ARTA's Group Benefits Program is available exclusively to ARTA Regular members, Affiliate members, and their dependents. Members can choose from eight voluntary insurance plans. Below are plan summaries for your reference. The full policy descriptions are available in the certificates of insurance.

For more information or to apply for coverage, contact ARTA's Plan Administrator, Johnson Inc. at 1-877-989-2600.

1. Extended Health Care Plan WITH 60 Day Travel
2. Supplemental Travel Plan over 60 Days (only available with the base plan)
3. Extended Health Care Plan WITHOUT Travel
4. Dental Care Plan
5. Long Term Care Plan
6. Guaranteed Life Insurance Plan
7. Term Life Insurance Plan
8. Home and/or Automobile Insurance Plan

 

1. Extended Health Care Plan WITH 60 Day Travel

Apply early. When enrolling in ARTA's Health Plan, your acceptance will be guaranteed without a medical exam provided you apply for coverage before, or within, 60 days of leaving another group insurance plan. After this date, medical evidence is required by the insurer, Manulife Financial, and Health coverage may be declined.

IN PROVINCE
Eligible extended health care expenses (incurred in province of residence) will be reimbursed at 80% according to the various maximums and limits outlined in the certificate of insurance up to a combined annual maximum per person of $10,000 in each calendar year.

OUT-OF-PROVINCE/CANADA
Eligible international Travel Emergency Medical expenses incurred due to an unforeseen accident or sudden illness while traveling outside your province of residence, including outside Canada, will be reimbursed at 100% to a lifetime maximum of $1,000,000 per person.

Note*
All limits shown are the maximum payable per person each calendar year, unless indicated otherwise.

The Extended Health Care Plan pays for eligible expenses which are not covered by your Provincial Government Health Insurance Plan (GHIP) and which are recommended as medically necessary by a legally qualified physician. Tests or procedures not recognized by Health and Welfare Canada, or the Provincial Health Ministry, which are considered experimental or cosmetic in nature, are not covered under the Plan.

ARTA is not responsible for any government actions implemented during the policy year which may impact on the ARTA plans.

IN-PROVINCE EXTENDED HEALTH CARE ELIGIBLE EXPENSES

Eligible Expenses - 80% reimbursement up to a combined annual maximum per person of $10,000 in each calendar year. All amounts shown are annual calendar year limits payable per covered person, unless otherwise stated.

Drugs - $1,100 Per Year
Drugs which by law require a prescription from a physician or dentist, including sera and injectibles, and diabetic supplies. Non-prescription drugs required as a result of colostomy or ileostomy and/or treatment of cystic fibrosis, diabetes or Parkinsonism.

Vision Care
$175 in any 2 calendar years - Prescription eyeglasses and contact lenses. $200 in any 2 calendar years - Subject to approval by Johnson Inc., contact lenses to correct vision to at least 20/40 level when it cannot be so improved by eyeglasses.

Private Duty Nursing
$1,500 in any 3 consecutive years in the patient's home by a registered nurse, subject to prior approval by Johnson Inc.

Paramedical Services
$500 per calendar year for Massage Therapist, Physiotherapist, Athletic Therapist and Chiropractor combined. $225 per calendar year for each other eligible specialty: Psychologist, Speech Therapist, Naturopath, Acupuncturist, Osteopath, Podiatrist/Chiropodist.

Ambulance Service
To and from the nearest hospital that can provide treatment, including the cost of air travel when medically necessary.

Diagnostic Services
Radiology, blood transfusions, and oxygen.

Aids and Appliances (purchase or repair of):

- Trusses, splints, braces, crutches, casts, artificial limbs or eyes.
- Breast prosthesis.
- Custom-made orthopaedic shoes ($500 in any 3 consecutive years).
- Orthotics ($300 in any 3 consecutive years).
- Elastic support stockings ($200).
- Hearing aids ($400 in any 3 consecutive years).

Rental of:
Wheelchair, hospital bed, respirator or ventilator

Accidental Dental - $1,000 Per Year
Treatment required following accidental damage (from an external blow to your mouth) to your natural or artificial teeth. Dental work must be completed within 6 months of accident.

Referral Treatment Outside Canada
Physician charges, hospital room and board at ward rates up to 31 days per period of disability.

Prescribed Health Educational Program
Up to an annual limit of $100 (recommended by your physician).

Hospital
Difference between standard ward and semi-private, private and preferred hospital rates up to a daily maximum of $100 per covered person. Coverage includes confinement in a hospital, convalescent and rehabilitative hospitals.

