Group Insurance for Members

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Here for you now ... Here for your future. À votre service...pour le soin de votre avenir.

Since 1968 Depuis 1968

Group

Insurance

for Members

your

retirement

YOU

RTO/ERO

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Inside

About us ...1 Your Group Insurance strengths ...4 Your health resources ...5

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About us...

Established in 1968 by the Ontario Teachers’

Federation, RTO/ERO has become a leader

in providing benefits to retired educators

and support staff. Our plans are designed

exclusively for retired teachers, school and

board administrators, educational assistants,

administrative professionals, custodians,

university and college faculty, and support staff.

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your

questions

and answers

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3 Why is a group insurance plan important?

As an active educator or support staff, you spent your career insured by a group insurance plan. This provided you with the ultimate protection; knowing that participants spoke with one voice and those with your interests in mind owned the plan. With RTO/ERO, as a plan participant, you have a voice in how the plan is managed. RTO/ERO is the only voluntary insurance plan available in Ontario, designed by education retirees, that chose to maintain coverage on a group insurance basis.

Do I need insurance in my retirement?

YES! Educators and support staff spend an average of nearly 30 years in retirement. Government coverage can be limited and can change at any time, so it’s important to have a group insurance plan that helps you to cover your healthcare costs.

How do I get coverage?

Complete the enclosed application or visit our website to download and print it.

www.rto-ero.org/our-health-plans

What insurance does RTO/ERO offer?

RTO/ERO offers a full suite of group insurance plans, which can be purchased separately:

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Dental;

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Extended Health Care (including comprehensive travel coverage);

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Semi-Private Hospital and Convalescent Care; and

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Supplemental Travel (for extended vacations).

We also offer access to a complete range of individual insurance plans including:

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Accidental Death & Dismemberment;

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Hospital Money;

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Home and Auto;

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Long Term Care; and

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Term and Guaranteed Life.

When should I apply?

You can apply as soon as you know the date of your retirement and the date that your existing group insurance benefits terminate. Your RTO/ERO benefits will begin the day after the termination of your current coverage. You are guaranteed acceptance only if you apply within 60 days of the termination date of another group insurance plan. If you apply after 60 days or you are joining from an individual insurance plan, you will be asked to complete a medical questionnaire and will be subject to approval.

Are members happy with their RTO/ERO Plans?

99% of members are satisfied with the RTO/ERO Plans, based on a survey conducted by Goldfarb Intelligence Marketing in 2012.

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Health Matters is a quarterly newsletter that features important health-related stories and information.

RTO/ERO’s Group Insurance Plan designs have evolved over the years with input from various sources, including its membership. The RTO/ERO Group Insurance Plans are more grounded to its membership’s needs and feedback which provides a distinct advantage and is an important value-added component compared to most other competitors.*

* According to a study conducted by independent ﬁ rm Coughlin Employee Beneﬁ ts Specialists in March 2011.

your

group insurance

strengths

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Strength in numbers. The majority of education retirees choose RTO/ERO’s Group Insurance Plans and 99% of them are happy with their choice;

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RTO/ERO is a not-for-profi t organization and our unique plans are owned and managed by our members. A Health Services and Insurance Committee, comprised exclusively of your peers, controls our insurance plans and responds to your needs;

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Our plans are well-funded and have been around since 1984;

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Everyone benefi ts from the same coverage regardless of age;

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Single, couple or family coverage available;

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You will speak with a real person and receive top-of-the-line customer service in English and French, with dedicated teams to take care of your enquiries;

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Most claims can be submitted electronically, payments are deposited to your bank account, and you can access your information online – in real-time; and

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Walk-in service is welcome in the Greater Toronto Area to assist members with administration and claim services.

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RTO/ERO group insurance plan details and forms:

www.rto-ero.org/our-health-plans

Join us.

RTO/ERO is here for you.

Health Matters is a quarterly newsletter that features important health-related stories and information. Departments | Health Matters Health Matters| Departments

34 Renaissance Fall 2014 35

inside

Going on vacation?

Time to prepare your home! ...36

Travelling with medication ...37

RTO/ERO TRAVEL Q&A ...38

Stress and health ...39

Older travellers ...40

The truth about generic drugs ...41

Information contained in Health Matters is intended to be used for general information and should not replace consultation with health care professionals. Consult a qualifi ed health care professional before making medical decisions or if you have questions about your individual medical situation. RTO/ERO makes every effort to ensure that the information in Health Matters is accurate and reliable, and cannot guarantee that it is error-free or complete. RTO/ERO does not endorse any product, treatment or therapy; neither does it evaluate the quality of services operated by other organizations mentioned or linked to Health Matters.

