Group Insurance Benefits for Employees
In this section you will find information about the Queen’s Employee Benefits Plan offered through Manulife.
Eligibility
Your eligibility for benefits coverage depends on a number of factors:
- the type and length of your appointment;
- whether you are full-time or part-time and the number of hours per week you work, if you are part-time;
- the terms of your collective agreement (unionized employees);
- your age – if you are an employee working beyond your Normal Retirement Date
- Are residing in Canada
For further information, please contact your HR Advisor
Coverage Details
The information below provides a summary of the benefits available for employees participating in the Queen’s Employee Benefits Plan. For more details, please visit the Manulife Secure site to access the Benefits at a Glance document.
Health
Health Insurance helps you manage routine and unexpected costs, protecting your budget. Queen’s extended health insurance provides coverage for filling a prescription, getting new glasses, needing coverage for out-of-province or out-of-country coverage. An overview of what is covered includes:
Prescription drugs
- Pay Direct Drug Card (Benefits Card)
- Generic drug substitution (effective October 1, 2020)
- Dispensing fee – the plan covers up to a maximum $10 dispensing fee
Paramedical
- Chiropractor
- Naturopath
- Speech Therapist
- Osteopath
- Physiotherapist
- Registered Psychologists along with other mental health practitioners
- Podiatrist
- Chiropodist
Vision
- Eye Examinations
- Glasses, contact lenses, laser eye surgery
Medical Supplies and Services, such as
- Private Duty Nursing
- Hearing Aids
- Wigs
- Orthopedic Shoes/Orthotics
Out-of-province/country coverage
Dental
Dental Insurance helps you manage routine and unexpected costs, protecting your budget. Queen’s dental insurance provides coverage for:
- Preventative Services
- Basic Endodontic/Periodontic
- Dentures/Bridges/Crowns
- Recall Examination Frequency
- Orthodontic
Income Protection
Income Protection insurance provides you with financial support through salary replacement for plan members who are unable to work due to injury or disease and financial support in the event of a death, critical illness or accidental dismemberment or death. Products include:
- Long-Term Disability (LTD)
- Life and Optional Life Insurance
- Critical Illness (CI) Insurance
- Accidental Death or Dismemberment (AD&D) Insurance
Generic Drug Substitution
Generic drug substitution means that after October 1, the drug cost reimbursed by the plan will beis based on the lowest-price alternative medication, which is typically a “generic drug”. This process will happen automatically when you pick up your prescription at the pharmacy.
If you:
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Prefer to use the brand-name drug, you will need to pay the difference between the brand-name drug and the generic version of the drug at the time the prescription is filled.
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Have a medical reason for ruse of the brand-name drug, ask your doctor to complete a Request for Approval for Brand-name Drug Form and submit directly to Manulife for an exception.
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When Manulife approves the exception, the full cost of the brand-name drug will be covered the next time you fill your prescription. You may also submit a claim to be reimbursed for the difference if you filled the brand-name drug prescription before it was approved.
- Want to know if the brand-name drug you are prescribed with has a generic equivalent, check out the lookup tool on the My Drug Plan Feature on the Manulife site. If there is no generic equivalent, the brand name can be submitted for consideration for full reimbursement.
Definition of an Insurable Dependent
Covered dependents of an insured member include:
- a legal spouse or common law spouse or partner* (which includes spouses covered by the terms of a separation agreement) or former spouse (divorced or ex-common-law spouses for whom continued insurance coverage is mandated by a court order);
- unmarried natural, adopted, or step-children of the employee or the insured spouse or any other unmarried children for whom the employee or the insured spouse has been appointed guardian for all purposes by a court of competent jurisdiction; and
- under 21 provided they rely fully upon the employee for support and maintenance;
- unmarried children under 25 years of age and continuing to attend an accredited educational institution, college or university on a full-time basis provided they rely fully upon the employee for support and maintenance; and/or
- upon approval by Great West Life, any mentally or physically disabled child past the maximum ages stated above (age 21 or age 25 if in school) provided they became disabled prior to the maximum ages and the disability has been continuous. The child, upon reaching the maximum age, must still be incapable of self-sustaining employment and be completely dependent on the employee for support and maintenance.
*A common-law spouse or partner means a person who is living with the employee in a common-law relationship. A common-law relationship is considered to exist where two persons have lived together in a conjugal relationship for at least 12 months.
Making Updates to Your Coverage
Go online to your Manulife secure account within 31 days of:
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Marital status change
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Dependant child eligibility change (I.e., birth, adoption, legal guardianship, a stepchild)
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Death of a spouse or child
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Loss of spousal coverage
- Over-age student status – add or extend – Tell Manulife if you have a dependant child who is a student between the ages of 21 and 25 and going to college or university. This way, they can still have benefits while they’re under 25 and still in school. You need to inform Manulife each year that they’re in school.
If you do not submit a request to change your coverage within 31 days, you may have to submit a Late Application and be subject to late provisions under the benefits plan (I.e., reduced dental maximums for the first 24-months for added dependants)
Making Updates to Your Beneficiary Information
- Verify your current elections using the online tool or by calling the Manulife Customer Care Centre at 1-800-268-6195, Monday to Friday from 8 am until 8 pm
- If you have yet to designate a beneficiary or which to update your beneficiary information, complete the beneficiary form, sign and return it to Manulife by mail or upload via the secure site
- Beneficiary forms can be found on the Manulife plan member site:
Forms > Find a form
For More Information
If you need help navigating the Manulife secure site or have questions about your benefit coverage, you can call Manulife Customer Care Centre at 1-800-268-6195, Monday to Friday from 8 am until 8 pm.