Article 37 : group insurance
37.1 Definitions
Total disability: An employee is considered to be totally disabled when he suffers from a total and uninterrupted disability attributable to an injury, sickness, complications resulting from pregnancy or a mental condition. He is unable to perform the duties of his usual position for the duration of the maximum number of days of sick leave. Subsequently, the conditions established by the insurance provider in the article on extended long-term disability apply.
Partial disability: An employee is considered to be totally disabled when he suffers from a total and uninterrupted disability attributable to an injury, sickness, complications resulting from pregnancy or a mental condition. He is unable to perform the duties of his usual position for the duration of the maximum number of days of sick leave. However, with the University's approval, he may perform a portion of the usual duties of his position or another position with similar duties, and the salary received for the duties performed is at least 30 (thirty) percent less than his regular salary. An employee cannot be deemed partially disabled before having met the definition of totally disabled.
37.2 Eligibility for group insurance
- Unless otherwise provided for by the Agreement or insurance plans in effect, all regular employees covered by the Agreement are eligible for group insurance from their starting date in a regular position.
- Term employees are eligible for certain group insurance coverage when they have accumulated two (2) years of continuous service, as provided in the clauses 37.6 to 37.14 inclusively.
- When a regular employee reaches 65 years of age and is still working and holding a regular position, the group insurance as provided for in 37.15 ends. All other group insurance benefits are maintained, without limitation until the age of 71, in accordance with the conditions that apply to all other employees.
- Barring any provision to the contrary in the insurance contracts in effect, when an active employee dies, his spouse and dependants continue to have access to the collective insurance benefits for one (1) year.
37.3 Group insurance
Barring any agreement to the contrary between the parties to the Agreement, the terms and conditions governing the following collective insurance contracts remain the same as the ones in effect at the time of the issuance of the certificate held by the Institute until April 30, 2018. Effective May 1, 2018 the Group insurance plan will be modified per the Letter of Agreement signed 12 September 2017, between PIPSC and the University of Ottawa:
- Basic employee life insurance
- Basic dependent life insurance (new coverage as of May 1, 2018)
- Optional life insurance for employees, spouse and/or eligible dependents
- Extended health insurance plan
- Basic dental insurance
- Optional dental insurance
- Optional hospital room coverage
- Optional accidental death and dismemberment insurance
- Basic long term disability program
- Optional long term disability (as of May 1, 2018)
- Health Care Spending Account (as of May 1, 2018)
37.4 The University's participation in the payment of collective insurance premiums is as indicated in clauses 37.6 and follows.
37.5 The University must provide the Institute with a copy of the insurance contracts in force, as well as the related additional clauses, as changes are made.
37.6 Basic employee life insurance and basic dependent life insurance
Until April 30, 2018 term employees who have worked two (2) years of continuous service and regular employees must participate in a basic life insurance plan for which the University pays one hundred percent (100%) of the monthly premiums for the first $25,000 of coverage. The University agrees to continue the current practice with regards to the payment of insurance policy premiums until this date.
Effective May 1, 2018 the employee will pay one hundred percent (100%) of the monthly premiums and the basic employee life insurance and basic dependent life insurance.
37.7 Optional life insurance
If they so choose, term employees who have two (2) years of continuous employment and regular employees can participate in an optional life insurance plan based on the insurance provider's conditions and must pay the required premium for the policy. The University agrees to continue the current practice with regards to the payment of insurance policy premiums.
37.8 Extended health insurance plan
Term employees who have two (2) years of continuous service and regular employees must participate in an extended health insurance plan, the monthly premiums for which are paid one hundred percent (100%) by the University. The University agrees to continue the current practice with regards to the payment of insurance policy premiums.
37.9 Basic dental insurance
Term employees who have two (2) years of continuous service and regular employees must participate in a basic dental insurance plan, the monthly premiums for which are paid one hundred percent (100%) by the University. The University agrees to continue the current practice with regards to the payment of insurance policy premiums
37.10 Reimbursement of dental expenses are based on the Ontario Dental Association fee guide for general practitioners for the year prior to the current year and on the least expensive treatment that yields professionally adequate results.
37.11 Optional dental insurance
If they so choose, term employees who have two (2) years of continuous service and regular employees can participate in an optional dental insurance plan in accordance with the provider's conditions and must pay the required premium for the policy. The University agrees to continue the current practice with regards to the payment of insurance policy premiums.
