Microsoft word - b5.tmp

Regular Employees
BENEFIT DETAILS

Great-West Life is a leading Canadian life and health insurer. Great-
West Life's financial security advisors work with our clients from coast to
coast to help them secure their financial future. We provide a wide range
of retirement savings and income plans; as well as life, disability and
critical illness insurance for individuals and families. As a leading
provider of employee benefits in Canada, we offer effective benefit
solutions for large and small employee groups.
Great-West Life Online
Information and details on Great-West Life's corporate profile, our
products and services, investor information, news releases and contact
information can all be found at our website www.greatwestlife.com.

Great-West Life Online Services for Plan Members
As a Great-West Life plan member, you can also register for
GroupNet™ for Plan Members at www.greatwestlife.com. To access
this service, click on the GroupNet for Plan Members link. Follow the
instructions to register. Make sure to have your plan and ID numbers
available before accessing the website.
This service enables you to access the following and much more, within
a user friendly environment twenty-four hours a day, seven days a week:
 your benefit details and claims history
 online claim submission for many of your claims, as outlined in the Healthcare and Dentalcare sections of this booklet  extensive health and wellness content Using our GroupNet Mobile app, you can access certain features of GroupNet for Plan Members to:  submit many of your claims online – part of our industry-leading  access personalized coverage information about benefits, claims and more – quickly and easily, any time  locate the nearest provider who has access to Provider eClaims,
Great-West Life’s Toll-Free Number
To contact a customer service representative at Great-West Life for
assistance with your Healthcare and Dentalcare coverage, please call
1-800-957-9777.



This booklet describes the principal features of the group benefit plan
sponsored by your employer, but Group Policy Nos. 163679 and
163680 and Plan Document No. 57758 issued by Great-West Life are
the governing documents. If there are variations between the information
in the booklet and the provisions of the policies or plan document, the
policies or plan document will prevail.
This booklet contains important information and should be kept in a safe
place known to you and your family.
The Plan is administered by
ENCOMPASS Benefits & HR Solutions Inc.
Access to Documents
You have the right, upon request, to obtain a copy of the policy, your
application and any written statements or other records you have
provided to Great-West Life as evidence of insurability, subject to certain
limitations.
Legal Actions
Every action or proceeding against an insurer for the recovery of
insurance money payable under the contract is absolutely barred unless
commenced within the time set out in the Insurance Act or other
applicable legislation (e.g. Limitations Act, 2002 in Ontario, Quebec Civil
Code).
Appeals
You have the right to appeal a denial of all or part of the insurance or
benefits described in the contract as long as you do so within one year
of the initial denial of the insurance or a benefit. An appeal must be in
writing and must include your reasons for believing the denial to be
incorrect.
Benefit Limitation for Overpayment
If benefits are paid that were not payable under the policy, you are
responsible for repayment within 30 days after Great-West Life sends
you a notice of the overpayment, or within a longer period if agreed to in
writing by Great-West Life. If you fail to fulfil this responsibility, no further
benefits are payable under the policy until the overpayment is
recovered. This does not limit Great-West Life’s right to use other legal
means to recover the overpayment.

Protecting Your Personal Information

At Great-West Life, we recognize and respect the importance of privacy.
Personal information about you is kept in a confidential file at the offices
of Great-West Life or the offices of an organization authorized by Great-
West Life. Great-West Life may use service providers located within or
outside Canada. We limit access to personal information in your file to
Great-West Life staff or persons authorized by Great-West Life who
require it to perform their duties, to persons to whom you have granted
access, and to persons authorized by law. Your personal information
may be subject to disclosure to those authorized under applicable law
within or outside Canada.
We use the personal information to administer the group benefits plan
under which you are covered. This includes many tasks, such as:
 determining your eligibility for coverage under the plan  investigating and assessing your claims and providing you with  verifying and auditing eligibility and claims  creating and maintaining records concerning our relationship  underwriting activities, such as determining the cost of the plan, and analyzing the design options of the plan  preparing regulatory reports, such as tax slips Your plan sponsor has an agreement with Great-West Life in which your plan sponsor has financial responsibility for some or all of the benefits in the plan and we process claims on your plan sponsor’s behalf. We may exchange personal information with your health care providers, your plan administrator, any insurance or reinsurance companies, administrators of government benefits or other benefit programs, other organizations, or service providers working with us or the above when relevant and necessary to administer the plan. As plan member, you are responsible for the claims submitted. We may exchange personal information with you and a person acting on your behalf when relevant and necessary to confirm coverage and to manage the claims submitted.
You may request access or correction of the personal information in your
file. A request for access or correction should be made in writing and
may be sent to any of Great-West Life’s offices or to our head office.
For a copy of our Privacy Guidelines, or if you have questions about our
personal information policies and practices (including with respect to
service providers), write to Great-West Life’s Chief Compliance Officer
or refer to www.greatwestlife.com.
Liability for Benefits

Your plan sponsor has entered into an administrative services
agreement with The Great-West Life Assurance Company to process
claims on your plan sponsor’s behalf. However, your plan sponsor has
full liability for the Healthcare (except Global Medical Assistance and
Out-of-Country Care) and Dentalcare benefits outlined in this booklet.
TABLE OF CONTENTS
Commencement and Termination of Coverage Optional Accidental Death, Dismemberment and Long Term Disability (LTD) Income Benefits Diagnostic and Treatment Support Services (Best
Benefit Summary
This summary must be read together with the benefits described in
this booklet.

