Health Benefit FAQs

How do I become eligible for benefits?

Any Member in good standing who has sufficient hours for coverage and is working under a collective agreement requiring employer contributions to this Plan is eligible for benefits.

You must complete a Medical Services Plan (MSP) application form and an Enrolment and Beneficiary card.

Permit Members or Lodge 191 Members who have been suspended or have taken a withdrawal card, must become Members in good standing of Lodge 191. Coverage under the Plan will commence on the 1st day of the month following the month (lag) in which 350* hours have been credited to the Member’s hourbank.

 

Do I lose benefits if I’m unemployed?

Coverage will terminate when there are insufficient hours in the Hour Bank to allow for a deduction of 125 hours.

 

How does coverage lapse?

Coverage lapses when there are insufficient hours in the Member’s hourbank to support the monthly deduction of 125 hours and either does not self-pay or no longer qualifies for self-payment.  If full coverage lapses for a Member who has continually been a Member in good standing, then that Member will be required to accumulate 250 new hours reported to the Plan in order to re-qualify for full benefits.

 

How long does self-pay coverage last?

A Member in good standing of Lodge 191 (dues-paying) may continue full coverage through self-payment. A self-pay notice will be sent to the last known address. The maximum number of self-pays allowable is 12 consecutive months.

 

What classifies a dependent?

  1. The spouse of a covered Member;
  2. Any unmarried child of a covered Member to age 21, (age 19 for MSP) provided such person is mainly dependent on and living with the covered Member;
  3. Any unmarried child of a covered Member to any age provided the child is in full-time attendance at a recognized school, college, or university; (age 25 for MSP)
  4. Any unmarried mentally or physically handicapped child of a covered Member to any age, provided such person is mainly dependent on and living with the covered Member or the spouse of the covered Member.

 

I have just become disabled and I’m unable to work.  Am I eligible for Wage Indemnity? How do I apply?

A benefit of the Employment Insurance (EI) weekly maximum benefit rate will be paid to each eligible Member who is disabled and unable to work as the result of a non-occupational accident or sickness.

Take the following steps as soon as possible after you have become disabled:

  1. Contact your doctor immediately upon becoming disabled. You must be seen and treated during the time of your disability.
  2. Obtain a claim form from the Union office or the Administrator’s office and read the instructions on filing an EI sick claim.
  3. Complete the form where indicated and have your doctor complete the physician’s portion of the form.
  4. Your Union must complete the Authorization at the bottom of the form.
  5. Send the completed form to the Administrator without delay.
  6. If you qualify, claim cheques will be sent directly to your home address.
  7. Claims for disability must be submitted no later than 30 days after your total disability begins.

 

What does our emergency travel insurance cover? How do I apply?

Travel insurance is designed to cover losses arising from sudden or unforeseeable circumstances occurring while you are temporarily travelling outside your province or territory of residence.

This coverage is provided by Viator/Global Excel Management Inc.  Eligible Members and their families are covered for $5 Million per lifetime for Out of Canada Emergency travel protection.

This coverage is valid for trips of 180 consecutive days or less. Global Excel must be contacted before you seek medical treatment. If your condition renders you unable to do so, then someone else must contact Global Excel immediately for you. Do not assume that someone will contact Global Excel on your behalf. It remains your responsibility to ensure that Global Excel has been contacted prior to receiving medical treatment or as soon as reasonably possible.

Before you leave the province, ensure you have a Viator/Global Excel Medical Assistance Card in your wallet.  Please contact the Plan Administrator if you do not have a Viator/Global Excel booklet or Medical Assistance Card.

Please note: in order for Travel Card Members to qualify for coverage, they must become a Member in good standing of Lodge 191, at which time, reciprocation to their previous union plan will stop and the accumulation of 350* new hours to the Plan would begin accumulating. Coverage under the Plan would commence on the 1st day of the month following the month (lag) in which 350 hours have been credited to the Member’s hourbank as a Lodge 191 Member in good standing.

 

How does the EFAP Program provided by Shepell work? Does it cost extra money?

The EFAP is a voluntary, confidential, short-term counseling and advisory service that connects you and your eligible family members to a network of dedicated professionals who are available to give you assistance 24 hours a day.  There is no cost to you or your family to utilize the EFAP Program.

Please contact Shepell at 1-844-880-9142 to access your EFAP.

 

How does reimbursement of my claims work?

Please refer to the Plan Booklet to see what services are eligible for reimbursement and how it is arranged.

 

How do I login to DA Townley’s Member website?

Please contact D.A. Townley, ask for the Administration Department and you will be provided with login credentials.