Departments |

Continued on page 36 Scan this QR code with your smartphone to view Health Matters in the Members’ Centre. 3 4 PHO TO: JOSEPH MICHAEL HO W AR TH Health Matters

R e n a i s s a n c e

MyMedRec: Canada’s leading healthcare organizations develop mobile app

MyMedRec can: Keep medication and

immunization records up to date; Help you administer your and

your family’s medication safely; Remind you when to take and fill

prescriptions; and Share information with health

professionals via email. With an easy-to-use interface that puts medication and immunization information at a person’s fingertips, MyMedRec is helping Canadians take better control of their healthcare.

Available for iPhone, Android devices and BlackBerry10, MyMedRec is a free app that empowers people to use their smartphones as a tool to better manage a wide range of information that will help them — and their healthcare professionals — administer their medications safely and appropriately.

“I manage multiple medications that I take six times throughout the day,” says Maureen Smith, an Ottawa resident who is living with a rare disorder known as Congenital Panhypopituitarism. “The best feature

of the app is its adaptability; there are so many options, you can really personalize it to meet your needs.” Affecting one in every 200,000 peo-ple, Congenital Panhypopituitarism is a condition where the pituitary gland fails to produce growth hormone and, as the master gland, stimulate all the endocrine hormones, regulate body functions like

metabolism, growth and development, tissue function, and mood.

The condition robbed Ms. Smith of her mobility — until she got on a regime of medications that not only got her out of a wheelchair but, quite frankly, saved her life. MyMedRec ensures she takes and monitors the medications she needs to replace the hormones her body doesn’t produce. “MyMedRec has been an excellent tool to help me keep track of my medications and set reminders for the ones I may forget,” says Ms. Smith.

Available globally, MyMedRec has been developed by seven of Canada’s leading healthcare organizations — Canada’s Research-Based Pharmaceutical Companies (Rx&D); the Canadian Nurses Association; the Canadian Pharmacists Association; the Canadian Medical Association; the Institute for Safe Medication Practices Canada; the Victorian Order of Nurses; and the Best Medicines Coalition — to ensure patients and their healthcare teams have all the information they need, when they need it.

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Of all the insurance I have, the RTO/ERO Group Insurance Plan is the only one where I have a say in the improvements that can be made to the plan. That’s because as an

RTO/ERO member I own the plan and I like that.

Roger LaLonde, member since 2002

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Even though I could have stayed with my board plan when I

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retired, I opted for the RTO/ERO Extended Health coverage as it gave us the comfort and security we sought. When my husband died suddenly in 2001, I received back the cancellation money for a scheduled cruise. When I broke my ankle in Australia in 2003, I was ﬂ own home, following two surgeries, and did not pay one cent out of my pocket.

Mary Ellen Lawless, member since 1995

your

health

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Join Canada’s largest retired educator plan, providing health

coverage to over 89,000 members and their families. The

RTO/ERO plan is owned and managed by RTO/ERO members.

RTO/ERO Group Insurance summary

(all maximums listed below are per insured person):

Dental Plan

Fee Guide

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2015 Provincial Fee Guide for General Practitioners.

Basic and Preventive (85% reimbursement)

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Unlimited annual maximum;

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One standard oral examination, recall oral examination, polishing and ﬂ uoride applications every nine months;

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Other services, including fi llings, x-rays; and

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Repairs/rebase/relining of existing dentures.

Endodontics and Periodontics (80% reimbursement)

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$850 annual maximum; and

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Includes root canal therapy, treatment of bones and tissues, scaling and occlusal equilibration.

Major Restorative (50% reimbursement)

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$800 annual maximum for crowns, posts, onlays and inlays, including crowns on implants; and

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$800 annual maximum for fi xed bridges and partial dentures, including those on implants.

Extended Health Care Plan

Prescription Drugs (85% reimbursement of ingredient costs)

for retired educators and educational support staff

Group Insurance coverage

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The Ontario Drug Benefit Program deductible is reimbursed based on 85% of ingredient costs.