Employee Basic Life Insurance
400% of annual earnings to a minimum of $50,000 and a maximum of $750,000, reducing by 50% or $50,000 at age 65, whichever is greater, and further reducing to $5,000 at age 71
Dependent Basic Life Insurance

Optional Life Insurance
Available in $10,000 units to a maximum of $500,000, for you or your spouse, subject to approval of evidence of insurability* If you are covered under this plan as both an employee and a spouse, you are limited to the $500,000 maximum *Evidence of insurability is not required for the first $50,000 of Optional Life Insurance if you apply for coverage within 31 days of becoming eligible to participate in the plan.
Optional Accidental Death,
Dismemberment and Specific Loss
(Principal Sum)
Available in $10,000 units to a maximum of $500,000
Long Term Disability Income Benefits
66.7% of the first $6,000 of your monthly earnings plus 50% of the remainder to a maximum benefit of $7,500 or 85% of your pre-disability take-home pay, whichever is less
Healthcare
Covered expenses will not exceed customary charges
An amount equal to the dispensing fee portion of the drug charge In-Canada Prescription Drug, In-Canada Hospital, Visioncare, Global Medical Assistance and Out-Of-Country Emergency Care Expenses Out-of-Pocket Maximum for Quebec Residents An out-of-pocket maximum is applied to in-province expenses for drugs listed in the Liste de médicaments published by the Régie de l'assurance-maladie du Québec if you live in Quebec (provincial formulary drug expenses). If the sum of the non-reimbursable amounts you are required to pay for provincial formulary drug expenses incurred for you and your dependent children or for your spouse in a calendar year reaches the maximum out-of-pocket level established by law, the amount payable for provincial formulary drug expenses incurred for the same individuals for the rest of the calendar year will be adjusted as follows: 1. reimbursement will be made at 100% 2. no further out-of-pocket amounts will apply The out-of-pocket maximum does not apply to drug expenses incurred outside Quebec $10,000 each calendar year to a lifetime maximum of $25,000 $500 lifetime or as otherwise required by law $5,000 lifetime or as otherwise required by law Wheelchairs (rental and/or purchase) $2,500 every 3 years Outdoor Wheelchair Ramps Eye Examinations - dependent children under age 19 Glasses, Contact Lenses and Laser Eye Surgery
Dentalcare
Covered expenses will not exceed customary charges
The dental fee guide in effect in your province of residence on the date treatment is rendered Major Coverage - dentures remakes and tissue conditioning COMMENCEMENT AND TERMINATION OF COVERAGE
You are eligible to participate in the plan after 3 months of continuous employment. You are considered continuously employed only if you satisfy the actively at work requirement throughout the eligibility waiting period.  You and your dependents will be covered as soon as you become You may waive health and/or dental coverage if you are already covered for these benefits under your spouse's plan. If you lose spousal coverage you must apply for coverage under this plan. If you do not apply within 31 days of loss of such coverage, or you were previously declined for coverage by Great-West Life, you and your dependents may be required to provide evidence of good health acceptable to Great-West Life to be covered for health benefits, and may be declined for or offered limited dental benefits.  You must be actively at work when coverage takes effect, otherwise the coverage will not be effective until you return to work. Increases in your benefits while you are covered by this plan will not become effective unless you are actively at work.  Only permanent employees working a minimum of 22 hours per Your coverage for the Healthcare (except Global Medical Assistance and Out-of-Country Care) and Dentalcare benefits terminates on the last day of the month in which your employment ends, you are no longer eligible, or the plan terminates, whichever is earliest. Your coverage for all other benefits terminates when your employment ends, when you are no longer eligible, or the plan terminates, whichever is earliest.  Your dependents' coverage terminates when your coverage terminates or your dependent no longer qualifies, whichever is earlier.  When your coverage terminates, you may be entitled to an extension of benefits under the plan. Your plan sponsor will provide you with details.
Survivor Benefits

