Article 43 : group insurance
Definitions
Total disability: An employee is considered to be totally disabled when suffering from a total and uninterrupted disability attributable to an injury, sickness, complication resulting from pregnancy, or a mental condition. The employee is unable to perform the duties of the usual position for the duration of the maximum number of sick leave days. 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 suffering from a total and uninterrupted disability attributable to an injury, sickness, complication resulting from pregnancy, or mental condition. The employee is unable to perform the duties of the usual position for the duration of the maximum number of sick leave days. However, with the University's approval, the employee may perform a portion of the usual duties of the position or another position with similar duties. The salary received for the duties performed shall be at least 30% less than his regular salary. An employee cannot be partially disabled before having met the definition of total disability.
Eligibility for Group Insurance
43.1 Unless otherwise provided for by the Agreement or insurance plan in effect, all regular employees covered by the Agreement are eligible for group insurance from the starting date in a regular position.
43.2 Term employees shall be eligible for certain group insurance coverage when they have accumulated two (2) years of continuous service, as provided in the following articles.
43.3 When an employee reaches 65 years of age and is still working and holding a regular position, the group insurance as provided for in Article 43.24 shall end. 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.
43.4 Upon the death of an active employee, access to group insurance continue for one (1) year for the employee's spouse and dependents, unless otherwise indicated in the insurance contract.
Group Insurance
43.5 For group insurance, the University pays the premium for benefits, shares the premium costs or does not pay the premium costs, depending on the provisions of each insurance plan listed in this article.
43.6 The University provides the Bargaining Unit with a copy of the insurance contracts in force, as well as the related amendments, as changes are made.
43.7 The terms and conditions governing the group insurance contracts listed below shall remain as they were when the Union's bargaining certificate was issued, except when parties negotiate different terms and conditions.
- Basic Employee Life Insurance
- Basic Dependent Life Insurance (new coverage effective May 1st 2017)
- Extended Health Insurance Plan
- Basic Dental Insurance
- Optional Dental Insurance
- Optional Private or Semi-Private Hospital Room Coverage
- Optional Accidental Death and Dismemberment Insurance
- Basic Long Term Disability Program
- Optional Long Term Disability (new coverage as of May 1st 2017)
- Health Care Spending Account (new coverage as of May 1st 2017)
Basic Employee Life Insurance
43.8 Regular employees will participate in a basic life insurance plan for which the University pays 100 per cent of the monthly premiums for the first $25,000 of coverage. The University agrees to continue the current practice with regard to the payment of insurance policy premiums until April 30, 2017.
Basic Dependent Life Insurance
43.9 Effective May 1st, 2017, the employee will pay 100 per cent of the monthly premiums and a mandatory dependant life insurance will be included.
Optional Life Insurance for Employees, Spouse and/or Eligible Dependents
43.10 Regular employees can participate in optional life insurance plans for either employee or spousal coverage. Such plans are based on the insurance provider's conditions and the employee will pay required premium for the policy. The University agrees to continue the current practice with regard to the payment of insurance policy premiums. Effective May 1, 2017, optional dependent life insurance will be added under the same terms as the optional life insurance for employee and spouse.
Extended Health Insurance Plan
43.11 Regular employees will participate in an extended health insurance plan, the monthly premiums for which are paid in full by the University. The University agrees to continue the current practice with regard to the payment of insurance policy premiums.
Basic Dental Insurance
43.12 Regular employees will participate in a basic dental insurance plan, the monthly premiums for which are paid in full by the University. The University agrees to continue the current practice with regard to the payment of insurance policy premiums.
43.13 Reimbursement of dental expenses will be 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 will yield professionally adequate results.
Optional Dental Insurance
43.14 Regular employees can participate in an optional dental insurance plan in accordance with the provider's conditions and shall pay the required premium for the policy. The University agrees to continue the current practice with regard to the payment of insurance policy premiums.
43.15 Reimbursement of dental expenses will be 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 will yield professionally adequate results.
Optional Hospital Room Coverage
43.16 Regular employees can participate in an optional hospital room coverage in accordance with the provider's conditions and will pay the required premium for the policy. The University agrees to continue the current practice with regard to the payment of insurance policy premiums.
Optional Accidental Death and Dismemberment Insurance
43.17 Regular employees can participate in an optional accidental death and dismemberment insurance plan in accordance with the provider's conditions and will pay the required premium for the policy. The University agrees to continue the current practice with regard to the payment of insurance policy premiums.
Long Term Disability Program
43.18 a) Only regular employees who have completed their probationary period will participate in a long term disability program for which the University pays 100 per cent 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 regard to the payment of insurance policy premiums.
b) As of May 1st 2017, 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 100 percent of the monthly premiums for the basic plan and the employee will pay the required premium for the optional long term disability program.
Optional Long Term Disability
43.19 As of May 1st, 2017, an employee will have an option to secure additional coverage, at his or her expense, as provided in the Insurance contract.
Health Care Spending Account (starting on May 1st 2017)
43.20 Employees shall have an annual Health Care Spending Account for their usage, in accordance with specific guidelines stipulated by CRA and the Insurance contract.
43.21 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 will need to take to apply for benefits from the insurance provider.
43.22 The parties acknowledge that 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.
43.23 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.
43.24 An employee on disability does not accumulate annual leave. Any period during which an employee is on disability shall be 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 shall be based on the overall portion of normal work load performed by the employee when he worked at the University during the year in question. If the employee has completed six (6) consecutive months of the fiscal year with his normal work load, he will move up to the next level of his pay grade. An employee is not eligible for any leave while he is on long-term disability.
43.25 An employee shall have no work load obligations while he is on total disability and shall not receive work-related compensation. Access to benefits included in the group insurance plan in which the employee was participating shall be maintained as if he were not on disability, but the employee does not make any contributions.
43.26 When the employee's total disability ends and he resumes all or a portion of his work load, the remuneration granted by the University shall be based on the base salary determined pursuant to 43.28.
43.27 Subject to the approval of the Dean or Director, an employee can undertake a portion of his work load as per his doctor's opinion, giving due regard to the employee's medical condition. Such approval is not refused without valid reason. Disability benefits and pay shall be determined on the basis of the disability and the amount of time worked. Benefits granted to the employee shall be maintained as if the employee was not on disability. Contributions shall be 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 shall be determined according to a formula established by the parties every from time to time.
43.28 At least six (6) months before the expiry of the collective agreement, the parties agree to obtain an external report on the benefit plans, with a methodology and scope consistent with best industry practice for the purpose of sustainability at a reasonable cost to both parties. The consultant, methodology, cost sharing and scope will be agreed to by the parties.
43.29 On an annual basis the University will consult with the Bargaining Unit regarding the financial status of the various components of the employees’ benefit plans. All pertinent data, while respecting confidentiality, will be shared with the Bargaining Unit.