Benefits for Bargaining Unit Employees

This Benefits Guide for Bargaining Unit Employees (PDF, 705KB) provides a comprehensive overview of health and life insurance benefits programs for Bargaining Unit employees. Share the details with your family so you can make the most of your benefits program.

In the event of any conflict between this guide and the actual plans, contracts or regulations, follow those documents over this guide.

For a quick summary of your benefits, please review Your Benefits at a Glance (PDF, 159KB).

For a list of forms related to pay and benefits, visit Forms & Tools for All Employees.

Benefits are an important part of your total compensation package. Your employer pays your Medical Services Plan premiums; these are valued at $450 per year (more if you have coverage for two adults). There's no cost to you to participate in the extended health and dental plan. The reimbursements you receive under the plan for eligible items and services are paid for by the employer. In some years, this may be several thousands of dollars. The Employee Basic Group Life Insurance plan provides employee life insurance at a reasonable group premium rate and a portion of your premium is paid by your employer. On average, your benefits add over 20% to your overall compensation.

Your health and life insurance benefits program consists of the following benefit plans.

Core Benefits

  • Medical Services Plan of B.C.
  • Extended health
  • Dental
  • Employee Basic Life Insurance

Optional Benefits

  • Optional family funeral benefit
  • Employee Optional Life Insurance
  • Spouse Optional Life Insurance
  • Child Optional Life Insurance
  • Employee Optional Accidental Death and Dismemberment Insurance
  • Spouse Optional Accidental Death and Dismemberment Insurance
  • Child Optional Accidental Death and Dismemberment Insurance

Employees

This benefits program applies to:

  • Regular Bargaining Unit employees, including part-time employees.
  • Auxiliary employees who’ve completed 1,827 hours of work in 33 pay periods with the same ministry.
  • Auxiliary employees (BCGEU only) who have worked three consecutive years with the same ministry without a loss of seniority and have 1,200 hours of straight-time in the past 26 pay periods.

Auxiliary employees who are not eligible for health and welfare benefits receive a compensation allowance as calculated in accordance with the main agreement.

You must enrol to be eligible for coverage.

You can extend your benefits to your spouse and to children who meet eligibility requirements.  You must enrol your dependants to receive coverage.

Spouse

Your legal or common-law spouse (opposite or same sex) who's living with you is eligible for coverage. By enrolling your common-law spouse in your benefits plans, you're declaring that person as your common-law spouse, and that you've been living in a common-law relationship or cohabitating for at least 12 months. The cohabitation period may be less than 12 months if you claimed the common-law spouse’s child/children for tax purposes. A separate form isn't required.

If your spouse is also a BC Public Service employee or is enrolled in a benefits program with an employer outside of the BC Public Service, you can both enrol in your benefits plans, listing the other as a dependant. You may be able to submit your extended health and dental receipts to both plans and receive up to 100% of your eligible expenses reimbursed.

If you separate from your spouse, they're no longer eligible for coverage under your benefits plan. Any terms and conditions under separation and divorce agreements are your responsibility. You must wait 12 calendar months from the cancellation date of a previous common-law spouse to enrol a new common-law spouse or new dependants. The waiting period doesn't apply when you're going from legal spouse to a common-law spouse, legal spouse to legal spouse, or common-law spouse to a legal spouse. You're responsible for cancelling your spouse’s coverage when they're no longer eligible.

Dependent Children

Children (natural, adopted, stepchildren or legal wards) are eligible for coverage if they’re unmarried/not in a common-law relationship, mainly supported by you, dependants for income tax purposes, and any of the following:

  • Under the age of 19.
  • Under the age of 25 and in full-time attendance at a school, university or vocational institution which provides a recognized diploma, certificate or degree.
  • Mentally or physically disabled and past the maximum ages stated above. This only applies if they became disabled before reaching the maximum ages and that the disability has been continuous. The child, upon reaching the maximum age, must still be incapable of self-sustaining employment and must be completely dependant on you for support and maintenance.
  • Residing with your former spouse who isn't eligible for health and dental coverage.

A grandchild is not an eligible dependant unless adopted by or a legal ward of the employee or the employee’s spouse.

Dependent Children Over 19

Unless you certify that your child is in full-time attendance at a school, university or vocational institution which provides a recognized diploma, certificate or degree:

  • Extended health and dental coverage for a dependant child will automatically end on the date your child turns 19.
  • MSP coverage will end at the end of their birth month.

Before your child turns 19:

  • You’ll receive Confirmation of Dependant Eligibility forms from Great-West Life (GWL) and Medical Services Plan (MSP).
  • Submit your GWL form back to GWL as per instructions in the letter.
  • Submit your MSP form to the Benefits Service Centre through an AskMyHR service request using the category Myself (or) My Team or Organization > Benefits > Submit a Health Benefit Form/Application.

In subsequent years, return the GWL form back to GWL and submit an AskMyHR service request for MSP using the category Myself (or) My Team or Organization > Benefits > Submit a Health Benefit Form/Application before September 30, advising that your child is still a full-time student. Include your child’s name and the school they’re attending. You’re responsible for cancelling coverage for dependent children who are no longer eligible for coverage. Coverage for a dependent child with full-time student status will automatically end at age 25 unless the child has disability status.

When Does Coverage Begin?

BENEFIT

REGULAR EMPLOYEE

AUXILIARY EMPLOYEE

Medical Services Plan

  • You can enrol immediately
  • Coverage begins the first day of the month after becoming a regular employee or upon enrolment, whichever is later
  • You can enrol after meeting eligibility requirements
  • Coverage begins the first day of the month after meeting eligibility requirements or upon enrolment, whichever is later (e.g. completion of 1827 hours of work within 33 pay periods)

Extended Health & Dental Plans

  • You can enrol immediately
  • Coverage begins on the first day of the month after completion of three full calendar months of regular employment, or upon enrolment, whichever is later
  • You can enrol after meeting eligibility requirements
  • Coverage begins the first day of the month after meeting eligibility requirements or upon enrolment, whichever is later

Employee Life Insurance Plan

  • There is no need to enrol
  • You must designate a beneficiary
  • Coverage begins immediately
  • There is no need to enrol
  • You must designate a beneficiary
  • Coverage begins immediately upon meeting eligibility requirements

Optional Family Funeral Benefit

  • You can enrol immediately
  • If you enrol within 31 days of hire or 60 days of acquiring your first dependant, coverage begins immediately
  • You can enrol after meeting eligibility requirements
  • If you enrol within 31 days of meeting eligibility requirements or 60 days of acquiring your first dependant, coverage begins immediately
Optional Life & Optional Accidental Death & Dismemberment (AD&D) Insurance
  • You can enrol immediately
  • You must enrol within 31 days of becoming eligible or you'll waive coverage. You must list which dependants you wish to cover under each insurance plan
  • If selected, coverage begins the first of the month following enrolment except where evidence of insurability and approval is required. Coverage will begin once approval is granted by the carrier
  • You can enrol after meeting eligibility requirements
  • You must enrol within 31 days of becoming eligible or you'll waive coverage. You must list which dependants you wish to cover under each insurance plan
  • If selected, coverage begins the first of the month following enrolment except where evidence of insurability and approval is required. Coverage will begin once approval is granted by the carrier

Coverage for eligible dependants is effective on the date on which your coverage is effective or on the first of the month following the date the enrolment form is received by MyHR’s Benefits Service Centre, whichever is later.

Where evidence of insurability and approval is required coverage will begin once approval is granted by the carrier.

Check that coverage is in place after you have enrolled by logging into Employee Self Service (Benefit Summary) and verify that coverage is effective prior to using the services. Any questions regarding coverage can be directed to MyHR.

How to Enrol for the First Time

Employees can enrol online through Employee Self Service (under Benefits Summary). By enrolling online, this will allow you to track the status of your application through AskMyHR. Complete all forms that are applicable, and you must save them before submitting them.

If you don't have access to Employee Self Service, complete the manual forms below that are applicable and send them to the Benefits Service Centre for processing. Refer to the Contacts section for submission information.

  1. MSP Application for Group Enrolment (PDF, 579KB)
  2. Bargaining Unit Benefits Program Enrolment/Change form (PDF, 388KB)
  3. Group Life Beneficiary Designation (PDF, 156KB)

PharmaCare Registration. All plan members must sign up for PharmaCare. This will assist with prescription coverage, limiting the impact on your lifetime maximum.

You're automatically enrolled in Employee Basic Life Insurance, but you may want to designate a beneficiary.

Because the Group Life Beneficiary Designation form is a legal document, you must print, sign and mail the original document to the Benefits Service Centre.

Benefits Service Centre
Block E, 2261 Keating Cross Road
Saanichton BC  V8M 2A5

Once your applications have been processed, you can log into Employee Self Service at any time to view your Benefits Summary (except for your life insurance beneficiaries).

Submit all forms through AskMyHR using the category Myself (or) My Team or Organization > Benefits > Submit a Health Benefit Form/Application. An extended health and dental identification card will be mailed to your home address, for you and your spouse (if applicable).

How to Update Your Coverage

If you want to add or cancel dependants after your initial enrolment, you'll need to complete the following forms that are applicable (if you have access to Employee Self Service, you can access the forms online):

Baby Enrolment or Addition of a Newborn

The easiest way to enrol your newborn for MSP is to complete the Online Birth Registration through the Vital Statistics Agency. The agency sends your baby’s information to Health Insurance BC. If you have MSP coverage through work, you must complete the Baby Enrolment form (PDF, 136KB) or the MSP Group Change Request form (PDF, 594KB).

Your benefits will be effective on the first of the month following your application unless there’s a waiting period. Changes in coverage take effect as they occur, providing the employee is actively at work.

Waiting periods may apply. You should verify that coverage is in effect prior to purchasing items or services.

Optional Life Insurance Plans

There are two opportunities where you can update your Optional Life Insurance plans after your initial enrolment (which will require evidence of insurability).

Once a year, for the change to be effective April 1 of that year, applications must be received by the end of the second week of March.

During an eligible life event:

  • Marriage or entering a common-law relationship.
  • Divorce, separation or the end of a common-law relationship.
  • Birth or adoption of a child.
  • Loss of a child’s status as a dependant (marriage, age limit, no longer a student).
  • Change in your child’s eligibility that allows coverage under the program.
  • Your spouse gains or loses benefits.

Eligible life events allow you to make changes within 60 days of the event.

