Health Benefits

FLOORLAYERS’ WELFARE TRUST FUND

HEALTH CARE BENEFITS – STANDARD COVERAGE

(Revised Benefit Schedule – January 1, 2017)

The Floorlayers’ Welfare Trust Fund is designed for members of floor covering local unions in the Province of British Columbia to offer protection and security for organized workers in the floor covering industry.

This text contains a brief outline of the benefits and features provided by the Fund. It is by no means complete but issued so that you will have a clear understanding of how the Plan operates for the benefit of you and your family.

BASIC MEDICAL AND SURGICAL COVERAGE

As provided by the Medical Service Plan of B.C.

VISION CARE

The plan provides $500.00 vision care coverage every 24 months, which can also be used toward laser eye surgery. Claim forms are available from the union office, who will be issuing reimbursement. DO NOT send eyeglass forms to Pacific Blue Cross. Eye exams are covered to a $50.00 max thru Pacific Blue Cross every 24 months.

EXTENDED HEALTH CARE

Is provided by Pacific Blue Cross. Some additional expenses are covered by Pharmacare. Drug reimbursement for Pharmacare eligible drugs is 80% and 50% for non Pharmacare eligible drugs. Prescription drug limit for the plan is $7,500.00 per family member per calendar year. Oral Contraceptives are covered and PSA testing is covered to a maximum of $35.00 payable per calendar year. Members with expenses over the Pharmacare Plan limit should also claim on their spouses plan if available. Extended Health limit is $100,000.00 per person in a 24 month period. A deductible of $75 per year for a single person and a $100 per year for a married person with dependants.

PHYSIOTHERAPISTS, CHIROPRACTORS & MASSAGE THERAPISTS

There is a limit of $1000.00 per year per family.

SHORT-TERM DISABILITY (WAGE INDEMNITY)

Provides a payment of $524.00 per week (based on a 7 day week @ $74.85 per day) for 15 weeks when sick or unable to work because of a non-occupational disability. Benefits are paid from the fourth day of a disability due to a non-occupational illness. The Plan is coordinated with E.I. Medical Benefits which provide an additional 15 weeks for those who qualify as a “Major Attachment” of the work force. Members who receive wage indemnity qualify for disability credits.

RITICAL ILLNESS

Is provided by ACE INA Insurance in the amount of $10,000 for member and $5,000 for spouse. Benefits can be used by Plan Members as they see fit and are non taxable. This coverage is for specific illnesses and subject to limitations, for details please reference the Critical Illness booklet.

DENTAL CARE

The Plan pays 90% of the cost of services provided under Part A which generally includes diagnostic, preventative and restorative services and the general day-to-day dentistry. The Plan pays 80% of the cost of dentures and 70% of the cost of other services provided under Part B, which are the more expensive services such as crowns and bridges. The maximum amount that will be paid by the Plan for any one member or any registered dependent is $2,500.00 in any calendar year for Part A and B.

ORTHODONTIA

In addition the Plan pays 60% coverage of $3,000.00 lifetime maximum ($3,000.00 paid by the Plan).

LIFE INSURANCE

$50,000.00 under a group policy payable to the beneficiary designated by the member in the event of death while insured under the group policy. Members are covered to the age of 65.

ACCIDENTAL DEATH & DISMEMBERMENT

In addition to the life insurance benefit, $50,000.00 will be paid for accidental death. In addition, for loss of:

  • Both hands or feet: $10,000.00
  • Sight of both eyes: $10,000.00
  • One hand and one foot: $10,000.00
  • One hand or one foot & the sight of one eye: $10,000.00
  • One hand or one foot: $5,000.00
  • Sight of one eye: $5,000.00

SPOUSE INSURANCE

$10,000.00 life insurance on the spouse of the member who has been registered with the Plan on the member’s dental plan.

JURY DUTY PAY

60% of wages plus holiday pay, welfare and pension plan credits for days the member serves as a juror. 30% of wages plus holiday pay, welfare and pension plan credits for days the member reports and doesn’t serve. The member also keeps the regular jury duty pay.

BEREAVEMENT LEAVE

60% of the member’s wage rate plus 8% holiday pay for each date of entitlement. For the death of the member’s husband, wife, common-law spouse, son, daughter, step-child, father or mother a maximum of 3 days benefit. For the death of the member’s brother, sister, father-in-law or mother-in-law 1 day of benefits will be paid. In the event of a member having both a father and a stepfather, (mother/stepmother) pass away, only one bereavement claim will be processed. Should a member’s spouse pass away and he/she remarries and consequently the second spouse passes away, a second claim will be allowed.

