charged the dispensing fee
(Dec 2007)
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******************************
OHIP will cover cost of
PSA
tests by 2009
BRAMPTON - Men aged 50 and older will have their annual prostate cancer screenings covered by OHIP starting in 2009, Ontario's Liberal government announced recently.
"We want to extend men's lives," said Ontario Health Minister George SmithermanSmitherman. "We're urging more men over 50 to get tested for prostate cancer and helping them to get tested by covering the test through OHIP."
Prostate cancer is the third leading cause of cancer death for Canadian men.
However, it's also one of the most treatable forms of cancer-- particularly when it is detected early.
The Prostate Cancer Antigen (PSA) test, which normally goes for roughly $30, allows doctors to detect illness at an early stage so that treatment can begin.
Currently, OHIP covers tests such as pap smears and mammograms for women.
Ian Smith of Brampton-based Blue Ribbon, a newly formed prostate cancer awareness and support association, said the announcement is a positive step forward.
"We welcome this announcement. We just wish it had been available a long time ago," Smith told The Guardian. "Women get various cancer tests covered by OHIP but men don't so this is good news."
PSA is an enzyme produced in the ducts of the prostate and absorbed into the bloodstream.
Although it doesn't always mean a person has cancer, Smith said the test looks for high PSA levels in the blood, which sort of acts like a red flag for patients who then may want to get tested further.
Smith said not everyone in the medical establishment agrees that PSA tests are reliable.
"But the important thing is the PSA test itself is perfectly accurate when it comes to detecting the amount of PSA in the blood. And what it says is there is something in the blood that shouldn't be there and it's a reason for further investigation," Smith said.
Smitherman said moving forward, Queen's Park will focus on improving breast, cervical and colorectal cancer screening rates and cover the HPV vaccine to prevent cervical cancer.
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GM and Chrysler already have coverage for the PSA test negotiated in 2005 Bargaining.
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BENEFIT COVERAGES FOLLOWING
2005 BARGAINING
Eye Exams (New)
In recognition of government delisting of eye exams, coverage will now include one eye exam every 24 months, paid to a maximum of $65 per exam. (Effective October 1, 2005).
Vision Care
Effective October 1, 2005, the vision care plan will provide benefit coverage as follows:
• Single vision: $200 every 24 months
• Bifocal: $255 every 24 months
• Multi-focal: $325 every 24 months
Dental Plan
• The annual maximum has been established at $2,800.
• The orthodontic lifetime maximum will now be $3,600.
(Both of these maximums are effective October 1, 2005).
• Effective January 1, 2006, benefits payable shall be based on the Provincial Dental Association fee guide in effect for the previous year.
Chiropractic Benefits
The annual maximum has been set at $450, effective Oct.1, 2005.
Speech Therapy
The annual maximum benefit for Speech Therapy will be$1,100, effective Oct.1, 2005.
Paramedical Coverage
The annual maximums for Naturopaths and Podiatrist/Chiropodist have each been increased to $325,effective Oct.1, 2005.
Psychologist Services
The annual maximum will now be available to be appliedagainst the cost of a psychological assessment for children under the age of 14.
Prescription Drug Program
• Effective January 1, 2006, prescription drugs will becovered at the cost of available generic drugs.
Brand name drugs will be provided where determined to be medically required.
• The maximum dispensing fee under the plan will be capped at $11 per prescription.
• The current 35¢ co-pay per prescription has been maintained.
Semi Private Hospital
Effective January 1, 2006, semi private hospital room coverage will be provided to a maximum of $200 per day.
Long Term Care
Effective January 1, 2006, the maximum rate for semi-private accommodation will be set at the current level of $1,724.32 per month. Current residents of long term care facilities will be exempt from this provision.
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CAW LEGAL SERVICES PLAN
Coverage Information
The Benefit Schedule is a detailed list of services and fees. It only applies to those who use Staff Lawyers or Co-operating Lawyers (or Co-operating Notaries in Quebec).
CLICK HERE TO VIEW FULL BENEFIT SCHEDULE
Staff Offices
Staff Offices are law offices owned and operated by the Plan. Eligible Participants who so choose can receive legal services at these locations from Staff Lawyers, who are employed by the Plan. Staff Offices are also the Plan's Intake Centres. Participants who wish to be informed about their coverage entitlements and to arrange for referral or reimbursement should contact the Staff Offices closest to them (see below). Participants who live elsewhere should contact our Head Office Intake Centre at 1-800-268-7573.