If you die while your coverage is still in force, the health and dental
benefits for your dependents will be continued for a period of 2 years or
until they no longer qualify, whichever happens first.
DEPENDENT COVERAGE
 Your unmarried children under age 21, or under age 26 if they are Children under age 21 are not covered if they are working more than 30 hours a week, unless they are full-time students. Children who are incapable of supporting themselves because of physical or mental disorder are covered without age limit if the disorder begins before they turn 21, or while they are students under 26, and the disorder has been continuous since that time. BENEFICIARY DESIGNATION
You may make, alter, or revoke a designation of beneficiary as permitted by law. You should review any beneficiary designation made under this policy from time to time to ensure that it reflects your current intentions. You may change the designation by completing a form available from your employer. EMPLOYEE BASIC LIFE INSURANCE
On your death, Great-West Life will pay your life insurance benefits to your named beneficiary. If you have not named a beneficiary or there is no surviving beneficiary at the time of your death, payment will be made to your estate. Your employer will explain the claim requirements to your beneficiary.  Your life insurance terminates when you retire.  You are entitled to waiver of premium benefits after you have been continuously disabled for 119 days. You will be considered disabled during the period you are entitled to receive Long Term Disability benefits.  If any or all of your insurance terminates on or before your 65th birthday, you may be eligible to apply for an individual conversion policy without providing proof of your insurability. You must apply and pay the first premium no later than 31 days after your group insurance terminates. See your plan sponsor for details. DEPENDENT BASIC LIFE INSURANCE
If one of your dependents dies, Great-West Life will pay you the dependent life insurance benefit. Your plan sponsor will explain the claim requirements.  Your dependent life insurance terminates when you retire or when you no longer have eligible dependents, whichever comes first.  If you are disabled and the premiums for your employee life insurance are waived, your dependent life insurance will also continue without premium payment until your own coverage terminates or your dependents no longer qualify.  If your spouse's insurance terminates on or before his or her 65th birthday, he or she may be eligible for an individual conversion policy without providing proof of insurability. You or your spouse must apply and pay the first premium no later than 31 days after the group insurance terminates. See your plan sponsor for details. OPTIONAL LIFE INSURANCE

Optional Life Insurance allows you to choose additional coverage for
yourself and your spouse. Check the Benefit Summary for the amount
of Optional Life Insurance available. When you apply for Optional Life
Insurance, you must provide proof of your insurability, and your
application must be approved by Great-West Life. If you apply for
coverage within 31 days of becoming eligible to participate in the plan,
the first $50,000 of Optional Life Insurance is not subject to evidence of
insurability. If you or your spouse die within two years after applying for
Optional Life Insurance, Great-West Life has the right to verify any
medical information you or your spouse provided. If any inconsistencies
are discovered, the claim will be denied and any premiums paid will be
refunded.
On your death, Great-West Life will pay your life insurance to your
named beneficiary. If you have not named a beneficiary or there is no
surviving beneficiary at the time of your death, payment will be made to
your estate. Your employer will explain the claim requirements. If your
spouse dies you will be paid the amount for which he or she was
insured.
 If you are approved for waiver of premium on your basic life insurance, any optional life insurance for yourself or your spouse will also continue without premium payment as long as your basic life insurance continues but not beyond the date your optional insurance would otherwise terminate.  If your or your spouse's optional life insurance terminates, you or your spouse may be eligible to apply for an individual conversion policy without providing proof of insurability. You must apply and pay the first premium no later than 31 days after your group insurance terminates. See your plan sponsor for details.  Your optional life insurance terminates when you reach age 65 or when you retire, whichever is earlier. Your spouse's coverage terminates when your insurance terminates, or when he or she reaches age 65 or is no longer your spouse, whichever comes first.
Limitation
No benefit is paid for suicide within the first two years of initial or
increased optional life coverage. In such a situation, Great-West Life
refunds the premiums that have been received.
OPTIONAL ACCIDENTAL DEATH, DISMEMBERMENT
AND SPECIFIC LOSS (AD&D) INSURANCE

If you or one of your dependents suffer one of the losses listed below as
the result of an accident which occurs while insured, Great-West Life will
pay the factor or portion of the Principal Sum shown opposite the loss in
the table below. Check the Benefit Summary for the amount of Optional
AD&D available. The loss must occur no later than 365 days after the
accident. For loss of use, the loss must be continuous for 365 days. If
you suffer multiple losses to the same limb as the result of the same
accident, only the loss providing the highest amount payable will be
paid.
If you die as a result of an accident, Great-West Life will pay the
Principal Sum to your named beneficiary. If you have not named a
beneficiary or there is not surviving beneficiary at the time of your death,
payment will be made to your estate. Your employer will explain the
claim requirements to your beneficiary.
If one of your dependents die as a result of an accident, you will be paid
the Principal Sum.
The Principal Sum is the maximum amount that will be paid for all
injuries resulting from the same accident. For paraplegia, hemiplegia,
and quadriplegia, the maximum amount that will be paid for all injuries
resulting from the same accident is two times the Principal Sum.
Amount Payable
One hand or one foot or sight of one eye Thumb and index finger or at least 4 fingers of one hand
Loss of Use
Both arms and both legs
(quadriplegia)
One arm and one leg on the same side of the body (hemiplegia) One arm and one leg on different sides of the body Your Optional AD&D insurance terminates when you reach age 71 or when you retire, whichever is earlier.
Surgical Reattachment
If you suffer the loss of a limb that is surgically reattached, Great-West
Life will pay 50% of the amount that would have been payable if the loss
had been permanent, regardless of the amount of use regained. The
balance of the benefit will be payable if the reattachment fails and the
reattached part is removed within one year after the reattachment was
performed.
Repatriation
If you die as the result of an accident that is at least 150 kilometres away
from your home, Great-West Life will pay up to $2,500 for the
preparation and transportation of your body to the place of burial or
cremation less any amounts paid under this plan's global medical
assistance benefit.
Educational Benefit for Dependent Children
If benefits are payable under this benefit provision for your death, Great-
West Life will pay the tuition fees for enrolling your dependent children
as full-time students at a post-secondary institution. To qualify for an
educational benefit, a dependent child must have been enrolled as a full-
time student at a post-secondary institution at the time of the accident
causing your death, or he must have been enrolled as a full-time student
at the secondary school level at the time of the accident causing your
death and enrols as a full-time student at a post-secondary institution
within 365 days after the accident.
Great-West Life will pay up to 5% of the Principal Sum, or $5,000,
whichever is less, for each year of full-time post-secondary school
enrolment. Great-West Life will pay the educational benefit each year for
a maximum of 4 consecutive years upon receipt of proof of full-time
enrolment.

