Effective July 1, 2015, the 3sHealth Extended Health Care Plan will be providing increased Hearing Aid coverage to plan members. Charges for the cost of, repair (excluding batteries or routine maintenance of) and installation of a hearing aid(s) purchased on the written recommendation of an audiologist will be covered to a maximum amount payable of $1,500 per insured person every five consecutive calendar years. This is an increase from the current coverage amount of $500 per insured person every five consecutive calendar years.
The new $1,500 hearing aid maximum will be applied to all eligible plan members. For example: if you purchased hearing aids on July 20, 2014 and received the $500 reimbursement, you will be eligible for the additional $1,000 in coverage between July 1, 2015 and December 31, 2019 (5 consecutive calendar years from the July 20, 2014 date of purchase). On January 1, 2020 the plan member will be eligible for the $1,500 maximum amount.
Effective July 1, 2015 the 3sHealth Enhanced Dental Plan will be providing increased orthodontic coverage. The dependent child orthodontic lifetime maximum will be increasing from $1,500 to $2,500 per eligible dependent child. Adult orthodontic coverage is also being added at a $1,500 lifetime maximum. The adult orthodontic coverage applies to both the plan member and eligible spouse.
The new dependent child $2,500 orthodontic maximum will be applied to all eligible plan members. For example: if you purchased orthodontic services and previously reached the $1,500 orthodontic maximum, you will be eligible for the additional $1,000 in coverage effective July 1, 2015. Only expenses incurred after July 1, 2015 in accordance with an approved orthodontic treatment plan will be eligible. If orthodontic treatment concluded prior to July 1, 2015, those expenses are not eligible. Second example: if you reached the $1,500 orthodontic maximum on February 28, 2015, but your child is still undergoing orthodontic treatment, charges from March, April, May, and June 2015 are not eligible. However charges incurred from July 1, 2015 forward would be eligible up to $1,000.
If you have any questions about these plan enhancements and/or whether you are eligible to participate in the 3sHealth Benefits Plans, please contact a 3sHealth Benefit Services Officer at 1.866.278.2301 or by email at email@example.com.
If you have any further questions or concerns, please contact your SEIU-West Member Resource Centre (MRC) at 1.888.999.7348.
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