Benefits

The ability to collectively negotiate our group benefits, including health and dental, is an important advantage of being a unionized professional. Most of your benefits are codified in your Collective Agreement. 

The union and the Employer have also jointly put together an OPS Benefits Guide (available below) to help you understand your benefits, as negotiated. 

OPS Benefits Guide

The OPS Benefits Guide is still being updated to reflect the latest changes to your benefits. 

Please read below to see a summary of changes to your benefits not yet reflected in the OPS Benefits Guide.

Updates not yet reflected in the OPS Benefits Guide

Health Care Spending Account

AMAPCEO negotiated an Employer-paid, tax-free Health Care Spending Account (HCSA) for permanent members in the OPS. 

Eligibility 

You will receive a HCSA if you: 

• Are a permanent employee enrolled in the Supplementary Health and Hospital and/or Dental plan; and 

• Have completed two months’ continuous service. 

Balance 

• The annual HSCA balance is $525 as of January 1, 2024.

• You can carry forward a maximum of one year’s worth of credits into the next calendar year. 

Coverage 

You can use your HCSA for either, or both of: 

• Eligible medical expenses as defined in the Income Tax Act. These include many items not covered by insured plans, such certain types of medical equipment and some paramedical providers (e.g., in-vitro fertility treatments); and/or 

• Out of pocket expenses under the insured plans where the expense is eligible under the Act (e.g., if you spend $90 on a registered massage therapist, and are reimbursed $35 under the insured plan, you can choose to apply $55 from the HCSA to the expense to achieve full reimbursement). 

Claims 

• Submit your claims through your online Canada Life account or through a print form available on the OPS Employer’s Intranet. 

Prescription drugs

The latest collective agreement includes changes in the administration of prescription drug coverage to what is described on page 12 of the 2015 OPS Benefits Guide. 

Prior authorization 

• Canada Life now has a standard prior authorization program for a list of certain prescription drugs covered under the drug plan. Under this program, your doctor will have to communicate a rationale to the insurer with a "Drug Prior Authorization Form" before coverage for these drugs is approved. This does not apply if you were taking the drug as of March 31, 2023.

• You can find this list of drugs on the Canada Life website, along with the applicable form for your doctor to complete. 

Generic substitution 

• Canada Life now reimburses you based on the lowest cost generic alternative product price, even if no substitution is prescribed by your doctor. 

• If you or your dependent can’t tolerate the generic drug, or if it is therapeutically ineffective, your doctor can complete a Request for Brand Name Drug Coverage form (available below) and submit it to Canada Life.

Health case management 

• Canada Life has implemented health case management to provide additional personalized support if you or your dependents are prescribed specific drugs that treat complex conditions, such as asthma, ankylosing spondylitis, Crohn's disease, psoriasis, psoriatic arthritis, and rheumatoid arthritis. 

• Canada Life case managers, who are registered nurses, will work directly with you and your doctor to identify the appropriate treatment, ensure the prescribed drug is working, and schedule follow-ups to ensure the condition is being managed effectively. 

• Health case management only applies to some of the drugs covered by the plan. 

SMART Drug Plan 

• Canada Life has implemented a SMART (Sustainable, Managed and Reasonable Treatment) Drug Plan—an assessment to ensure that only appropriate drugs are added to the plan. 

• Canada Life will assess new drugs that come to market to ensure only those which have enhanced treatment outcomes, safety, and cost-effectiveness are added to the program. 

Drug dispensing caps 

• Dispensing fees are now capped at $11.99 per prescription. If eligible, you can use your HCSA to cover the unpaid dispensing fee portion. 

• If you are taking maintenance drugs (used to treat chronic, long-term conditions, and taken on a regular, recurring basis), Canada Life has implemented an annual dispensing fee frequency cap of five times per calendar year for these drugs. Some examples include prescriptions to treat high blood pressure or cholesterol. 

Diabetic supplies and appliances covered 

AMAPCEO successfully negotiated a settlement with the OPS Employer that adds more diabetic devices to coverage included on page 16 of the 2015 OPS Benefits Guide. 

Coverage 

• The plan covers the purchase and/or repair of one blood glucose monitoring machine per consecutive four-year period to a maximum of $400 per person. 

• Effective January 1, 2020, coverage now includes continuous blood glucose monitors and flash glucose monitors. 

Psychological services 

AMAPCEO negotiated improvements for psychological services beyond those included on page 16 of the 2015 OPS Benefits Guide. 

Coverage 

• The plan now covers the services of psychotherapists as eligible practitioners, along with existing psychological service coverage as outlined in the Guide. 

Balances 

Effective April 1, 2023, coverage for psychologists, registered social workers, and psychotherapists is a maximum of: 

• $80 per half-hour visit, and 

• $1,600 per calendar year. 

Optional out-of-country coverage 

You now have the option of buying either individual or family optional upgrade package from Canada Life. If you choose to enroll, you will be responsible for 100% of the monthly premium. This is different from what is identified on page 17 of the 2015 OPS Benefits Guide. 

The package includes: 

• Emergency out-of-country medical coverage, and 

• Global Medical Assistance.  

Learn more on the OPS Employer’s Intranet. 
 

Dental claim reimbursement option 

AMAPCEO negotiated the ability for you to authorize Canada Life to pay your dentist directly for eligible claim expenses. This is in addition to the dental plan claim submission information on page 25 of the 2015 OPS Benefits Guide. 

• You have the option, with agreement from your dentist, to authorize the insurance carrier to pay your dentist directly for eligible claim expenses. 

• This shall not impact eligibility requirements or coverage of dental benefits and you are responsible for making payments to your dentist at the time of service for any applicable deductible and out of pocket expenses not covered by the Dental Plan.  

Fixed-term employees 

AMAPCEO negotiated greater opportunities for fixed-term (FXT) employees to opt into health and dental benefits than what are identified on page 48 of the 2015 OPS Benefits Guide. 

Enrolment 

• Fixed-term employees may now apply for insured benefits within 60 days. 

• If you receive a contract extension longer than your original contract, you will have an additional 31-day window to opt-in. This will only be offered once, at the first eligible contract extension. 

If you have questions or need assistance

Please contact an AMAPCEO Workplace Representative near you. They do not have to be in your Ministry.

Workplace Representatives are trained union members who have volunteered to confidentially assist members like you in the workplace. They should be your first point of contact in seeking information and representation with an issue at work.

Your Workplace Representative may ask you to use the union’s secure web-based system, RADAR, to provide details about your situation. RADAR will help you and your Workplace Representative keep track of things without the privacy concerns that could come from using the Employer’s email system.