Benefits Plan for Members

Dear Members,

For medical, dental and vacation pay, call 416-636-4700 or 1-888-863-2278.

Please find below some important information about your benefits.

Health & Welfare Overview

Eligibility

• Hours required for initial coverage:
  • Accumulate 3 months of deductions in hour bank – equivalent to 345 hours of work)
  • Eligibility begins 1st day of the 2nd month following reaching 345 hours (e.g. A member reaches 345 accumulated hours in December 2020 – member benefits would begin February 1st)
• 115 hours are required to be earned or taken from the bank to remain eligible in Plan A.
• Every month, there is a drawdown on the hour bank of 115 hours to keep the member enrolled in Plan A
  • All hours that the member works in a month are added to the hour bank
  • Every month that the member is in benefits, hours are deducted from the hour bank
• Earned hours are added to the hour bank two months after the fact
  • e.g. – An employee works and earns hours in January. These hours are reported by their employer in February, and they will be reflected in the March hour bank.
• Other alternatives to maintain coverage:
  • Fund Assistance – coverage is maintained by the Trust Fund while member is in a period of disability (STD, LTD, EI Disability, CPP Disability, WSIB, MVA) – 30 month maximum unless totally and permanently disabled from any occupation
  • Plan B – only requires 85 monthly hours with reduced benefits
• Self Payments – member can pay hourly rate out of pocket
  • Plan A = $399.92
  • Plan B = $295.60
  • Payment is reduced by any hours in the hour bank

Plan A

• Member coverage will continue to be maintained by the Trust during the first (1st) month in which hours in their hour bank are less than the required 115 hours to maintain Plan A benefits.
• Provided the member is in good standing, members may remain under Plan A for six (6) months total – one (1) fund assisted (free) month AND five (5) months of self-payments.
• If, after the 1 month of fund-assisted coverage and five (5) self-payments, if a member’s Hour Bank is still below the 115 hours) required to maintain coverage in Plan A, that member will automatically be transferred to Plan B.

Plan B

• To remain in Plan B members will continue to be required to maintain 85 hours in their hour bank, after which the Plan B self-payment provisions continue to apply. After transferring from Plan A, members continue to be allowed to self-pay to remain in Plan B for up to twelve (12) additional months during any single period of unemployment.

Self-Payments

• When a first time a self-payment is required, a friendly notice will be issued to the member indicating amount to pay, which will be reduced by amount remaining in their reserve hour bank
• Self-payments can be made through online banking, through Canada Post or via Interac in office (no cash or credit card payments)
• We are not able to accept employer cheques for self-payment

Re-instating Coverage

• To reinstate Plan A coverage when in Plan B, a member must accumulate 345 hours in hour bank – 85 hours will still be deducted from bank monthly to continue Plan B
• If terminated from all coverage, Plan B will be reinstated after two months of Plan B hours (170) have been earned (beginning 1st day of second month after accumulation), provided they are earned within 6 months of terminating. Otherwise, the employee will start fresh and have to earn 345 hours.

Eligible Dependents

• Spouse – legal husband or wife (common-law must be living together at least one year) – only one at a time
• Child – covered up to age 21 (age 25 if child is full-time student in post-secondary school) or indefinitely if permanently and functionally impaired
  • Natural children, adopted children, stepchildren or custodial child of legal spouse are eligible
  • Must not be married or working full-time

Coordination of Benefits

• Required for members who have multiple benefit plans in their family
• Determines which plan has primary responsibility for claim
• Members own coverage will always be primary coverage for their own claims
• If spouse has coverage, spouse’s plan will be primary for their personal claims
• Unpaid amounts may be submitted through secondary insurance company with an Explanation of Benefits from primary insurer indicating the amount reimbursed
• For children, primary coverage is through parent whose birthday come first in the year and unpaid balances are issued to other parent’s plan
• If filing two separate claims, it is important that the member make copies of receipts and records

IUPAT Member Benefit Card

Eligible service providers include:

• Pharmacists
• Dentists
• Paramedical practitioners
• Healthcare practitioners

Please note: Electronic submission of claims reduces member out of pocket expenses.

IUPAT Benefit Apps

This is available to all members:

• BPA eClaims App
• vCare – Virtual Healthcare App
• BPA mHealth App

For more information about the benefit apps, please visit here.

Vacation Pay

• Payouts occur twice annually – 1st week of May and 1st week of November
  • Please ensure to contact the benefits office with address changes as soon as possible
• Early payouts can be requested for members suffering financial hardship
  • Vacation Pay requests are to be submitted to the union representative and approved by the Union prior to being submitted to the benefits office.

Contact the IUPAT Benefits Office if you need any information.

Phone: (416) 636-4700
Email: iupat@bpagroup.com