IMPORTANT ANNOUNCEMENT

UNITE HERE Local 47 Health Care Plan

Post Retirement Benefits

     Effective April 1, 2010, Post Retirement Benefits, consisting of Dental Care, Vision Care and Major Medical (inclusive of prescription drugs) as

     offered to actively employed UNITE HERE Local 47 Health Care Plan eligible participants, will be available to qualifying retired members, their spouse

     and eligible dependents, if applicable, with the following terms of eligibility and benefit limitations:

• eligibility is established by a retired member who has earned 10 or more years of “service” (10 or more calendar years with at least 350 hours
  of work in each year for which remitted contributions were reported to the Health Care Plan by a Plan participating employer);
   

• retired members must have been an Active member of the Health Care Plan immediately before (within 6 months of) retirement;
   

• retired members must be receiving a monthly pension from the UNITE HERE Local 47 Pension Plan to qualify for Post Retirement Benefits;
   

• retired former employees of the Syncrude (41B) Cafeteria (former Hofam Cafeteria) with 10 or more years of service (10 or more calendar
  years with at least 350 hours of work in each year) are “grandfathered” as pension contributions are not applicable;
   

• retired former employees of CNRL for whom a contribution was directed to an RSP are “grandfathered” for the “monthly pension from
  the UNITE HERE Local 47 Pension Plan” eligibility requirement;
   

• the maximum Post Retirement Benefits lifetime claims paid reimbursement ceiling is $5,000 in the aggregate (total for each Family Unit);
   

• only Dental Care, Vision Care, Prescription Drugs and Major Medical services expenses incurred in Canada are eligible for Post Retirement
  Benefits reimbursement; and
   

• upon the death of the qualified retired member, any balance remaining of the maximum lifetime claims paid $5,000 ceiling, if any, will be
  transferred to the deceased member’s spouse/dependents.
   

   Health Care Plan Benefit enhancements & revisions:

1.          Speech Therapy: the calendar year maximum reimbursement is doubled to $400 from $200; and;

2.          Vision Care:

    Health Care Plan Members and eligible Dependents may now purchase two (2) sets of frames and lenses,
    inclusive of duplicate or spare eye glasses, within the applicable 12 or 24 month period.
    All other Vision Care restrictions & limitations continue to apply.

    Previously the purchase of duplicate or spare eye glasses was not permitted.

    New Health Care Plan Benefits:

1.      Laser Eye Surgery for Vision Correction:

Effective March 1, 2008, Laser Eye Surgery, to a maximum of one surgery per eye, upon the written recommendation of and performed by a qualified medical practitioner, due to medical necessity or cosmetic reasons, is an eligible Health Care Plan benefit for Plan Members and each eligible Dependent, to a Lifetime Maximum reimbursement from the Health Care Plan for each eye of $400; and

2.      Speech Therapy Device:

Effective March 1, 2008, upon the written recommendation of a qualified medical practitioner, satisfactory to the Board of Trustees, a “Speech Therapy Device” is an eligible Health Care Plan benefit for Plan Members and each eligible Dependent, to a Lifetime Maximum reimbursement from the Health Care Plan of the lesser of 50% or $3,000 of the cost of the Speech Therapy Device, inclusive of the costs associated with the assessment by the medical practitioner of the necessity of the Speech Therapy Device as well as the fitting of the Device.

            3.      Extended Health Care "Lifetime Maximum Reimbursement:

                  The Lifetime Maximum Reimbursement has been increased to $50,000 from $35,000.
 

Alberta Blue Cross - Coverage for Seniors (offered by the Provincial Government of Alberta)

        For active UNITE HERE Local 47 Plan members the Alberta Blue Cross - Coverage for Seniors is in
        addition to the benefit offer by the UNITE HERE Local 47 Health Care Plan

  INTRODUCTION

     The Alberta Government provides premium-free Alberta Blue Cross Coverage for Seniors for health related services not covered by the    Alberta Health Care Insurance Plan (AHCIP). This coverage is available to all Albertans 65 years of age and older and all recipients of the Alberta Widows' Pension, and their dependants.

This program does not provide travel coverage. If you are planning to travel outside of the province or country, it is strongly recommended you purchase travel insurance to cover emergency hospital and medical expenses.

 QUALIFYING FOR PREMIUM-FREE COVERAGE

When an Alberta resident reaches 65 years of age, the resident and all eligible dependants automatically qualify for premium-free Alberta Blue Cross Coverage for Seniors, sponsored by Alberta Health and Wellness.

In order to be registered, seniors must complete a Proof of Age Declaration which Alberta Health and Wellness mails to them two months before their 65th birthday.

Single coverage-available to Alberta residents with no dependants; and

Family coverage-available to Alberta residents and the following eligible dependants*:

        1. Married spouse (husband or wife).

        2. Adult interdependent partner.**

        3. Unmarried children under 21 years of age who are fully dependent upon the subscriber

        4. Unmarried children under 25 years of age who are in full-time attendance at an accredited educational institute.

        5. Unmarried children 21 years of age or older who are fully dependent upon the subscriber due to mental or physical disability.


        Note: When seniors are moving to Alberta, the AHCIP and the supplemental Coverage for Seniors will begin on the first day of the third month following the      date of arrival. Seniors arriving from outside of Canada should contact Alberta Health and Wellness for information on effective dates.

        Alberta Health and Wellness also sponsors supplementary coverage for Albertans under the age of 65. For more information please refer to the Non-Group Coverage brochure, which is available at any Alberta pharmacy, Alberta Blue Cross or Alberta Health and Wellness office.