MSP Coverage

Medical Services Plan Coverage
Optional. Only enrol once in the plan to avoid paying unnecessary taxes MSP insures medically-required services provided by physicians and health care practitioners to all eligible British Columbians
Extended Health Plan Coverage
Extended Health Plan Coverage
Annual Deductible

$90

Reimbursement

Reimbursed at 80% for the first $1,500 paid in a calendar year per person and then 100% for the balance of the year (subject to some restrictions and plan maximums)

Lifetime Maximum

$3 million (includes coverage for out-of-province or out-of-country medical emergencies)

Prescription Drugs

Covered drugs and medicines purchased from a licensed pharmacy, which are dispensed by a pharmacist, physician or dentist subject to PharmaCare’s policies including reference based pricing and lowest cost alternative

Vision

$250/24 months for adults
$250/12 months for dependent children

Paramedical Services (chiropractor, massage therapy, naturopathic physician, physiotherapy, podiatry)

Acupuncture, chiropractor, naturopathic physician and podiatry: $200/year/person or $500/year/family
Massage therapy: $750/year/person
Physiotherapy: no maximum
Reimbursement subject to reasonable and customary limits

Dental Coverage
Dental Plan Reimbursement Coverage
Basic Services 100%

Cleaning, polishing, topical fluoride – once every nine months for adults, once every six months for dependent children

Major Services 65%

Services required for reconstruction of teeth and for the replacement of missing teeth (e.g., crowns, bridges and dentures)

Orthodontic Services 55%

Coverage for orthodontic services provided to maintain, restore or establish a functional alignment of the upper and lower teeth

Lifetime maximum is $3,500/covered person

Employee Basic Life Insurance Coverage
Employee Basic Life Insurance (to age 65) Premium Coverage
Mandatory Coverage Premium for the first $100,000 of insurance coverage is employer-paid. Employee-paid monthly premium for coverage above $100,000 is 18 cents per thousand dollars Coverage is equal to three times annual salary or employer-paid minimum coverage ($100,000), whichever is greater. Includes accidental dismemberment insurance, loss of sight insurance, and a terminally ill advance payment
Optional Family Funeral Benefit
Optional Family Funeral Benefit Premium Coverage
Optional Coverage $2.21/month Life insurance in the amount of $10,000 for spouse and $5,000 per dependent child
Optional Life Insurance
Optional Life Insurance Units of Maximum
You $25,000 $1 million
Your Spouse $25,000 $500,000
For All Your Dependent Children $5,000 $20,000 (Cost for all dependant children is $11.28 per unit of $,5000)
Optional Accidental Death & Dismemberment Insurance
Optional Accidental Death & Dismemberment Insurance Units of Maximum Annual Rate Per Year
You $25,000 $500,000 $9.60
Your Spouse $25,000 $500,000 $9.60
For All Your Dependent Children $10,000 $250,000 $3.30

Annual Rate for Each Unit ($25,000) of Coverage for Optional Life Insurance (NS=Non-Smoker; S=Smoker)
Gender/Age (yrs) Under 35 35-39 40-44 45-49 50-54 55-59 60-64
Female (NS) $9 $12 $18 $30 $48 $84 $108
Female (S) $12 $18 $30 $60 $90 $138 $192
Male (NS) $18 $18 $24 $48 $87 $144 $189
Male (S) $30 $36 $60 $102 $177 $294 $396

During initial enrolment, employees have 31 days to apply for up to $50,000 of Employee Optional and/or Spouse Life Insurance evidence free. Evidence of insurability is required for all future increases. Applications must be approved before coverage can begin.

Tips

  • To submit eClaims, log on to GroupNet, Great-West Life's plan member website. GroupNet provides online access to your personalized extended health and dental coverage and claims information.
  • Claiming deadline for extended health and dental is 15 months from the date the expense was incurred.
  • Ask your doctor or pharmacist if there's a less expensive generic medication that is right for you.
  • Don’t forget to update your benefits coverage as your personal circumstances change.
  • Remember to designate a beneficiary for your group life insurance.
  • Naming a beneficiary for your Public Service Pension Plan is a separate process from nominating your group life insurance beneficiary. For more information, contact the Public Service Pension Plan.

The Medical Services Plan of BC insures medically-required services provided by physicians to all eligible British Columbians.

All British Columbia residents must be covered under the Medical Services Plan (MSP). The employer covers the cost of MSP premiums for eligible BC Public Service employees and their spouse. You must enrol to be covered for an MSP account under the group plan.

  • There are no premiums for children, employees or employee’s spouse under 19 years of age.
  • MSP premium rates will be determined by the number of adults on an MSP account (the MSP account holder and, if applicable, a spouse).

Eligibility

To be eligible for coverage, employees and their dependants must:

  • Be residents of British Columbia.
  • Be Canadian citizens, permanent residents or temporary document holders.

Employees must also meet the eligibility requirements for regular and auxiliary employees.

If you and/or your dependants recently moved to B.C., MSP requires a waiting period of the remainder of the month in which your residence in B.C. is established, plus two months.

In B.C., the Insurance Corporation of BC (ICBC) has a partnership with MSP. Driver’s licenses and BC Care Cards are linked. The BC Care Card, which is replaced with the BC Services Card, is the card that shows you have MSP coverage with a unique lifetime identifier for health care called a Personal Health Number.

To be enrolled in the group plan, new or returning BC Public Service employees and their dependants (If applicable) must complete a two-step enrolment process as soon as they arrive in B.C. This allows time to process the application so enrolment and coverage for you and your dependants under the group plan won't be delayed:

  • Visit an ICBC office. Let them know you're new to the province and applying for MSP coverage.
  • Provide proof of your identity. ICBC communicates with MSP to confirm you've completed this step. If you're unsure what documents to bring, contact ICBC.

Complete the MSP Application for Group Enrolment (PDF, 579KB) and submit it through an AskMyHR service request using the category Myself (or) My Team or Organization > Benefits > Submit a Health Benefit Form/Application.

New residents from other parts of Canada should maintain coverage with their former medical plan during the waiting period. Residents arriving from outside Canada should contact a private insurance company.

First Nations & Inuit residents

Status Native and Inuit residents usually enrol through the First Nations Health Authority (FNHA). If your dependants don't qualify for FNHA coverage and you would like to add them, you must cancel your coverage with FNHA. Instead, you need to apply for MSP coverage through your employer and add your dependants through your employer. For further information about coverage for status Native and Inuit peoples, visit the B.C. Government website.

Your Medical Services Plan options

If you waive MSP coverage under this program, you must have coverage elsewhere or a self-administered account will be automatically set up for you, and you’ll be billed directly by Health Insurance BC.

MSP Coverage

You can select coverage for:

  • Employee only
  • Employee plus spouse

You must list any dependants you wish to cover.

You're responsible for any premiums you incur for any period during which you were eligible but were not enrolled in the group plan.

MSP insures services like your doctor’s visits, lab services, and diagnostic procedures, such as X-rays.

Tax consideration

If you and your spouse both have access to this benefit, only one person needs to enrol for coverage for the whole family. Because this is a taxable benefit, it's important to ensure you're only enrolled once to avoid paying unnecessary taxes. There may be a tax advantage for the lower income earner to provide coverage, but individual circumstances will vary.

The extended health plan is designed to partially reimburse you for a specific group of medical expenses which aren't covered by the Medical Services Plan or the PharmaCare program.

Overview

Great-West Life (GWL) administers your extended health plan on behalf of your employer. Detailed descriptions of expenses eligible for reimbursement under this plan are provided in the table below.

Before you receive reimbursements, you must pay the $90 annual deductible unless you're claiming for reimbursement of an expense not subject to the annual deductible.

Unless otherwise stated, you'll be reimbursed at 80% of the first $1,500 paid in a calendar year per person, and then 100% for the balance of the year (subject to some restrictions and plan maximums).

There's a lifetime maximum of $3 million per covered person, which includes coverage for out-of-province or out-of-country medical emergencies. This lifetime maximum may be reinstated after paying for any one serious illness based on satisfactory evidence provided by the employee to the carrier of complete recovery and return to good health.

This is an employer-paid, non-taxable benefit.

It's your responsibility to verify that an item or service is covered prior to purchase. Contact GWL if the item isn't listed in this guide. It's recommended that you get an expense pre-approved if the cost is over $1,000.

What's Covered by Your Extended Health Plan

The following is a list of expenses eligible for reimbursement under the extended health plan when incurred as a result of a necessary treatment of an illness or injury and, where applicable, when ordered by a physician and/or surgeon. Check GroupNet for detailed information or contact GWL at 1 855 644-0538.

What's Covered by Your Extended Health Plan
Feature Coverage
Accidental Injury to Teeth

Dental treatment by a dentist or denturist for the repair or replacement of natural teeth or prosthetics, which is required and performed and completed within 52 weeks after an accidental injury that occurred while covered under this plan. No reimbursement will be made for temporary, duplicate or incomplete procedures, or for correcting unsuccessful procedures. Expenses are limited to the applicable fee guide or schedule.

Accidental means the injury was caused by a direct external blow to the mouth or face resulting in immediate damage to the natural teeth or prosthetics and not by an object intentionally or unintentionally being placed in the mouth. 

Acupuncture

Acupuncture treatments performed by a medical doctor or an acupuncturist registered with the College of Traditional Chinese Practitioners and Acupuncturists of British Columbia. See the "Paramedical Services" section of this table for information about reasonable and customary limits. Coverage is $200/year/person or $500/year/family.

Braces, Prosthetics & Supports

To be eligible for reimbursement, you must include a practitioner’s note for all prosthetics, braces and supports to confirm the medical need for the device. Accepted practitioners include licensed chiropractors, physiotherapists and physicians. The prescription must include the medical condition and the braces must contain rigid material.

Breast Prosthetics

See the "Mastectomy Forms & Bras" section of this table for more information.

Chiropractor

Chiropractic treatments performed by a chiropractor registered with the College of Chiropractors of British Columbia. See the "Paramedical Services" section of this table for information about reasonable and customary limits. Coverage is $200/year/person or $500/year/family.

X-rays taken by a chiropractor are not eligible for reimbursement.

Contraceptives

Prescribed oral or injectable contraceptives. See the "Drugs & Medicines" section of this table for more information.

Counselling (registered clinical counsellor, registered clinical psychologist, registered social worker)

Service fees of a recognized social worker, registered clinical psychologist or counsellor payable to a maximum of $500 per family per calendar year. The practitioner must be registered in the province where the service is rendered.

To determine if a psychologist is registered for claiming purposes, contact the College of Psychologists of BC at 604 736-6164 (toll free 1 800 665-0979).

To determine if a counsellor is registered for claiming purposes, contact the BC Association of Clinical Counsellors at 250 595-4448 (toll free 1 800 909-6303).

To determine if a social worker is qualified for claiming purposes, contact the BC College of Social Workers at 604 737-4916 or use the searchable registry.

Visit MyHR for information about short-term counselling available through the Health and Well-being program.

Drugs & Medicines

Covered drugs and medicines purchased from a licensed pharmacy, which are dispensed by a pharmacist, physician or dentist subject to PharmaCare’s policies including reference-based pricing and lowest cost alternative.

Drugs and medicines include:

  • Injectables provided by a medical practitioner and drugs used by a medical practitioner when providing services under circumstances whereby the drug isn't otherwise provided.
  • Insulin preparations, testing supplies, needles and syringes for diabetes.
  • Vitamin B12 for the treatment of pernicious anemia.
  • Allergy serums when administered by a physician.
  • Other drugs and medicines that require a prescription from a medical provider who's legally authorized to do so, including oral and injectable contraceptives.