PSYCHOLOGICAL SERVICES

Covers all health-related psychological services provided by a registered psychologist or the services of a registered clinical counsellor upon referral by a registered psychologist. The plan has a maximum limit of $750.00 payable per family per calendar year and you will be required to pay 10% of the psychologist’s fee or, if referred by a registered psychologist, 10% of the registered clinical counsellor’s fee. These are fully confidential services, which are administered independently of your employer and the union.

DISABILITY CREDITS

Members on Wage Indemnity, E.I. Medical Benefits or WorkSafeBC are awarded approximately 4 hours each calendar day they are disabled that count towards maintaining their coverage while unable to work. Members are required to submit their E.I. and WorkSafeBC cheque payment stubs as proof of disability before credits are awarded.

APPRENTICE TRAINING CREDITS

Apprentices are also awarded hours dependent on their attendance in order to maintain coverage while attending vocational or training classes.

Your coverage begins on the first day of the month following the month in which all of these requirements are fulfilled.

Once you have qualified, 130 hours are withdrawn each month from your hour bank to pay for coverage under the Plan. You may accumulate up to six months coverage (780 hours) which can be used during a period of reduced employment, illness or extended vacation.

Your coverage will continue for as long as your hour bank contains sufficient hours and provided you remain a member of the union.

THE HOUR BANK SYSTEM

The hour bank system is designed so the employer pays the negotiated hourly rate on behalf of each employee coming within the scope of the collective agreement. The hours are accumulated in the member’s individual hour bank account to provide the health and welfare coverage when eligibility requirements are fulfilled. Regardless of which participating employer you are employed with, all your hours are channelled to the Administrator and are credited to your account.

ESTABLISHING COVERAGE UNDER THE PLAN

You must be a member of a participating local union or a management employee of a participating employer. You must file completed enrollment cards with the Administrator. A minimum of 350 hours must be reported and paid to the Plan on your behalf by a participating employer within a period of four consecutive months.

Your coverage begins on the first day of the month following the month in which all of these requirements are fulfilled.

Once you have qualified, 130 hours are withdrawn each month from your hour bank to pay for coverage under the Plan. You may accumulate up to six months coverage (780 hours) which can be used during a period of reduced employment, illness or extended vacation.

Your coverage will continue for as long as your hour bank contains sufficient hours and provided you remain a member of the union.

SELF-PAY REGULATIONS AND HOUR BANK SHORTAGES

If your hour bank drops below 130 hours, you will receive a shortage notice on the payment you must make to maintain coverage for one month. If you wish to maintain your coverage, you must make a self payment for the number of hours that you are short at the contribution rate stated on the notice. Payment must be made immediately on receipt of the notice and be received by the 15th day of the current month.

THE ONLY WAY TO GUARANTEE CONTINUOUS COVERAGE IS TO PAY THE SHORTAGE BY THE DATE SPECIFIED ON THE NOTICE.

Sometimes shortages occur because your employer did not report your hours on time, your name was accidentally left off the report, or an error was made in the number of hours reported under an incorrect Social Insurance Number. You should keep your pay slips in the event that any errors do occur.

Also, remember there is a lag month. For example, the January hours your employer remits go towards March coverage. If you received a shortage notice in January requesting payment for February coverage, the shortage should be paid by the 15th of January.

Self-pay limitations permit the member to self pay the full 130 hours per month for a maximum of six consecutive months at a subsidized rate. Following this, an additional 6 months will be offered to the member at the full self-pay rate. Members on full self pay do not qualify for the wage indemnity, jury duty benefits or bereavement leave.

TERMINATION OF COVERAGE

Your coverage is provided on a whole month basis and will terminate on the last day of the month if your hour bank falls below the 130 hours and you fail to make the required payment by the specified date on your shortage notice. Coverage automatically terminates if you cease to be a member of the union.

If you fail to pay a shortage notice and your hour bank remains below 130 hours you will receive a termination notice.

In case of death, the member’s dependents will continue to be covered for as long as there are sufficient hours in your hour bank.

CLAIM FORMS

The following claim forms and cards are available at the union office:

  1. Enrollment forms for MSP and PBCWage Indemnity claim forms
  2. Extended Health Care claim forms
  3. Jury Duty claim forms
  4. Change of Status forms for MSP and PBC
  5. Designation of Beneficiary form for life insurance
  6. Designation of Spouse forms for spousal insurance
  7. Bereavement Leave claim forms

FOR FURTHER INFORMATION

Call or write:
FLOORLAYERS’ WELFARE TRUST FUND
#200- 580 Ebury Place,
Delta, B.C. Canada
V3M 6M8
Phone: 604-524-6900
Fax: 604-524-6919

Get In Touch With Us

Have Questions?

The BC Floorlayers Union Local 1541 is always interested in hearing from both members and the general public.