The CPGA's Group Benefits Program is an "Optional Benefit." Coverage is not automatically provided by the Association. Members and apprentices wishing to participate must join the plan personally.

The plan has been designed similar to a corporate Employee Benefits Plan, however, it is available to eligible members and apprentices on a "Voluntary Basis". The plan includes: Life Insurance, Accidental Death and Dismemberment Insurance, Extended Health Care, and Basic Dental Care benefits.

The following outline is designed to give you an overview of the benefits in the program. All claims will be settled in accordance with the CPGA's master policy contract.

"Who can join?"

You may join after one year of membership or one year of apprenticeship.

Dependent coverage applies to the member's spouse and children up to the age of 18 (25 if in school full-time).

"Do I have to pass a medical?"

Members and apprentices joining on July 1st, immediately after completing one year of membership in the CPGA may join the plan without evidence of medical insurability.

Members and apprentices transferring from an employer’s plan may join without medical evidence within 30 days of the transfer. After the 30 day grace period, you must qualify medically for coverage.

Members and apprentices joining the plan at any other time must complete a medical questionnaire and may be required to pass a medical exam.

"When am I covered?"

Coverage starts on the 1st of the month following your acceptance into the plan and payment of the premium. Coverage remains in force unless you notify us of cancellation in writing, cease paying premiums, or until the master policy is terminated.

While you remain a member of the CPGA, you may continue to renew your coverage until December 31st following your attainment of age 65.

If you voluntarily terminate your coverage, you must wait 18 months to be eligible to re-enrol. You will then have to prove medical acceptability.

"What are the benefits?"

There are three plans to choose from. Each offers similar coverages and differs primarily in the principal sums insured , the deductible and percentage of reimbursement.

Life Insurance

Group life insurance benefit is payable in the event of the member's or apprentice's death. The plan includes Waiver of Premium in the event of total disability prior to age 65, and a Conversion Privilege upon termination prior to age 65.

Accidental Death & Dismemberment

AD&D covers accidental bodily injuries resulting in loss of life, limb, sight, hearing or speech. Accidents must occur while member or apprentice is insured under the plan and the loss must occur within 365 days of the date of the accident.

Payments for various occurrences are scheduled in the policy and range from 25% to 100% of the principal sum insured.

Coverage includes losses due to exposure, disappearance, and air travel as a regular passenger. There is an aggregate plan maximum amount payable as a result of a single accident of $3,000,000, regardless of the number of members involved.

Extended Health Care

Extended Health Care is designed to supplement government health care plans. It provides members and apprentices with reimbursement of charges for many medical services and supplies not covered by Provincial Health Care plans.

Each year, after you satisfy your annual deductible, the plan will reimburse you for eligible expenses on the basis of the reimbursement percentage of the plan you select.

Out-of-Province/Out of Canada Travel

This coverage was discontinued in June 1995. It is very important that you obtain out of province coverage whenever you travel. A wide variety of programs are available in the market place.

Dental Care

Dental Care is designed to encourage a regular program of dental hygiene by reimbursing a portion of the eligible expenses, (you receive the percentage of reimbursement according to the plan you select), after the annual deductible has been satisfied.

The plan includes: consultations, examinations, x-rays, cleaning, scaling, fluoride, space maintainers for children, fillings, extractions, anaesthesia, repairing, relining or rebasing of dentures, minor and major oral surgery, endodontic procedures and periodontic procedures. Reimbursement of expenses is based on the current "Province of Residence Fee Guide for General Practitioners". Not all dentists follow this schedule.

Important Limitations:

• Annual maximum paid is $500 per each insured family member in the first year and $1,000 each subsequent year of participation

• Maximum paid for late entrants during first 12 months of coverage is $100 per insured

• Braces, crowns, inlays and orthodontics are excluded from coverage

Pre-treatment Plan: It is strongly recommended that when a course of treatment is expected to cost more than $500, a treatment plan should be completed by your dentist and submitted to the insurer for review before the treatment commences. A treatment plan helps to avoid any misunderstanding as to the extent of coverage or limitations which may apply.

"How do I submit claims?"

Claim forms are available on this website. It is important to complete the forms in full and return them to Simmlands Insurance Brokers Limited. Incomplete forms or forms sent directly to the insurer cannot be processed and will be returned to you.

Cost Plus

Ask us about this unique tax planning feature of the program.