No benefits will be paid for tuition expenses incurred before the
accident, or room or board or other ordinary living, travelling, or clothing
expenses.
The Educational Benefit for Dependent Children is only payable on the
death of an employee; no benefits are payable on the death of a
dependent.
Family Transportation Benefit
If you are hospitalized more than 150 kilometres from your home as a
result of an injury for which benefits are payable under this benefit
provision, Great-West Life will pay the actual expense incurred less any
amount paid for the same expenses under this plan’s global medical
assistance benefit, up to $2,000, for transportation and lodging
expenses for one family member to join you.
Benefits for lodging are limited to moderate quality accommodation for
the area of hospitalization. Telephone expenses and taxicab and car
rental charges are included. Meal expenses are not covered.
Transportation expenses are limited to round trip economy class
transportation. If a private vehicle is used, expenses are limited to $.44
per kilometre travelled.
Occupational Training Benefit for Spouses
If benefits are payable under this benefit provision for your death, Great-
West Life will pay for expenses associated with your spouse’s enrolment
in an accredited occupational training program. The purpose of the
training program must be to provide the spouse with at least the
minimum qualifications required for employment in an occupation for
which the spouse would not otherwise qualify.
Great-West Life will pay up to 10% of the Principal Sum, or $10,000,
whichever is less.
No benefits will be paid for expenses incurred more than 3 years after
the accident causing your death, or room or board or other ordinary
living, travelling, or clothing expenses.

The Occupational Training Benefit for Spouses is only payable on the
death of an employee; no benefits are payable on the death of a
dependent.
Educational Benefit
If benefits are payable under this benefit provision for an injury that
requires you or your spouse to change occupations, Great-West Life will
pay the tuition fees for enrolling you or your spouse as a student at a
post-secondary institution for training in a new occupation. To qualify for
an educational benefit, you or your spouse must enrol at a post-
secondary institution within 365 days after the accident. Great-West Life
will pay up to $10,000.
No benefits will be paid for tuition expenses incurred before the
accident, expenses incurred more than 2 years after the accident
causing the injury, or room or board or other ordinary living, travelling, or
clothing expenses.
Wheelchair Benefit
If benefits are payable under this benefit provision for an injury that
requires the use of a wheelchair for you to be ambulatory, Great-West
Life will pay for alterations to your principal residence to make it
wheelchair accessible and habitable, and modifications to a motor
vehicle you use to make it accessible to and driveable by you.
Benefits for home alterations are payable only if the person or persons
making the changes are experienced in home alterations for
wheelchairs, and recommended by an organization recognized for
providing support and assistance to wheelchair users.
Benefits for vehicle modifications are payable only if the person or
persons making the changes are experienced in vehicle modification for
wheelchairs, and the modifications are approved by the provincial
vehicle licensing authority.

Great-West Life will pay the actual expense incurred less any amount
paid for the same expenses under this plan’s healthcare benefit, up to
$10,000 for all home and vehicle modifications combined.
No benefits will be paid for expenses incurred more than 365 days after
the accident, or for subsequent alterations to your home or vehicle after
an initial claim for benefits has been made under this wheelchair benefit
provision.
Limitations
No benefits are paid for injury or death resulting from:
 Intentionally self-inflicted injury or suicide  Viral or bacterial infections, except pyogenic infections occurring through the injury for which loss is being claimed  Any form of illness or physical or mental infirmity  Medical or surgical treatment, except surgical reattachment  War, insurrection or voluntary participation in a riot  Service in the armed forces of any country  Air travel serving as a crew member, or in aircraft owned, leased or rented by your plan sponsor, or air travel where the aircraft is not licensed or the pilot is not certified to operate the aircraft
How to Make a Claim
 To claim benefits, ask your plan sponsor for a claim form. Complete  If you die accidentally, your plan sponsor will explain the claim  Claims should be submitted as soon as possible, but no later than LONG TERM DISABILITY (LTD) INCOME BENEFITS