Paramedical Practitioners (80% reimbursement)

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$1,100 maximum per calendar year (for all practitioners combined);

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Fifteen eligible practitioners: acupuncturists, chiropodists, chiropractors, dieticians, herbalists, homeopaths, naturopaths, nutritionists, osteopaths, physiotherapists, podiatrists, registered clinical psychologists, registered massage therapists, speech therapists and shiatsu therapists; and

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Physician authorization is not required.

Vision Care (80% reimbursement)

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$375 maximum in any two consecutive calendar years;

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Covers purchase or repair of prescription eyeglasses, contact lenses, laser eye surgery, and corneal incision;

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Eye examinations to a maximum of $90 for one eye exam every two consecutive calendar years. Eligible dependent children are covered on an annual basis; and

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New lenses, if required due to eye surgery, are covered to a lifetime maximum of $375.

Eldercare Select

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Expert guidance and support to address a specific caregiving challenge and develop a customized plan of action;

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Access to 24/7 nursing and personal care in your or a loved one’s home (costs for nursing or other care services referred through Eldercare Select are your responsibility);

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25% discount off FirstWatch™, a personal medical response system; and

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Access to an online personal health record that allows tracking of health indicators, monitoring and trending those indicators.

Educational Program (80% reimbursement)

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Medically related education program(s) recommended by a physician, to a maximum of $200 per calendar year.

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Out-of-Province/Canada Travel (100% reimbursement)

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$2,000,000 coverage for eligible emergency medical expenses per person/trip;

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Unlimited number of trips, each up to 93 days in duration;

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Emergency medical expenses incurred due to an accident or sudden illness while travelling outside your province of residence/Canada;

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Pre-existing medical conditions are covered, subject to a 90-day medical stability clause; and

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$6,000 trip cancellation and interruption/delay per person/trip.

Aids and Appliances (80% reimbursement)

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Purchase or repair of hearing aids to a maximum of $1,000 in any three consecutive calendar years;

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Custom-made orthopaedic shoes and orthotics to a maximum of $500 in any two consecutive calendar years;

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Prostheses including artifi cial limbs or eyes, or breast prosthesis (including three mastectomy bras per calendar year);

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Supplies including trusses, splints, braces and casts;

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Medical supplies, including surgical support stockings to a maximum of $400 per calendar year, incontinence supplies up to a maximum of $500 per calendar year, and post-surgical comfort and convenience items (e.g., sock reacher, shoe lacer) up to $200 in any two consecutive calendar years; and

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Mobility aids including wheelchairs, canes, walkers, and crutches.

Diagnostic Services (80% reimbursement)

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Diagnostic services, subject to your Government Health Insurance Plan offset.

Private Duty Nursing (80% reimbursement)

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Out-of-hospital registered nurse, registered practical nurse or licensed practical nurse up to $2,000 in any two consecutive calendar years.

Transportation/Ambulance (80% reimbursement)

3 for retired educators and educational support staff

Group Insurance coverage

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Semi-Private Hospital and Convalescent Care Plan

Semi-Private Hospital (95% reimbursement)

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Unlimited maximum;

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Daily semi-private room charges in a licensed hospital.

Convalescent Care (80% reimbursement)

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Home care following a 24 hour hospitalization up to $75/day, maximum of 30 days;

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Home care following non-elective day surgery up to $75/day, maximum of three days; and

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Temporary stay in a long term care facility following a 24 hour hospitalization, up to $75/day, maximum of 30 days per calendar year.

Supplemental Travel Plan

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For individual trips that extend beyond the 93 days of travel coverage under the Extended Health Care Plan;

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Covers a maximum trip duration of 212 days. For those who only need a few extra days of coverage, a five day unit is available immediately following the first 93 days of travel; and

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Guaranteed acceptance for all Extended Health Care Plan participants.

RTO/ERO Monthly Rates – January 1 to December 31, 2015

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Single Couple Family Dental $55.12 $108.70 $135.55 Extended Health Care $84.78 $169.57 $203.50 Semi-Private Hospital and Convalescent Care $14.60 $29.16 $34.28

* RTO/ERO is a group insurance plan and is therefore subject to provincial retail sales tax (8% in Ontario, 9% in Quebec). These rates exclude retail sales tax. Our Plans are eligible for CRA’s medical expense tax credit.

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Provincial Office:

18 Spadina Road, Suite 300 Toronto ON M5R 2S7 Tel: 416-962-9463 Toll free: 1-800-361-9888 info@rto-ero.org | www.rto-ero.org

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JOHNSON INC. - Plan Benefits Service