Home Care
After a hospital stay of at least 24 hours, 80% of home care expenses are covered up to a maximum of $50 a day for up to 10 days. Upon written recommendation of a physician, completion of a Johnson Inc. authorization form and provided in your own home, the level of care includes:

- Activities of daily living (eating, bathing, dressing).
- Ambulation and exercise.
- Self-administered medications.
- Homemaker services or home health aide services.
- Functional ability improvement.
- Respite care for your primary caregiver.
- Outpatient services and supplies not covered by the Provincial Government.

Educational Programs
Medically recommended educational programs include wellness or rehabilitation (maximum $100 per calendar year).

Nutritionist/Dietician
Nutritionist/Dietician paramedical services (maximum $225 per calendar year).

Chiropractic/Podiatrist
Chiropractic/Podiatrist from first visit (maximum $500 per calendar year, combined with Physiotherapy, Massage, Athletic Therapy) A maximum of $225 applies to each of the other practitioners, such as speech therapy.

Visual Enhancement Equipment
Visual Enhancement Equipment (maximum $200 per 2 calendar years).

Note: All medical practitioners must be provincially licensed.


OUT-OF-PROVINCE/CANADA ELIGIBLE EXPENSES (Optional Coverage)

100% Reimbursement of unforeseen Out-of-Province or International Travel Emergency Medical Expenses to a lifetime maximum of $1,000,000 per person, for multiple trips up to 60 days duration. If you become ill or injured while traveling outside your province of residence, or Canada, comprehensive medical and supplementary benefits are payable through ARTA's Extended Health Care Plan WITH 60-Day Travel. The Plan provides assistance through the services of World Access Inc. for your eligible emergency medical expenses.

Eligible emergency expenses include:

- In-patient hospital charges up to the cost of semi-private accommodation.
- Physicians' charges.
- Prescription drugs.
- Diagnostic procedures.
- Private duty nursing up to an annual maximum of $5,000.
- Paramedical services of a chiropractor, podiatrist or physiotherapist to an annual maximum of $225 per speciality.
- Rental of a wheelchair, crutches and canes when ordered by a physician.

Medical Transportation
- Licensed ground or air ambulance for emergency transport to the nearest medical facility, limit of one return trip a year.
- If medically necessary, round-trip economy transportation will be arranged and a qualified medical attendant to accompany the patient.

Accidental Dental - emergency treatment and stabilization due to accidental injury to natural teeth or accidental damage to natural or artificial teeth from an external blow to the mouth to an annual maximum of $1,000.

Transportation to Bedside - provides one round trip economy airfare for one member of your family to be with an insured person who has been confined to a hospital for at least 7 days.

Trip Interruption/Delay - POST DEPARTURE - one way economy far or the excess cost over and above any prepaid travel plan, if your trip is interrupted or delayed due to your or your dependent's hospitalization outside your province of residence.

Return of Dependent Children - one way economy transportation or the excess cost of pre-paid travel arrangements for the return of your children by the most direct route to their place of residence, if dependent children are left unattended while traveling when you or your spouse are hospitalized.

Vehicle Return - arrange and cover the cost of returning your vehicle to the nearest appropriate rental agency, up to a maximum of $2,000, if an insured person is unable to do so due to sickness, injury or death.

Repatriation - provides up to $5,000 to return the deceased to the home province.

Additional Expenses - covers the cost of meals and hotel accommodation due to your hospitalization, up to a daily maximum of $150 up to 10 days.

Note* Prior approval must be obtained from World Access to guarantee payment of your claim expenses. You can contact them 24 hours a day, 365 days a year. World Access must be notified within 48 hours of the emergency in order to provide for your medical expenses and effectively monitor your care. If World Access is not contacted within 48 hours of the emergency, payments will be limited to $2,000.

Each insured may be required to provide proof of departure in the event of a claim. Proof can take any form, identifying you, specifying the date, and indicating that the transaction took place in your province of residence. Examples include a purchase made at the Canadian duty-free store, a stamped passport, an airline ticket or a credit card receipt.

Download

For more information you can contact World Access at one of the following numbers:

Canada & USA: 1-800-249-6556 (toll-free)
Other countries: (519) 742-6683 (call collect)
Fax: (519) 742-8553

In addition to the certificate number, World Access will require your Provincial Government Health Insurance Plan number and the ARTA/World Access Identification No. 9520 to process payments.