The plan provides you with regular income to replace income lost
because of a lengthy disability due to disease or injury. Benefits begin
after the waiting period is over and continue until you are no longer
disabled as defined by the policy or you reach age 65, whichever
comes first. Check the Benefit Summary for the benefit amount and
waiting period.
 If disability is not continuous, the days you are disabled can be accumulated to satisfy the waiting period as long as no interruption is longer than 2 weeks and the disabilities arise from the same disease or injury.  LTD benefits are payable for the first 24 months following the waiting period if disease or injury prevents you from performing the essential
duties of your regular occupation, and, except for any employment
under an approved rehabilitation plan, you are not employed in any
occupation that is providing you with income equal to or greater than
your amount of LTD insurance under this plan, as shown in the
Benefit Summary.
 After 24 months, LTD benefits will continue only if your disability prevents you from being gainfully employed in any job. Gainful employment is work you are medically able to perform, for which you have at least the minimum qualifications, and which provides you with an income of at least 50% of your indexed monthly earnings before you became disabled.  Loss of any license required for work will not be considered in  After the waiting period, separate periods of disability arising from the same disease or injury are considered to be one period of disability unless they are separated by at least 6 months.  Because you pay the entire cost of LTD coverage, benefits are not  Your LTD insurance terminates when you reach age 65 or when you
Other Income
Your LTD benefit is reduced by other income you are entitled to receive
while you are disabled. Your benefit is first reduced by:
 disability or retirement benefits you are entitled to on your own behalf under the Canada Pension Plan or Quebec Pension Plan  benefits under any Workers' Compensation Act or similar law  short term disability or sick leave benefits sponsored by the Canadian Conference of Mennonite Brethren Churches  loss of income benefits under an automobile insurance plan, to the  50% of earnings received from an approved rehabilitation plan There is a further reduction of your LTD benefit if the total of the income listed below exceeds 85% of your monthly take-home pay before you became disabled. If it does, your benefit is reduced by the excess amount.  loss of income benefits available through legislation, except for Employment Insurance benefits and automobile insurance benefits, which you or another member of your family is entitled to on the basis of your disability  the wage loss portion of any criminal injury award  disability benefits under a plan of insurance available through an  employment income, disability benefits, or retirement benefits related to any employment except for income from an approved rehabilitation plan, or short term disability or sick leave benefits (termination pay, severance benefits, and any similar termination of employment benefits, including any salary paid in lieu of notice, are included as employment income under this provision) sponsored by the Canadian Conference of Mennonite Brethren Churches
The balance of any earnings received from an approved rehabilitation
plan is not used to further reduce your LTD benefit unless that balance,
together with your income from this plan and the other income listed
above, would exceed your indexed monthly take-home pay before you
became disabled. If it does, your benefit is reduced by the excess
amount.
Cost-of-living increases in the other income listed above, that take effect
after the benefit period starts, except for income from an approved
rehabilitation plan, are not included.
Vocational Rehabilitation

Vocational rehabilitation involves a work related activity or training
strategy that is designed to help you return to your own job or other
gainful employment, and is recommended or approved by Great-West
Life. In considering whether to recommend or approve a rehabilitation
plan, Great-West Life will assess such factors as the expected duration
of disability, and the level of activity required to facilitate the earliest
possible return to work.

Limitations
No benefits are paid for:
 Disability arising from a disease or injury for which you received medical care before your insurance started. This limitation does not apply if your disability starts after you have been continuously insured for 1 year, or you have not had medical care for the disease or injury for a continuous period of 90 days ending on or after the date your insurance took effect.  Any period after you fail to participate or cooperate in a prescribed plan of medical treatment appropriate for your condition. Depending on the severity of the condition, you may be required to be under the care of a specialist. If substance abuse contributes to your disability, the treatment program must include participation in a recognized substance withdrawal program.  Any period after you fail to cooperate in applying for other disability benefits, reapplying for such benefits, or appealing decisions regarding such benefits, where considered appropriate by Great-West Life.  Any period after you fail to participate or cooperate in an approved  Any period after you fail to participate or cooperate in a recommended medical coordination program.  Any period after you fail to participate or cooperate in a required  The scheduled duration of a leave of absence. This does not apply to any portion of a period of maternity leave during which you are disabled due to pregnancy.  Any period in which you are outside Canada. This exclusion does not apply during the first 30 days of an absence, or if Great-West Life pre-authorized the absence prior to your departure.  Any period of incarceration, confinement, or imprisonment by  Disability arising from war, insurrection, or voluntary participation in
How to Make a Claim
Obtain an Employee Claim Submission Guide (form M4307B) from your
plan sponsor and follow the guide's instructions. Return the completed
form to your plan sponsor as soon as possible, but no later than 3
months after proof of your claim has been requested.
HEALTHCARE