Reimbursement of eligible drugs and medicines will be based on a maximum dispensing fee of $7.60 and a maximum mark-up of 7% over the manufacturer’s list price. All plan members must sign up for PharmaCare to assist with prescription coverage, limiting the impact on your lifetime maximum.

Unless medical evidence is provided to Great-West Life that indicates why a drug is not to be substituted, GWL can limit the covered expense to the cost of the lowest priced interchangeable drug.

Prior Authorization: Great-West Life requires prior authorization to provide appropriate drug treatment and to ensure the drugs prescribed are considered reasonable treatment for the condition. For brand name drugs, your physician would have to complete a Request for Brand Name form, to provide medical evidence that the generic version has adverse side effects. For more information, see the "Prior Authorization & Specialty Drugs" section.

Emergency Ambulance Services

Emergency transportation by licensed ambulance to the nearest Canadian hospital equipped to provide medical treatment essential to the patient.

Air transport when time is critical, and the patient’s physical condition prevents the use of another means of transport. Doctor’s note may be required.

Emergency transport from one hospital to another only when the original hospital has inadequate facilities.

Charges for an attendant when medically necessary.

Medical Examinations

Medical examinations rendered by a physician, required by a statute or regulation of the provincial and/or federal government for employment purposes, for you and all your registered dependants provided such charges are not otherwise covered.

Vision Examinations

Fees for routine eye examinations to a maximum of $75 per 24 months per person between the ages of 19 and 64, when performed by a physician or optometrist.

Exams for persons under age 19 and over age 64 are covered under the Medical Services Plan. Your practitioner may charge more than what's payable by the Medical Services Plan for this service. The balance is not covered by your extended health plan.

Hairpieces & Wigs

Hairpieces and wigs, when medically necessary, are eligible for reimbursement to a maximum of $500 per 24 months.

Hearing Aids & Repairs

Reimbursements at $1,500 per ear per 48 months for adults and 24 months for children. This benefit isn't subject to an annual deductible.

Batteries, recharging devices or other such accessories are not covered.

Hospital Charges

Additional charges for semi-private or private accommodation over and above the amount paid by provincial health care for a normal daily public ward while you're confined in a hospital under active treatment. This doesn't include telephone or TV rental or other amenities.

Massage Therapy

Massage treatments performed by a massage practitioner registered with the College of Massage Therapists of British Columbia. See the "Paramedical Services" section of this table for information about reasonable and customary limits. Coverage is $750/year/person.

X-rays taken, and drugs, medicines or supplies recommended and prescribed by a massage therapist are not covered.

Mastectomy Forms & Bras

Mastectomy forms and bras are eligible for reimbursement to a maximum of $1,000 per 12 months.

Medical Aids & Supplies

A variety of medical aids and supplies as follows:

For diabetes:

  • Testing supplies, needles and syringes.
  • Insulin injector.
  • Insulin infusion pumps if other methods aren't suitable.
  • If you switch from using testing supplies to an insulin injector, testing supplies aren't covered for the next 60 consecutive month period.
  • Light boxes including light visors used for the treatment of Seasonal Affective Disorder.
  • Oxygen, blood and blood plasma.
  • Ostomy and ileostomy supplies.
  • Aerochambers.
  • Compression hose.
  • Walkers, canes and cane tips, crutches, splints, collars and trusses (elastic or foam supports aren't covered).
  • Rigid support braces and permanent prostheses (artificial eyes, limbs and larynxes). Myoelectrical limbs are not covered, but the plan will pay an amount equal to the cost of a standard prostheses.
  • Stump socks to a maximum of $200 per calendar year.

Standard durable equipment as follows:

The cost of renting, where more economical, or the purchase cost of durable equipment for therapeutic treatment including:

  • Manual wheelchairs, scooters, manual type hospital beds and necessary accessories. If the patient is incapable of operating a manual wheelchair, an electric wheelchair will be covered; otherwise the plan will pay the equivalent of a manual wheelchair.
  • Cardiac screeners and blood glucose monitors.
  • Growth guidance systems.
  • Breathing machines and appliances including respirators, compressors, suction pumps, oxygen cylinders, masks and regulators.
  • Continuous positive airway pressure machine when prescribed for sleep apnea.
  • Infant apnea monitor.

Pre-authorization is recommended for items costing over $1,000 and is required for items over $5,000.

Naturopathic Physician

Naturopathic services performed by a naturopathic physician licensed by College of Naturopathic Physicians of British Columbia. See the "Paramedical Services" section of this table for information about reasonable and customary limits.

X-rays taken, and drugs, medicines or supplies recommended and prescribed by a naturopathic physician aren't covered.

Needleless Injectors

When prescribed by a physician:

  • Needleless injectors are payable up to $500/60 months.
  • Charges for supplies required for the administration of insulin (needles, etc.) aren't covered for a 60 consecutive month period from the purchase date of an insulin injector.
Orthotics & Orthopedic Shoes

When prescribed by a physician or podiatrist when medically necessary, custom-fit orthotics or orthopedic shoes, including repairs, orthotic devices and modifications to stock item footwear but not including arch supports/inserts. Payable to a maximum of $400 per person per calendar year. Not all casting techniques are approved for coverage, so please confirm with GWL prior to purchase.

Custom Orthotics

When submitting claims for custom orthotics, include the following information:

  • A prescription from the physician, podiatrist, chiropractor or nurse practitioner indicating the patient’s medical condition.
  • A detailed copy of the biomechanical assessment/examination.
  • Details of the casting technique used to acquire an anatomical model of the patient’s foot.
  • The date the orthotics were dispensed to the patient.
  • An invoice providing the name, address, and phone number of the clinic or provider along with a list of all charges.

Custom Orthopedic Shoes

When submitting claims for custom orthopedic shoes, include the following information:

  • A prescription from the physician, podiatrist or nurse practitioner indicating the patient’s medical condition and an explanation why stock-item orthopedic shoes can’t be used by patient.
  • Details of the casting technique used to acquire an anatomical model of the patient’s foot.
  • Details of the fabrication process and materials used to make the shoes.
  • An invoice providing the name, address, and phone number of the dispensing clinic or provider along with a list of all charges.
Out-of-Province/Out-of Country Emergencies

Reasonable charges for a physician’s services due to an emergency are eligible for reimbursement, less any amount paid or payable by the Medical Services Plan, subject to the lifetime maximum of $3 million for out-of-province/out-of country travel.

Paramedical Services (acupuncture, chiropractor, naturopathic physician and podiatry: $200/year/person or $500/year/family)

Massage Therapy: $750/year/person

Physiotherapy: no maximum

Services provided by licensed paramedical practitioners. For the purposes of this plan, paramedical services are a defined group of services and professions that supplement and support medical work, but don't require a fully qualified physician. These services include: acupuncture, chiropractor, massage therapy, naturopathic physician, physiotherapy, and podiatry. Claims will be reimbursed at 80% of the cost from the first visit, subject to reasonable and customary limits (R&C) until the annual maximum is reached.

R&C represents the standard fees healthcare practitioners would charge for a given service. They're reviewed regularly and are subject to change at any time. If your healthcare practitioner charges more than a R&C limit, you'll be responsible for paying the difference. If you have any questions about R&C limits for a given service, contact Great-West Life at 1 855 644-0538.

Physiotherapist

Professional services performed by a physiotherapist registered with the College of Physical Therapists of British Columbia. See the “Paramedical Services” section of this table for information about reasonable and customary limits. There's no maximum coverage.

Podiatrist

Professional services performed by a podiatrist registered with the British Columbia Association of Podiatrists. See the "Paramedical Services" section of this table for information about reasonable and customary limits. Coverage is $200/person/year or $500 year/family.

X-rays taken or other special fees charged by a podiatrist are not covered.

Prostate-serum Antigen Test

Once per calendar year.

Smoking Cessation Products

Drugs and supplies for prescriptions and non-prescription smoking cessation.

Maximum: $300/year/person to a lifetime maximum of $1,000.

You must register with the Quittin’ Time program prior to purchasing any products.

  • Members must submit proof of registration in the Quittin’ Time Program to Great-West Life along with the first claim of the 6 month period.
  • Great-West Life will activate the member’s drug card for the drug product purchased, and set the appropriate maximum and termination date for the six month period.

Great-West Life will write to the member to advise them they can continue to use their drug card until the earlier of the end of the six month period, or until they have reached their calendar year or lifetime maximum. Members will also be advised to notify Great-West Life if they switch to another smoking cessation product so their claims continue to pay correctly.

Vision Care

Purchase and/or repair of corrective eyewear, charges for contact lens fittings and laser eye surgery, when prescribed or performed by an optometrist, ophthalmologist, or physician. This benefit isn't subject to the annual deductible and is reimbursed at 100% (to benefit plan limits).

A combined maximum of:

  • Adults: $250/24 months.
  • Children: $250/12 months.

Check GroupNet to verify your personal eligibility period.

Charges for non-prescription eyewear aren't covered. See the "Vision Examinations" section for information about eye exams.

Any item not specifically listed as being covered under this plan is not an eligible item under this extended health plan.

Out-of-Province/Out-of-Country Coverage Under the Extended Health Group Plan

If you're covered under the extended health group plan and you travel out-of-province or out-of-country for business or personal travel, you're covered for medical emergencies, including those resulting from pre-existing conditions (except for a few inclusions) up to the lifetime maximum of $3 million per person. Eligible emergency medical expenses are subject to the annual deductible and will be reimbursed at 100%.

Eligible out-of-province/out-of-country expenses

  1. Local ambulance services when immediate transportation is required to the nearest hospital equipped to provide the treatment essential to the patient.
  2. The hospital room charge and charges for services and supplies when confined as a patient or treated in a hospital. Members should contact Travel Assistance for assistance if they have a medical emergency. See the Travel Assistance Brochure (PDF, 169KB) for contact information. When the patient’s medical condition permits, they'll be returned to Canada. Great-West Life's standard out-of-country confinement is up to a semi-private ward rate.
  3. Physician, Laboratory and X-ray services.
  4. Prescription drugs.
  5. Other emergency services and/or supplies, if Great-West Life would've covered the expenses in B.C.
  6. Medical supplies provided during a covered hospital confinement.
  7. Paramedical services provided during a covered hospital confinement.
  8. Medical supplies provided out of hospital if you would've been covered in Canada.
  9. Out of hospital services of a professional nurse.

These expenses are eligible in a medical emergency only, and when ordered by the attending physician. A medical emergency is:

  • a sudden and unexpected injury
  • the onset of a condition not previously known or identified prior to departure from B.C. or Canada
  • an unexpected episode of a condition known or identified prior to departure from B.C. or Canada

An unexpected episode means it would not have been reasonable to expect the episode to occur while travelling outside of Canada. If a person was suffering from symptoms before departure from Canada, GWL may request medical documentation to determine whether, in the circumstances, it could have reasonably been anticipated that the person may require treatment while outside Canada.

Non-emergency continuing care, testing, treatment, surgery and amounts covered by any government plan and/or any other provider of health coverage are not eligible.