        BENEFITS

    PRESCRIPTION DRUGS

        The co-payment (the portion of the prescription cost you pay to your pharmacy when you have your prescription filled) is 30 per cent to a maximum of $25. For most prescriptions. you will not have to pay more than $25 for each prescription when paying your co-payment.

        Sometimes you may have to pay more than the $25 co-payment maximum. Here are some cases when you might have to pay extra:

        • If your drugs are not listed in the Alberta Health and WeI/ness Drug Benefit List;

        • If you want a more expensive brand of drug than the lowest-cost or generic brand;


        • If the brand of drug you want costs more than the maximum cost set by Alberta Health and Wellness for that drug.

        To avoid surprises, ask your pharmacist about the cost of your prescription before it is filled.

    AMBULANCE SERVICES

        Ambulance service charges to the maximum rate established by Alberta Health and Wellness for transportation to or from a public, general, active treatment hospital in the event of illness or injury. Transportation must be provided in a ground vehicle licensed under the Ambulance Services Act and Regulations. This does not include inter-facility transfer by ambulance as that service is covered by Alberta's regional health authorities.

    CLINICAL PSYCHOLOGICAL SERVICES

        Up to $60 per visit to a maximum of $300 under either single or family coverage each benefit year (July 1 June 30) for treatment of mental or emotional illness by a registered chartered psychologist.

    HOME NURSING CARE

        Up to $200 under single or family coverage each benefit year for charges incurred for nursing care provided in the patient's home on written order of a physician. Home nursing care must be provided by a registered nurse or licensed practical nurse who is not a relative of the patient.

    PROSTHETIC AND ORTHOTIC BENEFITS

        Up to one hundred per cent (100%) of the maximum allowable amount for items included on a benefit list as defined by Alberta Health and Wellness. Coverage includes the purchase or repair of artificial eyes, prosthetic devices (except myoelectriccontrolled prostheses) and braces required for six months or longer. A physician's written order is required. Foot orthotics are not included as a benefit.
MASTECTOMY PROSTHESIS

        Up to one hundred per cent (100%) of the maximum allowable amount for items included on a benefit list as defined by Alberta Health and Wellness. This coverage does not apply to the purchase of a supporting brassiere.

    HOW TO CLAIM FOR BENEFITS

        Each subscriber is provided with an Alberta Blue Cross identification card issued in the name of the AHCIP account holder (maximum of two cards).

        For eligible prescription drugs, you are responsible for paying 30 per cent of the cost, to a maximum of $25 for each drug prescribed. The program covers the remaining eligible portion, billed directly to Alberta Blue Cross by the pharmacist. Your Alberta Blue Cross identification card must be presented at the time of purchase.

        If you are covered by more than one supplementary health benefit plan, coordination of benefits (sharing the cost) with the other plan may further decrease, or eliminate, your portion of the expenses.

        To claim reimbursement for other eligible expenses, submit your claim on an Alberta Blue Cross claim form, available at any Alberta Blue Cross office, Alberta pharmacy or on the Alberta Blue Cross Web site www.ab.bluecross.ca 

        To be eligible for reimbursement, claims must be received by Alberta Blue Cross within 12 months of the service date. The service must have been provided after the effective date of your coverage.

        If you have any questions about your claim please call Alberta Blue Cross.

        The identification number of the individual who receives the service should be quoted on all claims and correspondence sent to Alberta Blue Cross. This number is displayed on the back of your Alberta Blue Cross card.


    FOR MORE INFORMATION ON CLAIMS OR TO LOCATE THE BLUE CROSS OFFICE NEAREST YOU PLEASE CONTACT ALBERTA BLUE CROSS AT:

        498-8000 (Edmonton and area)
        234-9666 (Calgary and area)
        1-800-661-6995 (toll-free)
        e-mail via www.ab.bluecross.ca

    FOR MORE INFORMATION ON COVERAGE. AND BENEFITS PLEASE CONTACT ALBERTA HEALTH AND WELLNESS AT:

        • 427-1432 (Edmonton and area)
        • Toll-free for the rest of Alberta to 310-0000 and then (780) 427-1432 Dial 711 for TTY for the Deaf and Hard of Hearing
        • e-mail AHClPMAIL@health.gov.ab.ca
        • Web site at www.health.gov.ab.ca
        • In person:  8:15 am-4:30 pm, Monday to Friday Main floor offices at: 10025 Jasper Avenue, Edmonton 727-7 Avenue SW, Calgary


    WHAT IS NOT COVERED?

    The following are not covered under the program:

        1. Benefit expenses exceeding a total of $25,000 per subscriber in a benefit year (July 1 -June 30). On an exception basis, this annual maximum may be raised.

        2. Benefit expenses incurred prior to the effective date of coverage.

        3. Claims for benefit expenses received by Alberta Blue Cross more than 12 months after the service was provided.

        4. Services covered by AHCIP.

        5. Charges for drugs supplied directly and charged for by a physician, with the exception of allergy serums.

        6. Diabetes supplies (not including insulin).

        7. Registration, admission or user fees charged by a hospital.

        8. Drug products not listed in the Alberta Health and WeI/ness Drug Benefit List. Ask your pharmacist and/or physician if your prescribed medication is on this list.


        Please note: The information contained in this brochure is a summary of benefits, restrictions and limitations applying to Alberta Blue Cross Coverage for Seniors, effective June I, 2003. This summary does not constitute a contract. Rules and regulations governing participation are available for review during business hours at any Alberta Blue Cross