YOUR EWAO-ATEO
BENEFITS PLAN
PUTTING YOU FIRST
We are extremely pleased to introduce
your new EWAO-ATEO Benefits Plan.
It’s a plan tailor-made for eligible
EWAO-ATEO members and one that
provides you and your family with
valuable financial protection.
Full plan details, including who can
participate, enrolment deadlines,
eligible expenses, exclusions and how
to make claims are available on
OTIP’s secure member website
once you have enrolled.
The benefit year starts September 1
and ends on August 31, except
where otherwise indicated. The
plan has no overall deductibles
or waiting periods. Certain
restrictions, limitations and
exclusions will apply. In the event
of your death before retirement,
family members continue health
and dental coverage at no
charge for 24 months.
The plan is administered by OTIP,
a not-for-profit organization
dedicated to Ontario education
workers.
ABOUT THIS GUIDE
This quick reference guide is intended
to provide you with a brief overview of
the new EWAO-ATEO Benefits Plan
and is not intended to be
comprehensive. If there is a
discrepancy between the information
in this guide and the benefits booklet,
the terms and details of the benefits
booklet apply.
Please refer to the benefits booklet for
full plan terms and details.
OVERALL BENEFITS PLAN
Funding Health, Dental, Basic Life and AD&D are 100% paid by
EWAO-ATEO for eligible full-time members
✓ Funding pro-rated for members less than full-time
(difference is member-paid)
✓ Optional benefits are member-paid
Who is eligible Mandatory Health and Dental for full-time members
✓ Can “opt-out” of Health and/or Dental with
comparable coverage
✓ Members less than 0.5 FTE are not eligible to participate in
the plan, unless they had coverage under a prior plan, in
which case, these benefits will continue
✓ Voluntary Health and Dental for members less than
full-time
✓ Mandatory Basic Life and AD&D for all members
Lifetime maximum Unlimited (except where stated)
Reimbursement 100% (except where stated)
BASIC LIFE AND ACCIDENT INSURANCE
Basic Life ✓ 1x annual salary to $500,000 maximum
✓ 50% reduction at age 65
✓ Ends at retirement
Basic AD&D ✓ Coverage matches Basic Life amount
✓ Ends at retirement
Member Optional Life and AD&D ✓ Member and Spousal Optional Life and AD&D
Spousal Optional Life and AD&D coverage up to $400,000 (units
Child Optional Life of $10,000)
✓ Child Optional Life coverage in units of $5,000
Contract members not eligible for this up to $25,000
coverage ✓ Member-paid, based on gender and age
✓ Ends at retirement
PRESCRIPTION DRUGS
✓ Pay-direct benefits card
✓ Prescription formulary, including life-sustaining drugs
✓ Mandatory generic substitution (lowest cost therapeutic equivalent drug)
✓ Dispensing fee maximum of $8
✓ Maintenance medications limited to 6 dispensing fees/prescription/12 months
✓ Pharmacy fees up to $250 maximum on specialty drugs
✓ Preventive vaccines
✓ Fertility drugs up to $15,000 lifetime
✓ Sexual dysfunction drugs $500/benefit year
✓ Smoking cessation drugs $500/lifetime
✓ Anti-obesity drugs $300/benefit year
✓ Diabetic supplies (reasonable and customary costs)
PARAMEDICAL
($ MAXIMUM/BENEFIT YEAR;
REASONABLE AND CUSTOMARY COSTS)

Chiropractor ✓ $500 DENTAL INSURANCE

Massage Therapist ✓ $750 Fee guide ✓ Current fee guide for General
Naturopath ✓ $500 Practitioners in the province of
Acupuncturist ✓ $500 residence
Osteopath ✓ $500 Basic dental ✓ 100% of check-ups, X-rays, fillings,
Physiotherapist/ ✓ $2,500 combined other
Occupational Therapist ✓ $2,500 max/benefit year combined with
Periodontal/Endodontic services
Podiatrist/Chiropodist ✓ $500 combined
✓ Recall exams: once every 9 months
Psychologist ✓
adults and once every 6 months per
Registered Family Therapist ✓
$1,500 combined child (18 and under)
Registered Social Worker ✓
✓ Full mouth X-rays or panoramic
Psychotherapist ✓
X-rays once every 24 months
Audiologist ✓
Periodontal/ ✓ 100% of root canals and related
Speech-Language Pathologist ✓
$1,000 combined Endodontic services
Communicative Disorders ✓
services ✓ 100% of scaling, root planing, gum
Assistants
treatments, etc.
✓ 12 units of scaling and root planing
VISION CARE combined/benefit year
✓ Glasses, contact lenses and laser eye surgery: Major ✓ 50% of crowns, bridges, inlays, onlays,
$400 combined maximum per 2 benefit years for restorative and dentures, implants (subject to Alternate
adults and each benefit year for children under 18 prosthetic Treatment clause)
✓ Eye exam: once per 2 benefit years for adults and once services ✓ $2,500 maximum/benefit year
each benefit year for children under 18 ✓ Crown, bridge or denture replacement
once every 3 benefit years; onlay 1 per
36 months
HOSPITAL Orthodontics ✓ 50% coverage for children
✓ Semi-private hospital room ✓ $3,500 lifetime
✓ Includes costs for semi-private room in private
OHIP-funded facilities
TRAVEL MEDICAL (OUTSIDE OF CANADA)
MEDICAL SUPPLIES AND SERVICES Emergency medical ✓ 100%
services ✓ Up to 60 days/trip
Ambulance Transport to nearest facility ✓ $5 million lifetime
Includes air ambulance maximum/person
Hearing aids $2,500/2 benefit years Referred medical ✓ 50%
Orthotics $400/benefit year services not available ✓ $3,000 maximum/
in Canada 3 calendar years
Orthopaedic shoes ✓ Two pairs/benefit year
(custom) ✓ $500 maximum/pair
Orthopaedic shoes ✓ $500/benefit year, including
(stock) modifications and adjustments
Private duty nursing $50,000/benefit year

Surgical Stockings ✓ 6 pairs/benefit year PLAN ADMINISTERED

Wigs $1,000/benefit year following
BY OTIP
chemotherapy www.otip.com
1-866-783-6847

10/19