Exclusions

  • Expenses incurred due to elective treatment and/or diagnostic procedures.
  • Complications related to such treatment expenses incurred due to therapeutic abortion, childbirth, or week 35 or later, or if high risk, during pregnancy.
  • Charges for continuous or routine medical care normally covered by the government plan in your province/territory of residence.

Business travel medical insurance

Employees without extended health coverage through their employment with the BC Public Service are not covered under the Group Business Travel Insurance Plan. There are limited exceptions. Employees without extended health coverage should confirm their travel medical insurance status before making travel arrangements. If out-of-province or out-of-country business travel is required, employees without coverage under the corporate travel medical policy should purchase an individual travel insurance plan and claim the expense through their travel claim. When purchasing travel insurance, make sure to read and understand the fine print. Most individual travel insurance plans exclude coverage for pre-existing conditions. Employees should carefully consider their personal health circumstances before agreeing to travel for work.

Optional medical travel insurance

Great-West Life has a travel insurance website to enable you to purchase optional travel medical insurance. For more information, review Great-West Life’s Optional Emergency Travel Medical Benefit Information Sheet (PDF, 206KB). This travel medical insurance is first payer to your group plan with Great-West Life, and you’ll save 10% by purchasing it from this website. If you have other similar coverage – such as through a credit card plan or another group or individual insurance plan – claims will be coordinated within the guidelines for out- of-province/country coverage issued by the Canadian Life and Health Insurance Association.

To apply, you'll need your Great-West Life group plan number (50088) and your identification number from your Great-West Life ID card.

This travel insurance has a maximum amount payable per covered trip of $2 million Canadian. Coverage is available for either single or annual travel policies if you're under age 80. There are exclusions for pre-existing conditions.

Travel Assistance provides assistance if you or an eligible dependant experience a medical emergency while traveling out-of-province. Trained personnel who speak various languages will provide advice and coordinate services for you. This service is available 24/7 and assists members in locating hospitals, clinics and physicians. 

Travel Assistance also provides the following services:

  1. Medical advisors;
  2. Advance payment when required for hospital admission;
  3. Helping to locate qualified legal assistance, local interpreters and appropriate services for replacing lost passports;
  4. Assisting unattended children;
  5. Return of vehicle;
  6. Transportation reimbursement;
  7. Medical evacuation;
  8. Travelling companion expenses;
  9. Transportation of remains if a plan member dies while travelling, expenses for preparing and transporting the plan member’s remains home are covered. The assistance company can also help make the appropriate arrangements.

Travel Assistance provides advice and coordinates services at no additional charge. However, it's not a means of paying for any healthcare expenses that you may require. The actual cost for any service(s) received is your responsibility. Some of these expenses may be claimed through Medical Services Plan of BC, travel insurance purchased by you or your extended health plan.

Please ensure that you have your Assure card with you when you travel as the Travel Assistance phone numbers are listed on the back of your card.  Have your Great-West Life Plan ID and provincial health care numbers ready for personal identification.

For more information on what Travel Assistance provides, please visit the Travel Assistance page.

Great-West Life’s prior authorization process is designed to provide an effective approach to managing claims for specific prescription drugs.

How Prior Authorization Works

Prior authorization requires that you request approval from Great-West Life for coverage of certain prescription drugs. When a claim is submitted for any of these drugs, they'll ask for information to help them assess the claim. Your request must be approved before your claim is paid. To ensure your claim is processed without delay, please provide all necessary information before filling a prescription.

Why we require prior authorization

Drugs that are approved for one or more medical conditions are sometimes prescribed for other conditions without being proven as an effective treatment. The practice of requesting additional information is designed to help:

  • Provide coverage for appropriate drug treatment;
  • Ensure the drugs prescribed are considered reasonable treatment for the condition;
  • Keep your drug plan affordable and accessible.

Drugs requiring prior authorization

Great-West Life maintains a limited prior authorization drug list and the corresponding forms. Before a claim for any of these drugs is approved, they review the circumstances to determine whether the drug is a reasonable treatment for the condition for which it was prescribed. The prior authorization drug form list changes from time to time. Your group benefits plan may not provide coverage for all of the prior authorization drugs listed, as coverage depends on the terms of your plan.

To view the prior authorization drug form list, visit Great-West Life to determine if a certain drug requires prior authorization. If you have questions about which drugs are covered by your plan, call your local Great-West Life Group Customer Contact Services office at 1 855 644-0538.

How to request prior authorization

If you’re prescribed a drug that requires prior authorization, you must complete the appropriate section(s) of a Request for Information form with your prescribing doctor and submit the form to Great-West Life. Your claim can't be considered for reimbursement until they receive this form. If you anticipate submitting a claim for a drug that requires prior authorization, take a Request for Information form to your doctor’s appointment. Completed forms can be faxed or mailed to Great-West Life.

Fax
Great-West Life
Fax Number: (204) 946-7838
Attention: Drug Services

Mail
Great-West Life
Drug Services, P.O. Box 6000
Winnipeg MB  R3C 3A5

If your claim is approved, in most cases, additional Request for Information forms for the drug won't be required. Future claims for the drug will be processed in the same manner as prescription drugs that don't require prior authorization. Certain drugs may require additional approval after a specified period. In these situations, you may be asked to provide further information regarding the progress of your treatment Prior authorization review. All requests for prior authorization are reviewed by Great-West Life. Their decision is based on the information provided to determine whether the prescribed drug represents reasonable treatment.

Notification Regarding the Claim Decision

Once Great-West Life reviews your completed Request for Information form, they'll advise you by letter if whether or not the request for prior authorization has been approved. If the request is declined, you may wish to discuss your medication needs with your doctor or pharmacist. (You have the option of paying for the total cost of the drug yourself.)

Specialty Drug Program

Great-West Life’s enhanced drug coordination process coordinates eligible drugs under specific provincial programs. You may be required to apply to the provincial program for drug coverage. Some drugs included in this program are also under prior authorization.

How the Specialty Drug Program works

You go to your pharmacy to fill a prescription.

1. The drug is included in the Specialty Drug program.

  • The claim will be paid, but you’ll need to apply to your provincial program.
  • You’ll receive a letter to apply to the provincial program and respond to Great-West Life within 70 days.
  • Great-West Life will coordinate your drug plan with your provincial plan.

OR

2. The drug is included in Specialty Drug program and the Prior Authorization program.

  • If your claim is denied, you’ll receive a message to apply to your provincial program.
  • You’ll receive a letter to apply to the provincial program along with the applicable Prior Authorization form.
  • If approved, Great-West Life will pay any amounts not eligible under the provincial program.
  • If the provincial plan declines your claim, send the Prior Authorization form to Great-West Life to assess eligibility under the drug plan.
  • You’ll be notified if your claim is accepted or not.

Prescription Drug Coverage: BC Public Service Extended Health Plan

The following communication is to provide details of the prescription drug coverage under the extended health plan for BC Public Service employees.

What's BC PharmaCare and how does it coordinate with your drug plan?

BC PharmaCare helps all B.C. residents with the cost of eligible prescription drugs, even if you have private drug coverage through the BC Public Service extended health plan. If you fill a prescription that's eligible with BC PharmaCare (BC PharmaCare covers about 50% of all prescription drugs available in Canada), then BC PharmaCare will start paying for these drugs once your total annual prescription costs reach your deductible, which is based on 3% of your net family income. Your extended health plan will pay your deductible portion in accordance to the plan’s reimbursement limits until the deductible is satisfied, and then PharmaCare will start paying for you and your dependants’ eligible drugs for the rest of the calendar year.

In the example below, based on a net family income of $50,000 and total eligible family drug costs of $2,000 for the year, BC PharmaCare will start paying for eligible prescriptions after the cost of your family’s eligible drug spend has accumulated to $1,500 ($50,000 x 3%) within a calendar year.

BC Pharmacare Coordination

How does PharmaCare know how to calculate my deductible?

You must register for Fair PharmaCare in order for BC PharmaCare to access your income tax returns to calculate your deductible. If you don't register, your deductible will be set at the maximum of $10,000, which will add unnecessary costs to your drug plan.

What if I've already notified our previous insurer, Pacific Blue Cross, that I registered with Fair PharmaCare?

If you've already registered with Fair PharmaCare, and submitted the information to Pacific Blue Cross, that information should have been transferred to Great-West Life.

What if I haven't registered with Fair PharmaCare?

If the eligible drug costs for you and your dependant(s) have accumulated and reached a certain threshold within a calendar year, then Great-West Life will notify you that you need to register for Fair PharmaCare or your drug claims will be temporarily suspended until Great-West Life receives confirmation of Fair PharmaCare registration. Learn more about Fair PharmaCare.

In addition to coordinating drug costs with BC PharmaCare, the drug plan for BC Public Service employees follows BC PharmaCare’s pricing policies which includes the Lowest Cost Alternative (LCA) Program and the Reference Drug Program (RDP).

What's the Low-Cost Alternative (LCA) Program?

When the same drug is made and sold by more than one manufacturer, the plan covers the less costly version. Drugs deemed the "lowest cost alternative" are usually (but not always) generics. The LCA drugs (usually generics) are fully covered by the plan but the more costly brand drugs are only partially covered up to the LCA price.

For example:

  • Celexa™ is the brand version of a popular antidepressant
  • The cost of one Celexa 20mg tablet = $1.52 (partially covered)
  • The generic version of one Celexa 20mg = $0.26 (fully covered)

Your drug plan would only pay up to the cost of the generic version ($0.26) if you filled a prescription for Celexa™, subject to the terms of your group benefits plan. To get fully reimbursed, you would need to purchase the generic version which can easily be done by the pharmacist without authorization from your doctor.

If there's a medical reason which requires you to take the brand name drug, ask your physician to complete a Request for Brand Name Drug Coverage form to provide the medical information on why you require the brand name drug. This form is available on the Great-West Life website.

What's the Reference Drug Program (RDP)?

Sometimes there are several drugs that treat the same illness or condition that are very similar in effectiveness, chemical structure, and safety. There are eight therapeutic classes in the Reference Drug Program. PharmaCare reviews the cost of the drugs within each category and determines the maximum daily cost it will cover. Each therapeutic category has reference drugs which are the most cost effective and these are fully covered by the plan, in accordance to the plan’s reimbursement formula. However, the more expensive drugs within a therapeutic category are considered non-reference drugs and these will only be partially covered, up to the maximum daily price.

For example, let’s consider the statins, a popular class of drugs for high cholesterol:

  • Reference statin drugs: atorvastatin and rosuvastatin are fully covered.
  • Non-reference statin drugs: fluvastatin, lovastatin, pravastatin, simvastatin are only reimbursed to a daily maximum of $0.26.

The RDP currently has 8 categories:

  1. Angiotensin receptor blockers for high blood pressure
  2. Proton pump inhibitors for acid reflux and ulcers
  3. Statins for high cholesterol
  4. H2 blockers for acid reflux
  5. Calcium channel blockers for high blood pressure
  6. Angiotensin converting enzyme inhibitors for high blood pressure
  7. Nitrates to prevent chest pain
  8. Non-steroidal anti-inflammatories for pain and inflammation

Can I get fully reimbursed for a non-reference drug within the Reference Drug Program if my doctor thinks it's medically necessary?