 

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2. Supplemental Travel Plan over 60 Days (only available with the base plan)

The ARTA Supplemental Travel Plan pays for eligible expenses for medical emergencies which occur during trips in excess of 60 days duration and which are in excess of the amount reimbursed by your Provincial Government Health Insurance Plan. Eligible expenses are the same as those specified under Out-of-Province/Canada eligible expenses under the Extended Health Care Plan Treatment for medical emergencies and must be recommended as medically necessary by a legally qualified physician.

EFFECTIVE DATE OF SUPPLEMENTAL TRAVEL PLAN COVERAGE

Your Supplemental Travel Plan coverage begins on the 61st day of any trip you report to Johnson Inc. The first 60 days of your trip are covered under the Extended Health Care Plan. In the event that your travel plans are longer than the 60 days in duration, make arrangements to extend your coverage before departure if possible. The extension is refundable if not used. Refunds will be issued for any unused 15-day units of coverage provided no claim has been incurred.

Note* Johnson Inc. must receive your request or enrolment form on or before the 60th day of your trip. Extensions of coverage may be declined in the there are claims in progress for the trip being extended.

PREMIUMS FOR SUPPLEMENTAL TRAVEL PLAN

Premiums for supplemental travel coverage will be deducted in equal monthly instalments from your bank account for the balance of the policy year.

Download

For more information or to apply for coverage, contact Johnson Inc. at 1-877-989-2600

 

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3. Extended Health Care Plan WITHOUT Travel

You can purchase an Extended Health Care Plan WITHOUT the 60 Day Travel coverage outlined above. However, you would not be eligible for Supplemental Travel coverage. You would also be required to submit medical evidence if you wish to purchase travel coverage at a later date.

For more information or to apply for coverage, contact Johnson Inc. at 1-877-989-2600.

 

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4. Dental Care Plan

You can choose one of three Dental Options A, B, or C on or after September 1, 2006, subject to minimum participation rules. You must participate in ARTA's Dental Plan for at least 24 months, if you enroll or change to a new Option on or after Sept. 1, 2006. You may change to an enhanced Option such as B to A at any time, but you must then remain in Option A for 24 months. You may change to a more restrictive Option such as A to B, but only after participating for 24 months in Option A. Annual maximums restart at the beginning of each calendar year and do not restart with a change to Option A, B or C. Apply early. When enrolling in ARTA's Dental Plan, after 60 days of leaving another plan, all benefit maximums will be pro-rated from the date of entry to December 31st of the first calendar year.

OPTION A

REIMBURSEMENT
(no deductibles apply)

80% of eligible Basic Preventative services (no annual maximum applies).

80% of eligible Minor Restorative expenses up to a combined annual maximum of $750 per covered person.

50% of eligible Major Restorative expenses per covered person including:
- Crowns/inlays/onlays - up to a combined annual maximum of $700.
- Fixed bridges/dentures - up to a combined annual maximum of $700.

Note*
All payments are based on the average current, reasonable and customary fees for General Practitioners in Alberta as determined by the Insurer.

Dentures are covered after the first 12 months of coverage.

You are required to remain in ARTA's Dental Care Plan for a minimum of 12 months from the effective date.

FILING FOR PRE-DETERMINATION OF DENTAL BENEFITS

If your proposal dental care is expected to cost more than $300, you should submit a treatment plan to Johnson Inc. for assessment before your dental work begins. The purpose is to determine, in advance, the reimbursement which you or your dependent can expect to receive from the Plan.

ELIGIBLE DENTAL EXPENSES

All amounts shown are annual limits payable per covered person, unless otherwise stated. You will be reimbursed for expenses above the amount that your provincial plan pays up to a specific percentage.

Basic & Preventive - 80%

Diagnostic Services
- Oral exams, recalls, x-rays (one every 12 months).
- Complete oral exam (one every 3 years).
- Full-mouth and panoramic x-rays (one every 3 years).

Preventative Services
- Dental consultation.
- Polishing (one every 12 months).
- Oral hygiene instruction and topical fluoride application.
- Space maintainers.
- Amalgam, silicate, acrylic and composite fillings, and veneer applications.

Note*
Scaling is covered under Minor Restorative.

Surgical Services
- Extractions of erupted and impacted teeth.
- Removal of residual roots.
- Removal of tumours, cysts, neoplasms, incision and draining of abscess.
- General anesthesia.
- Relining, rebasing and repair of dentures.

Minor Restorative - 80%

$750 Combined Annual Maximum (Endodontic/Periodontic)

Endodontic Services
- Treatment of dental pulp diseases, including root canal therapy.

