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2006 Benefit Plan
Improvements
The following benefit plan improvements are
effective June 16, 2006:
Paramedical Coverage
Increase current paramedical coverage to $500
maximum per benefit year per practitioner
per person with no per-visit
maximum
Vision Care
Effective June 16, 2006, $85 per 2 year period
per person for Eye Tests (Family coverage;
to the extent not otherwise
covered), where this service is not already covered by OHIP.
This provision
is separate from the $250 vision benefit for eye glasses, contact lenses or
laser eye correction surgery.
Managed Drug Formulary with Generic
Substitution
The prescription drug plan will be revised to a
new formulary called Rx05
Diagnostic equipment & extension devices
will be provided on the same basis as now
available through the Drug Plan,
but separate from the Drug Plan. (aerochanbers,
glucometers, etc)
No lifestyle drugs (ED, Fertility, Xenical,
Smoking Cessation)
Managed Drug Formulary - Appeal
Process
Appeal process for non-formulary drugs, and
non-generic substitution.
Exception/Special Authorization Application Form
The Employer will establish an appeal process
through which the Employee may provide
medical evidence of a requirement
for either a drug that is not on the formulary or has
not been dispensed in
favour of a generic. Reimbursement for such drug is considered
for payment
based on this process.
What is Rx05? (HR Information)
Rx05 Q and A (HR Information)
Memo to Physicians/Pharmacists (Updated
June 28, 2006)
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