If your doctor thinks it's medically necessary for you to take a non-reference drug because you have already tried a reference drug and it hasn't been effective, you may ask your doctor to apply to BC PharmaCare’s Special Authority Program on your behalf. Once approved, you can send in the form to Great-West Life to get a pricing exception and full coverage, to plan limits, for your non-reference RDP drug. For any additional information regarding the Reference Drug Program, please refer to the PharmaCare website.

What if I'm already at the pharmacy and realize that my doctor prescribed a non-reference drug? What can I do to get the drug changed to a fully covered drug?

You can go back to your doctor and ask them to prescribe a reference drug within that therapeutic category or ask your pharmacist if they have the ability to adapt the prescription to a reference drug. Under very limited conditions, pharmacists in British Columbia have the ability to change certain prescriptions from one drug to another without consulting your doctor.

BC PharmaCare’s Special Authority Drugs

In addition, some drugs may be eligible for coordination with BC PharmaCare’s Special Authority (SA) Program. If you're claiming a drug included in the (SA) Program, you may be eligible for coverage under the government plan. Great-West Life will notify you in writing asking you to apply to the government program. Once the government decision has been made, a copy of the response letter can be sent to Great-West Life at:

Great-West Life Drug Services

Mail
Box 6000
Winnipeg MB  R3C 3A5

Fax
1 204 946-7664

The dental plan is designed to assist you with the cost of your dental care and reimburses most basic and major dental and orthodontic services.

Overview

Great-West Life (GWL) administers your dental plan on behalf of your employer. Dental coverage is available for services in B.C. and for emergency dental services while traveling anywhere outside of B.C. The plan will cover eligible expenses up to the amount it would've covered had the services been performed in B.C.

What's Covered by Your Dental Plan?

Dental services fall into three categories:

  • Basic Preventative & Restorative Services
  • Major Services
  • Orthodontic Services

Reimbursement

Dentists set their own rates for service, but reimbursement of dental fees under this group plan is subject to the dental fee schedule published by the BC Dental Association for dentists, dental specialists, denturists, and to plan limits.

You'll be reimbursed 100% to plan limits for the cost of the basic dental services outlined below. If services are performed by a specialist, the fee is equal to that of the general practitioner, plus 10%.

It's your responsibility to verify that an item or service is covered before the treatment is performed. Contact GWL if the item isn't listed in this guide.

It's your responsibility to verify that an item or service is covered prior to purchase. Contact GWL if the item isn't listed in this guide.

Basic Services

Basic dentistry is comprised of routine services available in the office of a general practicing dentist that are necessary to restore teeth to natural or normal function.

Diagnostic Services

Procedures conducted to determine or diagnose the dental treatment required, including:

  • Standard oral examinations.
  • Specific oral examinations.
  • X-rays (including panoramic X-rays).
  • A specific oral examination will be reimbursed once for any specific area and only if a standard oral examination hasn't been reimbursed within the previous 60 days.
  • A complete oral examination will be reimbursed to a maximum of once every three years, but not if the plan has reimbursed for any examination during the preceding nine months.

Preventative Services

Procedures that prevent oral disease, including:

  • Cleaning and polishing teeth.
  • Scaling.
  • Topical fluoride – once every nine months.
  • Pit and fissure sealants, preventative restorative resins.
  • Fixed space maintainers intended to maintain space and regain lost space, but not to obtain more space.

Restorative Services

  • Fillings – amalgam fillings and composite (white) fillings on all teeth. Specialty fillings (and crowns) such as synthetic porcelain, plastic, composite resin, stainless steel and gold may result in additional cost to be paid by the employee (or dependant).
  • Stainless steel crowns on primary and permanent teeth.
  • Inlays and onlays.

Only one inlay, onlay or other major restorative service involving the same tooth will be covered in a five-year period.

Surgical Services

  • All necessary procedures for extractions and other surgical procedures necessary for the treatment of disease of the soft tissue (gum) and the bones surrounding and supporting the teeth.

Endodontics

  • Treatment of diseases of the pulp chamber and pulp canal, including but not limited to basic root canal.

Periodontal Services

  • Treatment of diseases of the soft tissue (gum) and bones surrounding and supporting the teeth, including occlusal adjustment, root planing, gingival curettage, and scaling.

Replacement & Repairs

  • The repair of fixed appliances and the rebase or reline of removable appliances (may be done by a dentist or by a licensed dental mechanic). Relines will only be covered once per 24-month period.
  • With crowns, restoration for wear, acid erosion, vertical dimension and/or restoring occlusion isn't covered. Check with GWL before proceeding.
  • Temporary procedures (e.g., while awaiting repair of an appliance) aren't covered.

Major Services

Major services apply to services required for reconstruction of teeth and for the replacement of missing teeth (e.g., crowns, bridges and dentures), where basic restorative methods cannot be used satisfactorily. To determine how much of the cost will be paid by the plan, and the extent of your financial liability, you should submit a treatment plan to GWL for approval before treatment begins.

Reimbursement

Major services are 65% covered to plan limits. Only one major restorative service involving the same tooth will be covered in a five-year period.

Restorative Services

  • Veneers.
  • Crowns and related services.
  • Specialty crowns and fillings, such as synthetic porcelain plastic, composite resin, stainless steel and gold may result in additional cost to be paid by the employee or dependant.

Fixed Prosthetics

  • Bridgework to artificially replace missing teeth with a fixed prosthesis.

Removable Prosthetics

  • Full upper and lower dentures or partial dentures of basic standard design and material. Full dentures can be provided by a dentist or a licensed dental mechanic. Partials can only be provided by a dentist.
  • No benefit is payable for the replacement of lost, broken, or stolen dentures. Broken dentures can, however, be repaired under basic services.

Replacement & Repairs

  • Removal, repairs and recementation of fixed appliances.

Plan Limits

A dentist may charge more for services than the amount set in the governing schedule of fees, or may offer to provide services more frequently than provided for in the fee guide. You're responsible for any financial liability resulting from services performed which aren't covered, or that exceed the costs covered by the plan.

Orthodontic Services

This plan is designed to cover orthodontic services provided to maintain, restore or establish a functional alignment of the upper and lower teeth. The plan will reimburse orthodontic services performed after the date coverage begins.

Pre-approval

To claim orthodontic benefits, GWL must receive:

  • A treatment plan (completed by the dentist) before treatment starts.

Reimbursement

Orthodontic services are 55% covered.

The total lifetime maximum payment for orthodontic services, for each covered person, is $3,500.

The carrier will pay benefits monthly. Photocopies of receipts, as treatment progresses, must be submitted monthly (do not hold receipts until the treatment is complete). You can submit monthly claims through GroupNet.

If you pay the full amount to the dentist in advance of completed treatment, the carrier will prorate benefit payment over the months of the treatment period.

No benefit is payable for the replacement of appliances which are lost or stolen.

Treatment performed solely for splinting isn't covered.

Any other item not specifically listed as being covered under this plan is not an eligible item under this dental plan.

Life insurance plans help protect you and your loved ones from the financial burden of a loss.

Great-West Life [Policy 6878GL(4)] administers your life insurance plan on behalf of your employer. This life insurance plan pays a benefit to your designated beneficiary or to your estate in the event of your death. Coverage is effective 24 hours a day, seven days a week. This policy is a term life insurance policy and has no cash value.

Features of the plan include:

  • Employee Basic Life Insurance
  • Accidental Dismemberment & Loss of Sight Benefit
  • Advanced payment for terminally ill employees
  • A funeral advance option
  • A conversion policy
  • Option to purchase other optional life insurance plans

You're automatically enrolled in Employee Basic Life Insurance, but it's recommended that you designate a beneficiary. Read how to submit or update your beneficiary. Read how to make a claim.

Why designate a beneficiary?

Life insurance payments are non-taxable when paid to one or more designated beneficiaries, and only a named beneficiary can apply for the funeral advance. If paid to an employee’s estate, the insurance becomes part of the proceeds of the estate and may become taxable. In addition, the benefit payment is subject to probate and can be used to pay outstanding debts, taxes and other estate costs. It generally takes longer for the benefit to be paid out through your estate. It's highly recommended that you nominate one or more beneficiaries for your life insurance during your initial enrolment and that you keep your beneficary designation up to date (e.g., if you get married/divorced, or if you have children).

The Benefit Service Centre must receive the original Group Life Beneficiary Designation form (PDF, 156KB) before they can update your beneficiary. If they don't receive the original form, the beneficiary will default to your estate unless you have previously designated a beneficiary, which will then remain on file.

Employee basic life insurance (to age 65)

Employee Basic Life Insurance is mandatory. No enrolment is necessary; you're automatically covered when you meet eligibility requirements.

Except as noted, coverage is equal to three times the annual salary or the employer-paid minimum coverage ($100,000), whichever is greater.

Annual salary is defined as your bi-weekly salary times 26.0893, and coverage is rounded up to the nearest $1,000.

Important information

  • For nurses hired before May 1, 1990: Coverage equals two times annual salary rounded up to the nearest $1,000, with an employer-paid minimum of $40,000 unless the plan member elected the higher level of coverage (outlined above). For more information, refer to articles 25.04 and 27.20 of the BCNU Collective Agreement.
  • For employees working past age 65: Employee Life Insurance (and long-term disability) will cease at the end of the month in which an employee turns 65. Employees have the option to convert their group life insurance plan to an individual plan. See "Converting to Individual Benefits Plans" for more information and important application deadlines.
  • For employees who retire before age 65: Employee Life Insurance will continue until the age of 65 provided that:
    • While an employee, the retiree was covered under the Public Service group life insurance plan (Policy 6878).
    • The retiree begins receiving a pension the month following termination of employment AND elects (on their pension application form) to continue life insurance coverage. Those under 65 will be provided with this option (see your pension package). You are not eligible for this coverage if there has been a break in service from the end of employment to the commencement of your pension payment.

Premiums

The premium for the first $100,000 of insurance coverage is paid by your employer and is a taxable benefit. The employee-paid monthly premium for coverage above $100,000 is 18 cents per thousand dollars (rate subject to change) and is paid through payroll deduction.

Limitations

There are no limitations or restrictions on claims for eligible employees under age 65 or eligible retired employees under age 65.

Other Benefits Included in the Employee Basic Life Insurance Plan

Accidental dismemberment & loss of sight

If you suffer one of the following losses as a result of an accident, you'll receive 100% of the principal sum for:

  • Loss of both hands or feet
  • Loss of sight of both eyes*
  • Loss of one hand and one foot
  • Loss of one hand or one foot and sight of one eye*

If you suffer one of the following losses, you'll receive 50% of the principal sum for:

  • Loss of one hand or one foot
  • Loss of sight of one eye*

*Loss of sight means total and irrevocable loss beyond correction by surgical or other means.