A deductible may be applied before you are reimbursed. All expenses
will be reimbursed at the level shown in the Benefit Summary. Benefits
may be subject to plan maximums and frequency limits. Check the
Benefit Summary for this information.
The plan covers customary charges for the following services and
supplies. All covered services and supplies must represent reasonable
treatment. Treatment is considered reasonable if it is accepted by the
Canadian medical profession, it is proven to be effective, and it is of a
form, intensity, frequency and duration essential to diagnosis or
management of the disease or injury.
Except to the extent otherwise required by law, your healthcare
coverage terminates when you retire.
Covered Expenses
 Ambulance transportation to the nearest centre where adequate  Semi-private room and board in a hospital in Canada For out-of-province accommodation, any difference between the hospital's standard ward rate and the government authorized allowance in your home province is covered. The plan also covers the hospital facility fee related to dental surgery and any out-of-province hospital out-patient charges not covered by the government health plan in your home province.  Convalescent care for a condition that will significantly improve as a result of the care and follows a 3-day confinement for acute care  The government authorized co-payment for accommodation in a nursing home. Residences established primarily for senior citizens or which provide personal rather than medical care are not covered.  Home nursing services of a registered nurse, a registered practical nurse if you are a resident of Ontario or a licensed practical nurse if you are a resident of any other province, when services are provided in Canada. No benefits are paid for services provided by a member of your family or for services which do not require the specific skills of a registered or practical nurse You should apply for a pre-care assessment before home nursing begins  Drugs and drug supplies described below when prescribed by a person entitled by law to prescribe them, dispensed by a person entitled by law to dispense them, and provided in Canada. Benefits for drugs and drug supplies provided outside Canada are payable only as provided under the out-of-country care provision. Drugs which require a written prescription according to the Food and Drugs Act, Canada or provincial legislation in effect where the drug is dispensed, including contraceptive drugs and products containing a contraceptive drug Injectable drugs including vitamins, insulins and allergy extracts. Syringes for self-administered injections are also covered Disposable needles for use with non-disposable insulin injection devices, lancets and test strips Extemporaneous preparations or compounds if one of the ingredients is a covered drug Certain other drugs that do not require a prescription by law may be covered. If you have any questions, contact your plan administrator before incurring the expense. The plan will also pay for preventative immunization vaccines and toxoids. Unless medical evidence is provided to the plan administrator that indicates why a drug is not to be substituted, the covered expense may be limited to the cost of the lowest priced interchangeable drug. For drugs eligible under a provincial drug plan, coverage is limited to the deductible amount and coinsurance you are required to pay under that plan.  Rental or, at the plan’s discretion, purchase of certain medical supplies, appliances and prosthetic devices prescribed by a physician  Custom-made foot orthotics and custom-fitted orthopedic shoes, including modifications to orthopedic footwear, when prescribed by a physician  Hearing aids, including batteries, tubing and ear molds provided at the time of purchase, when prescribed by a physician  Diabetic supplies prescribed by a physician: Novolin-pens or similar insulin injection devices using a needle, blood-letting devices including platforms but not lancets. Lancets are covered under prescription drugs  Blood-glucose monitoring machines prescribed by a physician  Diagnostic x-rays and lab tests, when coverage is not available  Treatment of injury to sound natural teeth. Treatment must start within 60 days after the accident unless delayed by a medical condition A sound tooth is any tooth that did not require restorative treatment immediately before the accident. A natural tooth is any tooth that has not been artificially replaced dental treatment completed more than 12 months after the accident orthodontic diagnostic services or treatment  Out-of-hospital services of a qualified acupuncturist  Out-of-hospital treatment of muscle and bone disorders, including diagnostic x-rays, by a licensed chiropractor  Out-of-hospital treatment of nutritional disorders by a registered  Out-of-hospital services of a qualified massage therapist  Out-of-hospital services of a licensed naturopath  Out-of-hospital services of a licensed osteopath, including diagnostic  Out-of-hospital treatment of movement disorders by a licensed  Out-of-hospital treatment of foot disorders by a licensed podiatrist or a qualified chiropodist, including diagnostic x-rays by a licensed podiatrist  Out-of-hospital treatment by a registered psychologist or qualified  Out-of-hospital treatment of speech impairments by a qualified
Visioncare
 Eye examinations, including refractions, when they are performed by a licensed ophthalmologist or optometrist, and coverage is not available under your provincial government plan  Glasses and contact lenses required to correct vision when provided by a licensed ophthalmologist, optometrist or optician  Laser eye surgery required to correct vision when performed by a
For information on available discounts on eyewear and vision care
services, refer to the Preferred Vision Services section of this booklet
following the Healthcare benefit.
Global Medical Assistance Program
This program provides medical assistance through a worldwide
communications network which operates 24 hours a day. The network
locates medical services and obtains Great-West Life's approval of
covered services, when required as a result of a medical emergency
arising while you or your dependent is travelling for vacation, business or
education. Coverage for travel within Canada is limited to emergencies
arising more than 500 kilometres from home. You must be covered by
the government health plan in your home province to be eligible for
global medical assistance benefits. The following services are covered,
