Step 6: Your benefits summary

Melissa Smith EDIT

123 Somewhere Drive
Vancouver, BC, A1B 2C3
Born: Jan 1, 1980

Family Members

John Smith, Spouse
Johnny Smith, Son


HEALTH EDIT


PREMIUM

Annual cost: $5049.00
Total paid by plan: $2940.00
Total paid by you: $2109.00

Payroll deduction: $81.11
Benefit Coverage
Medical
  • 100% of eligible expenses, except for prescription drugs which are:
    • 90% of the first $5,000; and
    • 100% thereafter
Prescription drugs
  • Coverage based on the cost of the prescribed drug, unless there is a generic equivalent
  • Dispensing fee cap: No cap
Hospitalization
  • Semi-private or private room: $200 per day
Paramedical
  • All eligible practicioners, no per-practicioner maximum: $1500 per benefits year
  • X-rays by Chiropractor, Podiatrist, and Chiropodist: $50 per benefits year
Psychology
  • $1500 per Benefits Plan year
Vision care
  • 100% up to $400 every 24 months
  • 1 eye exam every 24 months
Orthotics
  • $300 every 2 Benefits Plan years

TOTAL: $5049.00


DENTAL EDIT


ENHANCED

Annual cost: $1407.00
Total paid by plan: $0.00
Total paid by you: $1407.00

Payroll deduction: $54.11
Benefit Coverage
Dental care
  • 90% of eligible expenses for the following services:
    • 1 checkup every 6 months
    • 2 units of scaling with each recall exam
    • Topical application of flouride
    • 1 unit of polishing with each recall exam
    • Complete oral exam once every 36 months
    • Panoramic x-rays once every 36 months
    • Full mouth x-rays once every 36 months
    • Fillings (amalgam, silicate, acrylic and composite
    • Local/general anaesthesia
    • Extractions
    • Oral surgery

TOTAL: $1407.00


LIFE / DISABILITY EDIT

Benefit Coverage Premium
Basic Life
  • $50,000
$0.00
Short-term Disability (STD)
  • 100% of Benefits Salary for first 12 weeks
$75.00
Long-term Disability (LTD)
  • 75% of first $36,000 of Benefits Salary
  • 45% of remainder of Benefits Salary, to a maximum of $32,500/month
$925.00

TOTAL: $1000.00


OPTIONAL LIFE EDIT

John Smith
Male, Spouse
Born: Jun 1, 1982

Coverage Premium
$150,000 optional life coverage $70.50

TOTAL: $70.50

Johnny Smith
Male, Son
Born: Dec 1, 2013

Coverage Premium
$15,000 optional life coverage $7.50

TOTAL: $7.50


Total annual cost: $7534.00

Total paid by your benefits plan: $2940.00

Total paid by you: $4594.00

Payroll deduction amount: $176.69