If benefits are paid to you because of an Accidental Dismemberment or Loss of Sight Benefit claim, and you die as a result of that injury, the payment to your beneficiary will be reduced by the benefit payment you received before your death.

A claim for accidental dismemberment or loss of sight should be made in writing as an AskMyHR service request using the category Myself (or) My Team or Organization > Benefits > Bargaining Unit Employees. Forms and instructions will be forwarded for you and your physician to complete.

Advance payment for terminally ill employees

If you're suffering from a terminal illness with a life expectancy of 24 months or less, you may be eligible to receive an advance payment of up to $50,000 or 50% of your Employee Basic Life Insurance, whichever is less. This payment is non-taxable.

Contact MyHR to make a claim and provide them with the following information:

  • Full name
  • Social insurance number
  • Current address
  • Telephone number
  • Last day worked
  • Work status

The remaining portion of your Employee Basic Life Insurance will be paid to your designated beneficiary upon your death. Interest payments will be charged against the advance payment.

Funeral advance

An advance of $10,000 can be expedited to the beneficiary in the event of an employee’s death. This doesn't apply if the estate or a minor child has been designated as the beneficiary. The balance of the life insurance will be paid once the beneficiary has submitted the claim.

To apply for the funeral advance, the beneficiary should contact MyHR and provide the following information:

  • Name of deceased person
  • Date of birth of deceased person
  • Date of death of deceased person
  • Full name, address and phone number of beneficiary

After confirming that the funeral advance is payable, the Benefit Service Centre will contact the carrier and a cheque will be mailed directly to the beneficiary, usually within a few days of the request.

Optional Life Insurance Plans

Additional life insurance is available to you if you want to supplement your Employee Basic Life Insurance and/or if you wish to insure any of your dependants.

Employee optional life insurance

This optional plan provides employee life insurance in addition to basic life insurance. You may select insurance in units of $25,000 up to a maximum of $1 million. The beneficiary of this coverage is the same as designated for basic life insurance unless otherwise specified.

Spouse optional life insurance benefit

This optional plan provides life insurance for your spouse. You may select insurance in units of $25,000 up to a maximum of $500,000. You're the beneficiary of the life insurance.

Child optional life insurance benefit

This optional plan provides life insurance for any/all dependent children you choose to cover. Evidence of insurability isn't required, and you may select insurance in units of $5,000 up to a maximum of $20,000. You're the beneficiary of the life insurance.

Initial enrolment

During initial enrolment, you can select up to $50,000 of Employee Optional and/or Spouse Optional Life Insurance coverage without providing evidence of insurability. Thereafter, if you wish to increase your or your spouse’s life insurance coverage, you'll be required to provide an Evidence of Insurability form (PDF, 789KB) to the carrier. Applications must be approved before coverage can begin.

Waiver of premium benefit on optional life insurance

If you become disabled while insured, the insurance carrier will review whether you're eligible for a premium waiver on the optional life insurance for yourself and your covered dependants throughout the benefit period. Waiver of premium will continue during the period that you're continuously disabled, but won't continue beyond your 65th birthday.

Suicide limitation on optional insurance

Optional employee and spouse life insurance benefits aren't paid if the insured person (you or your spouse) commits suicide within two years after optional life insurance takes effect or increases. The beneficiary will receive a refund of the premiums paid for that insurance.

Optional family funeral benefit plan

This optional plan provides spousal coverage of $10,000 and coverage of $5,000 per dependant child. The beneficiary of this coverage is the employee. The premium is $2.21 per month, regardless of the number of dependants (rate is subject to change). Evidence of insurability isn't required.

Optional accidental death & dismemberment insurance (AD&D)

AD&D insurance is available to supplement your Employee Basic Life Insurance coverage and/or to cover any of your dependants as a result of accidental death or the loss of use of limbs, sight, speech, or hearing. This benefit doesn't provide coverage due to illness.  Coverage is provided 24 hours a day, 7 days a week. Evidence of insurability isn't required. 

Three plans are available:

1. Employee Optional AD&D
You may select insurance in units of $25,000 up to a maximum of $500,000.

2. Spouse Optional AD&D
You may select insurance in units of $25,000 up to a maximum of $500,000.

3. Child Optional AD&D
You may select insurance in units of $10,000 up to a maximum of $250,000

The beneficiary of this coverage is:

  • In the event of employee’s death: the same as designated for basic life insurance unless otherwise specified.
  • In the event of spouse’s or child’s death: the employee.
  • In the event of eligible injury to employee: the employee.
  • In the event of eligible injury to spouse or child: the employee.

Important Definitions Regarding Losses

Loss by dismemberment means:

  • For hands and feet, complete severance through or above the wrist or ankle joints.
  • For arms and legs, complete severance through or above the elbow or knee joints.
  • For thumb and big toe, complete severance of one entire phalange.
  • For fingers and other toes, complete severance of two entire phalanges.

Loss of sight, speech and hearing means total and irrecoverable loss beyond correction by surgical or other means.

Loss of use means total and irrecoverable loss of the ability to perform every action the arm, leg or hand was able to perform before the accident occurred, beyond correction by surgical or other means. Benefits won't be paid for loss of use of the same arm, leg or hand for which loss by dismemberment is paid.

Benefits

The amount of AD&D insurance you purchase is called the principal sum. For example, if you purchase two units of $25,000 for yourself, your principal sum is $50,000. If you purchase three units of $25,000 for your spouse, your spouse’s principal sum is $75,000.

Depending on the loss you, your spouse or your child suffers as a result of an accident, a percentage of the applicable principal sum is payable if any of the following occur within 365 days of the accident.

 
For Loss of Amount Payable
Life The principal sum
Both hands The principal sum
Both feet The principal sum
Sight of both eyes The principal sum
One hand and one foot The principal sum
One hand and sight of one eye The principal sum
One foot and sight of one eye The principal sum
Speech and hearing in both ears The principal sum
One arm 3/4 of the principal sum
One leg 3/4 of the principal sum
One hand 1/2 of the principal sum
One foot 1/2 of the principal sum
Sight of one eye 1/2 of the principal sum
Speech 1/2 of the principal sum
Hearing in both ears 1/2 of the principal sum
Thumb and index finger 1/4 of the principal sum
Four fingers of one hand 1/4 of the principal sum
All toes of one foot 1/8 of the principal sum
 
For Loss of Use of Amount Payable
Both arms and legs (quadriplegia) 2x the principal sum
Both legs (paraplegia) 2x the principal sum
One arm and one leg on same side of body (hemiplegia) 2x the principal sum
One arm and one leg on different sides of body The principal sum
Both arms The principal sum
Both hands The principal sum
One hand and one leg The principal sum
One arm 3/4 of the principal sum
One leg 3/4 of the principal sum
One hand 1/2 of the principal sum

Surgical reattachment

50% of the dismemberment benefit is payable if a dismembered part is surgically reattached regardless if use is regained. The balance of the dismemberment benefit is paid if the reattachment fails and the reattached part is removed within one year after the reattachment is performed.

Other benefits

If benefits are payable under this plan for a covered accident, there may be other benefits paid to plan maximums in addition to loss of life, dismemberment or loss of use benefits.

  • If death occurs 150 kilometres or more from home, up to $2,500 will be paid for preparation of the body and transportation to its burial place or crematory. This benefit is also available to your dependants under the family plan.
  • If your death is accidental, your spouse may be reimbursed for an occupational training program. Your child or children may be reimbursed for tuition if they enrol as a full-time student at a post-secondary institution.
  • Up to $2,000 for transportation and lodging expenses to have one family member join the covered person if they're hospitalized more than 150 kilometres from their home.
  • Fees to enroll in an education program if a job change is required because of an accident.
  • Expenses to make the covered person’s house and vehicle wheelchair accessible.

For more information on the limitations and specifications related to these additional benefits, please contact MyHR. If submitting an AskMyHR service request select the category Myself (or) My Team or Organization > Benefits > Bargaining Unit Employees.

AD&D limitations

No benefits will be paid for loss resulting from or associated with the following:

  • Suicide, regardless of state of mind.
  • Intentional self-inflicted injury, regardless of state of mind.
  • Viral or bacterial infections, except pyogenic infections, occur due to injury for the loss that is being claimed.
  • Disease or critical illness.
  • Medical or surgical treatment other than reattachment.
  • Service (including part-time or temporary service) in the armed forces of any country.
  • War, insurrection or voluntary participation in a riot.
  • Air travel, except as a passenger in a licensed aircraft flown by a pilot certified to fly the aircraft. No benefits will be paid where the aircraft is owned, leased or rented by the Province of B.C. or where the person who suffers the loss is acting as a crew member.

When you're ready to make an extended health, drug, dental, or life insurance claim, choose the method that works best for you.

GroupNet

GroupNet is Great-West Life's self-service website for your extended health and dental plans.

  • Submit eClaims
  • Update direct deposit banking information
  • View your coverage at a glance
  • Track your eligibility and limits
  • Print replacement ID cards

The Assure Card is your benefits ID card that has your Great-West Life Plan number and ID number on it. When you log into GroupNet, you'll see your group plan number (50088) and your travel assistance plan (170688). If you haven't received your ID card in the mail, you can register with GroupNet and print out a card. Register using Plan number 50088 and your ID number. If you don't know your ID number, or if you have problems registering with GroupNet, please call GWL. You, your spouse and any dependent children over 19 will be issued an Assure Card. Any dependent children under 19 don't receive a card, but you'll see them listed under your group coverage through GroupNet.

Please ensure that your address is updated with your employer and in GroupNet for Plan Members. If you have access to Employee Self Service (ESS), you can update your address online. If you don't have access to ESS, call MyHR (1 877 277-0772) and a Service Representative will be able to update your information in PeopleSoft.

Pay Direct

Pharmacies, dentists, chiropractors, physiotherapists, naturopathic doctors, podiatrists, psychologists, massage therapists and optical stores/optometrists/ophthalmologists can register for Pay Direct through GWL. If your service provider has signed up, simply show your Assure Card (and the card for your spouse’s program, if you can coordinate benefits) and you will pay only the portion of the expense that's not covered under your benefits plan.

Extended Health & Drugs

To make a claim for reimbursement, you can submit a paper or electronic claim.

Find the paper claim form on MyHR or GroupNet, and follow the submission instructions carefully. Make a photocopy of your expense receipt because the originals can't be returned to you.

Submit eClaims on GroupNet for prescription drugs, vision care, chiropractic, physiotherapy, podiatry, psychology, acupuncture, massage therapy and naturopathy. Keep your original expense receipts if you're asked to submit them.

Dental

Most dental offices will bill GWL directly when you present your Assure Card (and the card for your spouse’s program, if you've coordinated benefits), and you'll pay only the portion of the service not covered by your benefits plan(s). If not, you can submit a paper claim.

Find the paper claim form on MyHR or GroupNet, and follow the submission instructions carefully. Make a photocopy of the expense receipt because the originals can't be returned to you.

Monthly orthodontic claims may be claimed through GroupNet.