Head Office
Suite 600
1 St. Clair Avenue West
Toronto, Ontario
M4V 3C3
(416) 960-2410
(800) 268-7573
Fax: (416) 960-8047
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Locations
Brampton Office
Suite 2
23 Regan Road
Brampton, Ontario
L7A 1B2
(905) 790-6400
(877) 332-2444
London Office
Suite 102
1069 Wellington Rd. South
London, Ontario
N6E 2H6
(519) 681-7730
(800) 890-9772
Oakville Office
Suite 406
700 Dorval Drive
Oakville, Ontario
L6K 3V3
(905) 842-3101
(800) 465-9701
Oshawa Office
Oshawa Shopping Centre
Oshawa Executive Tower
Suite 603
King Street West
Oshawa, Ontario
L1J 2K5
(905) 433-4242
(800) 387-6592
Quebec Office
Suite 220
940 Grande Allee
Boisbriand, Quebec
J7G 2J7
(450) 437-6560
(800) 880-7959
St. Catharines Office
Suite 206
55 King Street
St. Catharines, Ontario
L2R 3H5
(905) 641-1313
(800) 318-0782
Toronto Office
Suite 904
505 Consumers Road
Toronto, Ontario
M2J 4V8
(416) 491-1211
(800) 221-5515
Windsor Office
2345 Central Avenue
Windsor, Ontario
N8W 4J1
(519) 944-5222
(800) 381-2209
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The Plan - Frequently Asked Questions (FAQ)
This page contains the answers to common questions about the CAW Legal Services Plan.
1. What is it?
The Plan is a self-administered, non-profit trust. It provides quality legal services at affordable prices to eligible CAW members and their families.
The Plan is established by collective agreements negotiated between each sponsoring company (Corporate Sponsors) and the CAW.
2. Who runs it?
Each separate Plan agreement establishes a Board of Trustees called the Administrative Committee. Each Committee has equal company and union representation and an independent chairperson.
In order to achieve significant cost savings, each separate plan uses the same central administration, run on a day-to-day basis by an Executive Director who reports to the trustees.
3. How is it financed?
Plan benefits and administrative expenses are paid from a trust fund. Contributions to this fund are made by the sponsoring companies in amounts established through collective bargaining.
4. Who is eligible?
Each separate Plan agreement has its own eligibility requirements. Most provide eligibility for bargaining unit employees (in most cases with at least one year of seniority) and retirees. Eligibility ceases in most cases if the employee has been continuously laid off for 18 months.
In most cases, spouses and surviving spouses of employees and retirees are also eligible, as are unmarried, dependent children, under age 26, who reside at home.
5. When does coverage start?
The effective date of Plan coverage varies for each sponsoring company. Check your collective agreement or call a Staff Office near you to find out when your coverage commenced.
Please note: Any matter that started before your commencement date is not covered.
Real Estate:
a) There is no coverage for purchases or sales if the Agreement of Purchase and Sale was signed prior to the date on which you became eligible for the Legal Services Plan benefit.
b) There is no coverage for Mortgages if the letter of commitment to the lender was signed prior to the date on which you became eligible for the Legal Services Plan benefit.
Other Matters:
c) There is no coverage if you hired the lawyer prior to the date on which you became eligible for the Legal Services Plan benefit.
d) Benefit changes only apply to cases that start on or after the effective date of the change.
6. How do I use it?
CALL THE PLAN FIRST! When you call, be sure you have your social insurance number, employee number and seniority date available. Your eligibility will be checked and the Plan coverage for the legal service that you require will be explained. The addresses and telephone numbers of all Plan offices are displayed on the Staff Offices page.
Call the Staff Office nearest to you. If there is no Staff Office near you, call the Head Office in Toronto.
1 St. Clair West Ave.
Suite 600
Toronto, Ontario
M4V 3C3
(416) 960-2410
(800) 268-7573
7. What if I have a complaint?
Please notify our Head Office in Toronto by calling 1-800-268-7573 or contact us.
8. What is excluded from Plan Coverage?
The Plan will not provide benefits or in any other manner pay for the following:
- fines and penalties, whether civil or criminal
- any judgment for civil damages, including judicially awarded costs
- costs attendant to the purchase or sale of real estate, such as registration fees, land transfer taxes, surveys, real estate agent commissions, title insurance premiums, and fees for title searches
- all disbursements such as court filing fees, process serving, transcripts, expert witnesses, etc.
- legal services outside of Canada or the U.S.A.