subject to Great-West Life's prior approval:
 On-site hospital payment when required for admission, to a  If suitable local care is not available, medical evacuation to the nearest suitable hospital while travelling in Canada. If travel is outside Canada, transportation will be provided to a hospital in Canada or to the nearest hospital outside Canada equipped to provide treatment When services are covered under this provision, they are not covered under other provisions described in this booklet  Transportation and lodging for one family member joining a patient hospitalized for more than 7 days while travelling alone. Benefits will be paid for moderate quality lodgings up to $1,500 and for a round trip economy class ticket  If you or a dependent is hospitalized while travelling with a companion, extra costs for moderate quality lodgings for the companion when the return trip is delayed due to your or your dependent’s medical condition, to a maximum of $1,500  The cost of comparable return transportation home for you or a dependent and one travelling companion if prearranged, prepaid return transportation is missed because you or your dependent is hospitalized. Coverage is provided only when the return fare is not refundable. A rental vehicle is not considered prearranged, prepaid return transportation  In case of death, preparation and transportation of the deceased  Return transportation home for minor children travelling with you or a dependent who are left unaccompanied because of your or your dependent’s hospitalization or death. Return or round trip transportation for an escort for the children is also covered when considered necessary  Costs of returning your or your dependent's vehicle home or to the nearest rental agency when illness or injury prevents you or your dependent from driving, to a maximum of $1,000. Benefits will not be paid for vehicle return if transportation reimbursement benefits are paid for the cost of comparable return transportation home Benefits payable for moderate quality accommodation include telephone expenses as well as taxicab and car rental charges. Meal expenses are not covered.
Out-Of-Country Care
 Emergency care outside Canada is covered if it is required as a
result of a medical emergency arising while you or your dependent is temporarily outside Canada for vacation, business or education purposes. To qualify for benefits, you must be covered by the government health plan in your home province. A medical emergency is either a sudden, unexpected injury, or a sudden, unexpected illness or acute episode of disease that could not have been reasonably anticipated based on the patient’s prior medical condition. Emergency care is covered medical treatment that is provided as a result of and immediately following a medical emergency. If the patient’s condition permits a return to Canada, benefits are limited to the lesser of: the amount payable under this plan for continued treatment outside Canada, and the amount payable under this plan for comparable treatment in Canada plus the cost of return transportation. any further medical care related to a medical emergency after the initial acute phase of treatment. This includes non-emergency continued management of the condition originally treated as an emergency any subsequent and related episodes during the same absence from Canada expenses related to pregnancy and delivery, including infant care: at any time during the pregnancy if the patient's medical history indicates a higher than normal risk of an early delivery or complications.  Non-emergency care outside Canada is covered for you and your
it is required as a result of a referral from your usual Canadian physician it is not available in any Canadian province and must be obtained elsewhere for reasons other than waiting lists or scheduling difficulties you are covered by the government health plan in your home province for a portion of the cost, and a pre-authorization of benefits is approved by Great-West Life before you leave Canada for treatment. investigational or experimental treatment transportation or accommodation charges. The plan covers the following services and supplies when related to out-of-country care:  diagnostic x-ray and laboratory services  hospital accommodation in a standard or semi-private ward or intensive care unit, if the confinement begins while you or your dependent is covered  medical supplies provided during a covered hospital confinement  paramedical services provided during a covered hospital  hospital out-patient services and supplies  medical supplies provided out-of-hospital if they would have been ambulance services by a licensed ambulance company to the nearest centre where essential treatment is available dental accident treatment if it would have been covered in Canada.
Other Services and Supplies
Services or supplies that represent reasonable treatment but are not otherwise covered under this plan may be covered by the plan on such
terms as the plan administrator determines.
Limitations
A claim for a service or supply that was purchased from a provider that
is not approved by the plan administrator may be declined.
The covered expense for a service or supply may be limited to that of a
lower cost alternative service or supply that represents reasonable
treatment.
Except to the extent otherwise required by law, no benefits are paid for:  Expenses private benefit plans are not permitted to cover by law  Services or supplies for which a charge is made only because you  The portion of the expense for services or supplies that is payable by the government health plan in your home province, whether or not you are actually covered under the government health plan  Any portion of services or supplies which you are entitled to receive, or for which you are entitled to a benefit or reimbursement, by law or under a plan that is legislated, funded, or administered in whole or in part by a government (“government plan”), without regard to whether coverage would have otherwise been available under this plan In this limitation, government plan does not include a group plan for government employees  Services or supplies that do not represent reasonable treatment  Services or supplies associated with: treatment performed only for cosmetic purposes recreation or sports rather than with other daily living activities the diagnosis or treatment of infertility, other than drugs contraception, other than contraceptive drugs and products containing a contraceptive drug  