Deadlines

It's recommended that you submit claims immediately after treatment. Late claims won't be accepted by GWL. Extended health claims, including drug claims and dental claims, must be received no later than 15 months from the date the expense was incurred.

For all claims questions, contact Great-West Life at 1 855 644-0538.

Life Insurance

To initiate a claim for any of the life insurance products, you, your supervisor, or your designated beneficiary can contact MyHR. If submitting an AskMyHR service request select the category Myself (or) My Team or Organization > Benefits > Bargaining Unit Employees.  A representative will send claiming information and will be available to answer your questions.

Coordinated Benefits

If your spouse is a BC Public Service employee and is covered under the BC Public Service benefits plan (excluding BC Ferries plan members), you're able to coordinate benefits and submit your extended health and dental receipts to both plans and get up to 100% of your eligible expenses reimbursed. If your spouse is enrolled in a benefits program with an employer outside of the BC Public Service, check your spouse’s benefits program to see if it allows for coordination of benefits plans.

Insurance companies follow the guidelines below to determine which plan pays first and how benefits are calculated.

When you make a claim under coordinated plans, photocopy your receipt(s) and submit your claim to your plan first.

Once approved, you'll receive an Explanation of Benefits Statement. Now you can submit a claim to your spouse’s plan, along with the Explanation of Benefits Statement and photocopies of your receipt(s).

Spouses will submit to their plan first and to your plan second.

If you have dependent children, the order of submission is determined by your birthdays. If your birthday is earlier in the calendar year than that of your spouse, you'll submit your children’s claims to your program first.

If you and your spouse have coordinated benefits and you're both covered under GWL, you can submit to both plans at the same time by filing an eClaim through GroupNet.

A retiree plan will always pay after any group plan that covers you as an employee.

When coordinating benefits, please ensure the same names are being used on both plans (e.g., legal names) so there are no delays with the coordination of benefits with the carrier. If the names don't match, there may be a delay in payment or payment may be missed.

Once your claim is processed, you'll receive notification. If you provided GWL with your banking information, they’ll deposit the reimbursement into your banking account, otherwise you'll receive a cheque in the mail.

The BC Public Service recognizes that each of us, throughout our career in the BC Public Service, may experience various work events (e.g., becoming a new employee, travelling out of the country, leaving the public service, etc.) that will change the type of coverage we receive.

The following is a list of common work status changes and the effects on benefits coverage. If you have any questions, contact MyHR. If submitting an AskMyHR service request select the category Myself (or) My Team or Organization > Benefits > Bargaining Unit Employees.

What Happens If ...?
Question

Answer

I transfer from a regular position to an auxiliary position?

Your benefits coverage ends at the end of the month of your date of transfer and you must re-qualify for benefits.

I'm on a temporary assignment to an excluded position from a base position in the Bargaining Unit?

If your temporary assignment is 21 days or longer, you're eligible (and can enrol) for the benefits program available to excluded employees. You become eligible on the first day of the month following the start of your temporary assignment to the excluded position. More information about benefits for excluded employees (Flexible Benefits Program) is available on MyHR.

If you return to your base position, you return to your Bargaining Unit benefits program. If you allocated funds to a Health Spending Account, it terminates at the end of the month you return to your base position. The remaining balance is forfeited.

If you're enrolled in any of the Optional Life Insurance Plans, your coverage transfers between the two benefit plans. A change in employment isn't considered an eligible life event, therefore no changes can be made to your life insurance coverage as a result of a job change.

Your extended health and dental claims history remains with you throughout your employment. You should always check your eligibility prior to purchase.

I transfer to an excluded position?

You become eligible (and can enrol) for the benefits program available to excluded employees. Refer to the "Eligible Employees" section in the Flexible Benefits Guide on MyHR.

If you're enrolled in any of the Optional Life Insurance Plans, your coverage transfers between the two benefit plans. A change in employment isn't considered an eligible life event, therefore no changes can be made to your life insurance coverage as a result of a job change.

Your extended health claims history remains with you throughout your employment. You should always check your eligibility prior to purchase.

I'm actively working, and I reach the age of 65?

There are no changes to MSP, extended health and dental. You're no longer eligible for Employee Basic Life Insurance or for any of the Optional Life Insurance or Optional Accidental Death & Dismemberment Insurance plans, but can convert to an individual plan. For more information, see "Converting to Individual Benefits Plans" on the “When Does Coverage End?” page.

You're also no longer eligible for long term disability.

I'm on sick leave?

There are no changes to coverage.

I'm approved for Long Term Disability (LTD) benefits?

There are no changes to coverage.

I commence a rehabilitation trial?

There are no changes to coverage.

I return to work from Long Term Disability (LTD)?

There are no changes to coverage.

I'm on leave with pay?

There are no changes to coverage. If you're on a leave with partial pay, visit MyHR for more information.

I'm on leave without pay?

Benefits coverage is suspended during a leave without pay, but you can continue to receive benefits coverage by paying the full cost of the plan premiums. If the leave is included in Part 6 of the Employment Standards Act your benefits, other than Optional Life Insurance, are continued. Review the Benefits While on Leave or Layoff section on MyHR.

I return from a leave without pay?

If your leave is under three months, contact MyHR when you return to reinstate your benefits. Submit an AskMyHR service request using the category Myself (or) My Team or Organization > Benefits > Submit a Health Benefit Form/Application. If your leave is greater than three months, follow the enrolment process to reinstate your benefits. Optional Life Insurance coverage that was not maintained will require requalification (application and submission of evidence of insurability.

I'm on maternity/parental/pre-placement adoption leave?

Benefits in place prior to your leave will remain in place during the leave. If you choose, you may waive MSP and extended health and dental plan coverage during your leave by completing and submitting cancellation forms (one for MSP and one for extended health and dental plans) along with your maternity/parental leave forms. As a condition of employment, you must maintain Employee Basic Life Insurance and long term disability coverage during the leave.

Your benefits will be maintained, with the exception of Optional Life Insurance, if you're on maternity/parental leave and have waived, are not eligible for or have deferred your top-up allowance.

You can choose to maintain your Optional Life Insurance coverage by submitting an application, and paying the premiums. If you discontinue your Optional Life Insurance, you need to reapply and requalify by submitting evidence of insurability. More information can be found on the MyHR page Benefits While on Leave or Layoff.

If you're taking extended child care leave after parental leave and would like to maintain your benefits, you'll have to pay the premiums. More information can be found on the MyHR page Benefits While on Leave or Layoff.

After your leave, if you don't fulfil the return-to-work requirements, you'll have to repay any premiums that were paid on your behalf by your employer during the leave. For more information, refer to Maternity, Parental & Pre-Placement Adoption Leave For B.C. Government Employees on MyHR.

Once your child is born, you can enrol them in your benefits plans by submitting the group change forms. You'll need to complete one for the MSP and one for your extended health and dental plans.

I travel out-of-province?

Coverage depends on a number of factors, including whether you're on government business.

The Medical Services Plan strongly advises B.C. residents to purchase additional health insurance when traveling out of province for personal travel to cover the cost of services not included in the plan.

I'm laid off from the BC Public Service?

Your MSP coverage, extended health and dental coverage and life insurance plans end on the last day of the month of layoff. Benefits coverage can be continued for six months following the month of layoff if you apply to continue coverage and pay the premiums. Visit MyHR for more information.

I retire from the BC Public Service?

Your coverage ends at the end of the month in which you retire. Retirement benefits are administered through the BC Public Service Pension Plan. Review retirement benefits criteria at the BC Pension Corporation website.

MSP isn't a benefit available to retirees under the Public Service Pension Plan. Health Insurance BC will direct bill you once your coverage ends under the group plan.

I resign from the BC Public Service?

Your extended health and dental coverage ends on your last day of work. Your Medical Services Plan coverage and life insurance plans ends on the last day of the month in which your employment ends. See "Converting to Individual Benefits Plans" under the “When Does Coverage End?” section for further information.

Benefits coverage extended to an eligible spouse and/or dependent children will end the same date that your coverage ends.

I die?

Employee Coverage
Benefits coverage will terminate at the end of the month in which death occurs. A life insurance claim will be initiated when MyHR is notified.

Medical Services Plan Coverage for Dependants
Coverage terminates for dependants at the end of the month in which the death occurs. Cancellation of the dependant coverage will generate an individual account for any covered dependants. Dependants are advised to call 1 800 663-7100 to confirm coverage and contact information so there's no lapse in coverage.

Extended Health & Dental Plan Coverage for Dependants
Coverage terminates for dependants at the end of the month following the month in which the employee dies (e.g., coverage terminates on April 30 when the employee’s death occurs in March). Dependants can purchase individual extended health and dental plan coverage when the group coverage ends through Great-West Life. Of course, family members are free to purchase coverage from whichever health insurance carrier they choose.

Optional Life & Optional AD&D Coverage for Dependants
Coverage ends at the end of the month in which the death occurs. Covered dependants can apply for individual coverage. See "Converting to Individual Benefits Plans" under the “When Does Coverage End?” section for further information.

Medical Services Plan

Coverage ends on the last day of the month in which any of the following occurs:

  • Your employment ends
  • You request that coverage end
  • You change from regular to auxiliary status
  • You take a leave of absence without pay greater than a calendar month (if you don't pay the required premiums)
  • You're laid off (if you don't pay the required premiums)

Extended Health & Dental Plans

Coverage ends on one of the following:

  • Your last day of employment
  • The day you request that coverage end
  • The last day of the month of a leave of absence without pay greater than a calendar month (if you don't pay the required premiums)
  • The last day of the month in which you change from regular to auxiliary status
  • The last day of the month of lay off (if you don't pay the required premiums)
  • The last day of the month in which you're on pay prior to retirement

Employee Life & AD&D Insurance

Coverage ends on the date the policy terminates or the last day of the month in which any of the following occurs:

  • Your employment ends
  • You turn 65
  • You change from regular to auxiliary status
  • You retire under the provisions of the Pension Public Service Act (unless you elect to continue coverage to age 65)
  • After the month in which a premium isn't received by you or your employer on your behalf
  • You cease to satisfy the actively-at-work requirement

Coverage for eligible dependants ends on one of the following:

  • The same date that your coverage terminates
  • The date you request coverage end
  • The date they cease to qualify as an eligible dependant
  • In the event of the employee’s death, extended health and dental plan coverage for dependants is maintained until the end of the month following the month of the employee’s death; MSP coverage for dependants terminates at the end of the month of the employee’s death

When your spouse turns 65, they're eligible to convert to an individual life insurance plan without a medical exam. See the section on Converting a Spouse’s Optional Life Insurance for further details.

Converting to Individual Benefits Plans

The conversion policy enables you to convert to individual extended health, dental and life insurance plans when your group coverage ends.

Converting to an individual plan may benefit you if you don't qualify for other insurance due to an existing medical condition.

You can apply to convert to some or all these plans.

You must apply and pay your first premium within 60 days of the end of the month in which your group coverage ends.

This conversion can't be made retroactive. If you miss this deadline, you're no longer eligible for conversion.