Periodontic Services
- Treatment of bones and tissues supporting teeth.
- Appliances and adjustments (one every 3 years).
- Root planning* and cleaning (one visit every 6 months).

Note* Scaling and/or root planning are limited to eight (8) units per year under Minor Restorative services and are subject to the $750 combined annual maximum.

Major Restorative - 50%

Crowns, posts, onlays and inlays - $700

Fixed bridges, dentures - $700
- Bridges - initial installation or repair.
- Full or partial dentures - after you have been enrolled for 12 months under this plan.

OPTIONS B & C - exclude major restorative.

Option B: 80% Basic/Preventative, 80% Minor Restorative
Option C: 65% Basic/Preventative, 65% Minor Restorative

Note: All payments are based on the average current, reasonable and customary fees for General Practitioners (versus Specialists) in Alberta as determined by the insurer. Note that unlike other provinces, the Alberta Dental Association has not published a fee guide since 1997. Each dentist can charge different fees for the same procedure. As a result, insurers must develop their own guidelines and reimbursement limits for Alberta. The insurer Manulife increased 2006 reimbursement limits for Alberta such that on average seven out of ten dental claims submitted will be eligible for payment in full, based on 2005 claims data. Any difference between what a dentist charges and the insurer's reasonable and customary fee guideline for General Practitioners is ultimately the responsibility of the Dental Plan members.

Coverage Outside your Province of Residence

If you or your dependents incurred emergency dental treatment expenses while travelling outside your province of residence, the plan will reimburse you on the same basis as though the expenses were incurred in your province of residence.

Monthly Premiums Effective September 1, 2006
The Plan Administrator, Johnson Inc., will mail all ARTA Health and Dental Plan members a renewal notice in early July. The notice will indicate rate changes, which become effective with your August 5th bank deduction. The August 5th bank deduction represents September benefits coverage, i.e. deductions one month in advance.

Download
Download

For more information or to apply for coverage, contact Johnson Inc. at 1-877-989-2600.

 

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5. Long Term Care Plan

ARTA's Long Term Care Plan is available to you, your spouse, parents and adult children, age 18-89, subject to medical evidence. You can choose coverage amounts of $50/day ($50,000/lifetime), $75/day ($100,000 lifetime max) or $100/day ($200,000 lifetime max). Level monthly premiums are tied to your age at issue.

For more information call 1-877-LTC-PLAN or visit www.johnson.ca/LTC.

 

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6. Guaranteed Life Insurance Plan

If you (and your spouse) are between the ages of 50 and 85, you can automatically become insured under the Guaranteed Life Insurance Plan. No medical is required. You can choose a coverage amount of $2,500, $5,000, $7,500, $10,000, $12,500, $15,000, $17,500, $20,000, $22,500, or $25,000. Premiums are guaranteed for life.

Download
Download

For more information or to apply for coverage, contact Johnson Inc. at 1-877-989-2600.

 

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7. Term Life Insurance Plan

If you (and your spouse) are between the ages of 45 and 70, you can apply for the Term Life Insurance Plan by answering 4 simple questions. You can choose a coverage amount of $25,000, $50,000, $75,000, $100,000, $125,000 or $150,000. Premiums are guaranteed not to increase for 10 years with reduced rates available for non-smokers.

Download
Download

For more information or to apply for coverage, contact Johnson Inc. at 1-877-989-2600.


# 301 West Chambers Building
12220 Stony Plain Road
Edmonton, AB T5N 3Y4
web site: http://www.johnson.ca

 

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8. Home and/or Automobile Insurance Plan

Reap the benefits of the home and auto insurance plan available exclusively for ARTA members through Johnson Inc.

With the Preferred Service Home-Auto Plan you can enjoy:

- Interest-free monthly payments with no down payment required.
- A Members-Only website to review your personal policy anytime.
- Your own personal representative with a direct toll free line and e-mail.
- Auto Club with emergency roadside assistance, trip planning advice…and a whole lot more!

Call us today for a no-obligation quotation, 1-800-563-0677 or visit the ARTA link online at http://www.johnson.ca/arta

You can contact The Alberta Retired Teachers' Association at:
#409, Barnett House
11010 - 142 Street
Edmonton, AB T5N 2R1
Phone: (780) 447-9474 or 1-800-232-7208 ext 474 (toll free in Alberta)
Fax: (780) 447-0613
Email: don@albertarta.com

 

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