37.12 Reimbursement of dental expenses is based on the Ontario Dental Association fee guide for general practitioners for the year prior to the current year and on the least expensive treatment that yields professionally adequate results.
37.13 Optional hospital room coverage
If they so choose, term employees who have two (2) years of continuous service and regular employees can participate in an optional hospital room coverage in accordance with the provider's conditions and must pay the required premium for the policy. The University agrees to continue the current practice with regards to the payment of insurance policy premiums.
Effective January 1, 2019 the optional hospital room coverage will be discontinued and will become part of the basic extended health program.
37.14 Optional accidental death and dismemberment insurance
If they so choose, term employees who have two (2) years of continuous service and regular employees can participate in an optional accidental death and dismemberment insurance plan in accordance with the provider's conditions and must pay the required premium for the policy. The University agrees to continue the current practice with regards to the payment of insurance policy premiums.
37.15 Long term disability program
Only regular employees who have completed their probationary period participate in a long-term disability program for which the University pays one hundred percent (100%) of the monthly premiums based on two thirds (2/3) of the employees' regular base salary. The University agrees to continue the current practice with regards to the payment of insurance policy premiums.
As of May 1, 2018, the disability plan will change to a basic plan requiring monthly premiums based upon sixty percent (60%) of the employees' regular base salary with the option to participate in an optional long term disability program to increase the percentage of the monthly premiums as provided for in the insurance contract. The University pays one hundred percent (100%) of the monthly premiums for the basic plan and the employee will pay the required premium for the optional long term disability plan.
37.16 Optional Long Term Disability
As of May 1, 2018, an employee will have an option to secure additional coverage, at their expense, as provided in the insurance contract.
37.17 Health Care Spending Account (starting on May 1, 2018)
Employees will be provided with an annual Health Care Spending Account for their usage, in accordance with specific guidelines stipulated by CRA and the insurance contact.
37.18 When an employee is on sick leave for a sufficient length of time to foresee that he may need to avail himself of long-term disability insurance, the Human Resources Service takes the necessary steps to notify the employee of the actions that he needs to take to apply for benefits from the insurance provider.
37.19 When an insurance provider determines an employee's eligibility for long-term disability benefits, this decision cannot be subject to a grievance under the Agreement.
37.20 An employee is considered to be disabled when he is eligible for long-term disability benefits. The period of the employee's disability is considered to be continuous, notwithstanding the return to his full-time duties, provided that his return to work does not exceed one hundred and eighty (180) consecutive calendar days.
37.21 An employee on disability does not accumulate annual leave. Any period during which an employee is on disability is considered, for pension plan purposes, to be a period of full-time employment at the University. When an employee is on disability during a given fiscal year, the employee's base salary may increase the following May 1st, for a cost-of-living adjustment only. Prior to April 30, 2010, the amount granted for seniority for the fiscal year is based on the overall portion of normal workload performed by the employee when he worked at the University during the year in question.
As of May 1, 2010, if the employee has completed six (6) consecutive months of the fiscal year with his normal workload, he moves up to the next level of his pay grade. An employee is not eligible for any leave while he is on long-term disability.
37.22 An employee has no workload obligations while he is on total disability and does not receive work-related compensation. Access to benefits included in the group insurance plan in which the employee was participating is maintained as if he were not on disability, but the employee does not make any contributions.
37.23 When the employee's total disability ends and he resumes all or a portion of his workload, the remuneration granted by the University is based on the base salary determined pursuant to 37.21.
37.24 Subject to the approval of the dean or the service director, an employee can undertake a portion of his workload, with his doctor's approval, giving due regard to the employee's medical condition. The dean's or service director's approval must not be refused without valid reason. Disability benefits and pay are determined on the basis of the disability and the amount of time worked. Benefits granted to the employee are maintained as if the employee were not on disability. Contributions are determined on the basis of the usual formula and rate, but according to the work pay.
An employee is entitled to sick leave pursuant to the provisions of the Agreement, provided that the condition requiring sick leave is different from the condition that caused the long-term disability.
When an employee is on sick leave, disability benefits and pay are determined according to a formula established by the Parties from time to time.
37.25 On an annual basis the University will consult with the Institute regarding the financial status of the various components of the employees' benefit plans. All pertinent data, while respecting confidentiality, will be shared with the Institute.