- services provided by non-lawyers, except Notaries in Quebec and British Columbia
- legal services which are for a Participant's business
- matters involving federal, provincial, municipal or local election to any public office
- any proceeding against the Participant's employer, its subsidiaries, dealers, directors, officers or agents
- any proceeding against the Participant's union, its subordinate or affiliated bodies or the officers or agents of such, or any labour union or association representing employees of the Participant's employer
- any proceeding arising under applicable labour relations acts, labour codes or labour standards acts
- any bankruptcy proceeding that would result in discharge of a debt owed to the Participant's employer, its subsidiaries, dealers, directors, officers or agents, the Participant's union or any benefit plan or trust established or maintained by the employer
- proceedings against or arising from any benefit Plan established or maintained by the Participant's employer, including proceedings against any trust or insurance carrier through which such benefits are provided to the employer, its employees or retirees including any dispute involving the Plan
- Workers' Compensation or Employment Insurance matters involving the Participant's employer
9. What about GST and sales tax?
The Plan does not pay sales or any other taxes related to lawyer or notary fees. The Plan does not pay GST.
10. How is the service delivered?
CALL THE PLAN FIRST! Plan Participants must contact the Staff Office located nearest them or the Head Office in Toronto to determine their eligibility and benefits under the Plan. Participants may go to a Staff Lawyer in the Staff Office, a Co-operating Lawyer or Notary or Non-co-operating Lawyer or Notary for their legal services.
Staff Lawyers are employed by the Plan, work in Staff Offices and provide legal services to Participants according to the Plan fee schedule.
Co-operating Lawyers and Notaries are in private practice and have contracted with the Plan to provide legal services to Participants according to the Plan fee schedule.
(Please Note: Co-operating Lawyers are not "CAW Lawyers". They are lawyers in private practice in your community who have agreed to bill according to our fee schedule. The Plan is not responsible for any act or omission by any Co-operating Lawyer or Notary.)
Non-co-operating Lawyers and Notaries are in private practice and have not contracted with the Plan to provide legal services to Participants according to the Plan fee schedule. They may extra-bill Participants over and above the Plan fee schedule.
No matter what kind of lawyer or notary you use, it is important to CALL THE PLAN FIRST to determine your eligibility and the benefit available to you under the Plan.
11. Who pays?
For legal fees paid by the Plan (see "Prepaid" and "Mixed" below) the Plan will pay directly for the services of Staff Lawyers or Co-operating Lawyers or Notaries. If you choose to use a non-co-operating lawyer or notary you pay him or her directly and submit the account to the Head Office in Toronto. The Plan will reimburse you up to the amount of the Plan fee schedule.
For legal fees that are your responsibility (see "Mixed" and "Referral" below) you pay the lawyer or notary directly. If you so choose and if available, the Plan will refer you to a Co-operating Lawyer or Notary who will only charge you in accordance with the current Plan fee schedule. For most cases, you will be charged an hourly rate; for others (e.g. Probate and some uncontested Family matters) you will be charged a fixed amount.
12. What types of benefits are provided?
There are three types of benefits available:
PREPAID (P): means that the Plan will pay all legal fees, except title search fees, at the Plan fee schedule rate. You are responsible for all disbursements and taxes (e.g. GST).
MIXED (M): means that the Plan pays for the first part of the legal fees (except taxes and GST) at the Plan fee schedule rate. Payment for subsequent legal fees is your responsibility. There are five types of Mixed Benefits.
M-2: The Plan pays for the first two hours.
M-4: The Plan pays for the first four hours.
M-10: The Plan pays for the first ten hours.
M-12: The Plan pays for the first twelve hours.
M-30: The Plan pays for the first thirty hours.
REFERRAL (R): means that, if you so choose and if available, the Plan will refer you to a Co-operating Lawyer or Notary or to a Staff Lawyer who will only charge you in accordance with the current Plan fee schedule rate. You are responsible for all fees, taxes and disbursements.
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Please Note:
1. The Committee that administers this benefit has the authority to make decisions, from time to time, that affect the benefits and coverage provided to members. Consequently, the information provided here is subject to change. Although every effort will be made to update this website, it is important for you to check with the Plan as to benefit coverage and eligibility whenever legal services are required. ALWAYS CALL THE PLAN FIRST!

2. Co-operating Lawyers are not "CAW Lawyers". They are not employed by the Plan. They are lawyers in private practice in your community who have agreed to bill according to our fee schedule. The Plan is not responsible for any act or omission by any Co-operating Lawyer.

3. In all cases in which there is a conflict of interest between the eligible employee and a spouse or dependent, the Plan coverage provided for the legal services required will extend ONLY to the employee or retiree. The spouse or dependent will be reimbursed for no more than one hour of initial advice and consultation at the Plan fee schedule hourly rate. |
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