Converting Your Individual Life Insurance Plans

If your employment ends or you reach age 65 (and are no longer eligible for group life insurance), you may convert your coverage to an individual policy, limited in both amount and plan, without a medical examination. Or, you may take a medical examination (paid for by the carrier) and choose any insurance plan offered by the company. If you don't meet the medical requirements, you can still convert your coverage to an individual policy, limited in both amount and plan.

The amount of the individual policy where no medical examination is taken may be any amount up to the amount of coverage combined (maximum $200,000) in force at the time your group coverage ends. The premium for the individual policy will depend on your age and on the type of policy you select. It's not the same rate as paid while covered under the group plan.

To start the conversion process for life insurance, contact MyHR. If submitting an AskMyHR service request select the category Myself (or) My Team or Organization > Benefits > Bargaining Unit Employees.

Converting Your Spouse’s Optional Life Insurance

Provided your spouse is under age 65, you may also convert their optional life insurance to an individual plan at the same time as you are converting your own coverage. The same application deadline applies.

If your spouse is older than you when you turn 65, your spouse is ineligible for conversion to an individual plan.

To start the conversion process for life insurance, contact MyHR. If submitting an AskMyHR service request select the category Myself (or) My Team or Organization > Benefits > Bargaining Unit Employees.

Individual Extended Health & Dental Plans

When your group coverage ends, an individual health and dental plan is available through Great-West Life. Visit their Health and Dental Insurance page for more information.

If you would like to purchase an individual extended health and dental plan, contact Great West Life.

Individual plans will be different than the group plan.

You're free to apply for insurance with any other insurance carrier you choose at any time. MyHR, the Public Service Pension Plan at BC Pension Corporation, and your employer aren't responsible for the lapse of the 60-day conversion period if you don't apply in a timely manner.

Bargaining Unit Benefits Guide Glossary
Term Definition
Actively-at-Work Requirement

To satisfy this requirement, an employee must:

  • Be fully capable of performing their regular duties; and
  • Be either:
    • Working at the employer’s place of business or a place where the employer’s business requires them to work.
    • Absent due to vacation, weekends, statutory holidays, or shift variances.
Annual Earnings For the purposes of Employee Basic Life Insurance, annual earnings are defined as 12 times your current monthly base rate of pay for your current classification, calculated as bi-weekly salary times 26.0893. Annual earnings are the employee’s basic annualized salary paid by the employer, including salary protection, classification adjustments, and some temporary market adjustments. Overtime, allowances, bonuses or any other additions to pay aren't included.
Auxiliary Employee An employee who's employed for work that isn't of a continuous nature. Refer to your Collective Agreement for information on eligibility requirements for benefits.
Bargaining Unit Employee The Bargaining Unit consists of those public service employees who are members of one of the following Bargaining Units: the British Columbia Government and Service Employees’ Union (BCGEU), the Communications, Energy and Paperworkers Union of Canada, (CEP), the Professional Employees Association (PEA), the British Columbia Nurses Union (BCNU).
Beneficiary

The person(s)/registered charity named to receive the insurance benefit if the employee dies while insured. If the employee dies without designating a beneficiary, payment will be made to the employee’s estate.

The employee is the beneficiary for Spouse Optional and Child Optional Life Insurance.

Carrier

The service provider that adjudicates the claims on behalf of the employer:

  • Great-West Life is the carrier for extended health and dental.
  • Great-West Life is the carrier for life insurance products.
Claim A request to the insurance provider for payment under the benefits plan.
Common-law Spouse

A common-law spouse is a person of the same or opposite sex where the employee has signed a declaration or affidavit that they have been living in a common-law relationship or have been co-habiting for at least 12 months. The period of co-habitation may be less than 12 months where the employee has claimed the common-law spouse’s child/children for taxation purposes.

By enrolling your common law spouse in your benefits program, you're declaring that person as your common-law spouse. A separate form (declaration) is not required.

Complete Oral Exam

Clinical examination and diagnosis of hard and soft tissues, including carious lesions, missing teeth, determination of sulcular depth and location of periodontal pockets, gingival contours, mobility of teeth, recession, interproximal tooth contact relationships, occlusion of teeth, TMJ, pulp vitality tests, where necessary and any other pertinent factors.

Conversion Policy

A policy that enables members to convert to individual benefits plans (extended health and dental, life insurance) when group coverage ends.

Coordination of Benefits

A provision describing which insurer pays a claim first when two policies cover the same claim. This provision applies only to extended health and dental plans.

Deductible

The amount you must pay each year before the plan starts to reimburse eligible medical expenses.

Dependants

A spouse or child who meets the eligibility requirements and is covered under your benefits program.

Qualifying Disability (Optional Life Insurance only)

An employee is considered disabled if disease or injury prevents them from being gainfully employed. Gainful employment means work:

  • That a person is medically able to perform;
  • For which they have at least the minimum qualifications;
  • That provides income of at least 60 per cent of their indexed annual earnings*; and
  • That exists either in the province or territory where they worked when they became disabled or where they currently live.

The availability of work won't be considered in assessing disability.

*Indexed annual earnings are pre-disability earnings that have been adjusted to reflect changes in the Consumer Price Index.

Dispensing Fee

The fee charged by pharmacies to dispense a medication.

Eligible Employee

All regular Bargaining Unit employees, whether full or part-time, may participate in this benefits program. In addition, auxiliary Bargaining Unit employees may participate in this benefits program upon meeting eligibility criteria (e.g., completion of 1827 hours of work in 33 pay periods). See your Collective Agreement for additional information about eligibility criteria.

Eligible Expenses

Charges for services and/or supplies that have been specifically included in the Extended Health and Dental Contract as a benefit. An expense is incurred on the date the service is provided or the supply is received.

Any payment to a pharmacy or practitioner which represents an amount more than the recognized fee schedules isn't included in the definition of an eligible expense.

Eligible Life Event A specific event or change that allows you to make changes to your benefit options within 60 days of the event. Eligible life events include events such as a birth or death of a dependant, a change in marital status, or the loss of a spouse’s benefits coverage.

Employer

BC Public Service or an employer participating in the public service benefits program.

Estate

The whole of one’s possessions (assets and liabilities) left by an individual upon their death.

Evidence of Insurability The documentation of the good health to be approved for Spouse Optional and Dependant Life Insurance. This is also called "evidence of good health."

Explanation of Benefits Statement

The statement you receive from your extended health/dental insurance carrier that itemizes how you're being reimbursed for the expenses that you submitted.

Fee Schedule

The dental fee schedule published by the BC Dental Association for dentists (general practitioners), dental specialists, and denturists that contains eligible dental services, financial limits, treatment frequencies, and fees in effect on the date the dental service was performed.

Most, but not all, plans will cover costs based on the fee guide. It's not mandatory for dental offices to follow the fees suggested in the fee guide.

Full-Time Attendance

A child is considered a full-time student when they meet the attendance requirements specified by the educational institution. If not specified, full-time attendance means that the child is enrolled for at least 15 hours of instruction per week, per term, and is physically present on campus or virtually present on campus by way of regularly scheduled, interactive, course-related activities conducted online. Students must be able to demonstrate, if requested, that they meet full-time attendance requirements.

Individual Benefits Plans

Benefits plans that an individual purchases for themselves.

Lowest Cost Alternative Program

Under PharmaCare, drugs deemed the lowest cost alternative are usually (but not always) generic drugs. Generic drugs contain the same active ingredients and are manufactured to the same standards set by Health Canada, and to the same strict regulations established by the Food and Drugs Act. Only minor ingredients like dyes, coatings or binding agents may vary. The real difference is in price; generic drugs cost 30-50% less, on average.

Minor

A person who's under 19 years of age.

Non-Taxable Benefits

Non-cash benefits, like extended health and dental, provided to employees by their employer. Employees aren't required to pay the tax on the cash value of the benefit.

Paramedical Services

A defined group of services and professions that supplement and support medical work, but don't require a fully qualified physician. These services include: acupuncture, naturopathic physician, chiropractor, physiotherapy, massage therapy and podiatry.

PharmaCare

PharmaCare helps British Columbians with the cost of eligible prescription drugs and designated medical supplies. It's one of the most comprehensive drug programs in Canada, providing reasonable access to drug therapy through seven drug plans.

Assistance through PharmaCare is based on income. The lower your income, the more help you receive. There's no cost to register and there are no premiums. More information is available on the B.C. Government website.

Pre-Authorization

Confirmation with Great-West Life regarding eligible medical/dental expenses and reimbursement percentage.

Premium

The amount paid by the employee or the employer to maintain insurance coverage.

Principal Sum

An amount equal to the employee’s life insurance.

Reasonable & Customary (R&C) Limits

Represents the standard fees health care practitioners would charge for a given service. R&C limits are reviewed regularly and are subject to change at any time. If your health care practitioner charges more than the R&C limit for that item or service, you'll be responsible for paying the difference. If you have any questions about R&C limits for a given service, contact Great-West Life at 1 855 644-0538.

Reference-based Pricing

A process where drugs that are deemed therapeutically equivalent are grouped together, and then the cost of the lowest-priced drug in the group (typically a generic drug) is used as the reimbursement level for all drugs in the group.

Regular Employee

An employee who is employed for work that is of a continuous full-time or continuous part-time nature.

Rehabilitation Trial

A trial period of employment for assessment and/or rehabilitation purposes.

Reimbursement

The amount you're paid back for an expense that you incur. Reimbursements can be partial or total.

Specific Oral Exam

The examination and evaluation of a specific condition in a localized area.

Statutory Benefits

Benefits that are fixed, authorized, or established by statute. The employer is required by the law (Employment Standards Legislation) of the province to provide these benefits to employees.

Taxable Benefits

Non-cash benefits, like Employee Life Insurance (employer’s portion) and Medical Services Plan coverage provided to employees by their employer. Employees are required to pay the tax on the cash value of the benefit.

Term Life Insurance Life insurance protection provided during your term of employment. Term life insurance has no cash value.

 

Contacts

For questions about extended health and dental claims, contact Great-West Life.

GWL Mailing Address
PO Box 3050, Station Main
Winnipeg MB  R3C 0E6

GWL Phone: Toll-free 1 855 644-0538

Visit Great-West Life's website.

To check your benefits or to submit a claim, visit GroupNet.

Optional emergency travel medical benefits

Visit Great-West Life's website.

Phone: Toll-free 1 800 565-4066

How to submit forms without access to Employee Self Service

Submit forms to the Benefits Service Centre (BSC) as directed.

BSC Mailing Address
Benefit Service Centre
Block E-2261 Keating Cross Road
Saanichton BC  V8M 2A5

BSC Fax
604 320-4031

Other Questions

Contact MyHR.

This guide describes the benefits program for eligible Bargaining Unit employees in the BC Public Service. While all efforts have been made to make the guide comprehensive, it doesn't contain all the details in the official documents that legally govern the operation of every benefits plan within the Benefits Program. These plans are subject to change from time to time. In the event of any discrepancy or misunderstanding, benefits will be paid according to the applicable contracts, policies, plan documents, and legislation.