Services or supplies not listed as covered expenses unless determined by the plan administrator to be covered expenses  Extra medical supplies that are spares or alternates  Services or supplies received outside Canada except as listed under Out-of-Country Care and Global Medical Assistance  Services or supplies received out-of-province in Canada unless you are covered by the government health plan in your home province and benefits would have been paid under this plan for the same services or supplies if they had been received in your home province This limitation does not apply to Global Medical Assistance  Expenses arising from war, insurrection, or voluntary participation in  Podiatric treatments for which a portion of the cost is payable under the Ontario Health Insurance Plan (OHIP). Benefits for these services are payable only after the maximum annual OHIP benefit has been paid  Visioncare services and supplies required by your plan sponsor or any employer as a condition of employment In addition under the prescription drug coverage, no benefits are paid for:  Atomizers, appliances, prosthetic devices, colostomy supplies, first aid supplies, diagnostic supplies or testing equipment  Non-disposable insulin delivery devices or spring loaded devices  Delivery or extension devices for inhaled medications  Oral vitamins, minerals, dietary supplements, homeopathic preparations, infant formulas or injectable total parenteral nutrition solutions  Diaphragms, condoms, contraceptive jellies, foams, sponges, suppositories, contraceptive implants or appliances  Any drug that does not have a drug identification number as defined  Any single purchase of drugs which would not reasonably be used  Drugs administered during treatment in an emergency room of a hospital, or as an in-patient in a hospital  Drugs that are considered cosmetic, such as topical minoxidil or sunscreens, whether or not prescribed for a medical reason  Drugs used to treat erectile dysfunction
Note: If you are age 65 or older and reside in Quebec, you cease to be
covered under this plan for basic prescription drug coverage and are
covered under the basic plan provided by the Régie de l’assurance-
maladie du Québec, unless you elect to be covered under this plan as
set out below.
A one-time election may be made to be covered under this plan. You
must make this election and communicate it to your plan sponsor by the
end of the 60-day period immediately following:
 the date you reach age 65; or
 the date you become a resident of Quebec, within the meaning of the Health Insurance Act, Quebec, if you are age 65 or over. While your election to be covered under this plan is in effect, you will be deemed not to be entitled to the basic plan provided by the Régie de l’assurance-maladie du Québec. “Basic prescription drug coverage” means the portion of drug expenses that is reimbursed by the Régie de l’assurance-maladie du Québec.
Prior Authorization
In order to determine whether coverage is provided for certain services
or supplies, the plan administrator maintains a limited list of services and
supplies that require prior authorization.
Prior authorization is intended to help ensure that a service or supply
represents reasonable treatment.
If the use of a lower cost alternative service or supply represents
reasonable treatment, a person may be required to provide medical
evidence to the plan administrator why the lower cost alternative service
or supply cannot be used before coverage may be provided for the
service or supply.
Health Case Management
Health case management is a program recommended or approved by
the plan administrator that may include but is not limited to:
 consultation with the person and his attending physician to gain understanding of the treatment plan recommended by the attending physician;  comparison with the person’s attending physician of the recommended treatment plan with alternatives, if any, that represent reasonable treatment;  identification to the person’s attending physician of opportunities for  monitoring the person’s adherence to the treatment plan recommended by the person’s attending physician. In determining whether to implement health case management, the plan administrator may assess such factors as the service or supply, the person’s medical condition, and the existence of generally accepted medical guidelines for objectively measuring medical effectiveness of the treatment plan recommended by the attending physician.
Health Case Management Limitation
The payment of benefits for a service or supply may be limited, on such
terms as the plan administrator determines, where:
 the plan administrator has implemented health case management
and the person does not participate or cooperate; or  the person has not adhered to the treatment plan recommended by his attending physician with respect to the use of the service or supply.
Designated Provider Limitation
For a service or supply to which prior authorization applies or where the
plan administrator has recommended or approved health case
management, the plan administrator can require that a service or supply
be purchased from or administered by a provider designated by the plan
administrator, and:
 the covered expense for a service or supply that was not purchased from or administered by a provider designated by the plan administrator may be limited to the cost of the service or supply had it been purchased from or administered by the provider designated by the plan administrator; or  a claim for a service or supply that was not purchased from or administered by a provider designated by the plan administrator may be declined.
Patient Assistance Program
A patient assistance program means a program that provides assistance
to persons with respect to the purchase of services or supplies.
A person may be required to apply to and participate in any patient
assistance program to which the person may be entitled. Further, the
covered expense for a service or supply may be reduced by an amount
up to the amount of financial assistance the person is entitled to receive
for that service or supply under a patient assistance program.

How to Make a Claim
 Out-of-country claims (other than those for Global Medical Assistance expenses) should be submitted to Great-West Life as soon as possible after the expense is incurred. It is very important that you send your claims to the Great-West Life Out-of-Country Claims Department immediately as your Provincial Medical Plan has very strict time limitations. Access GroupNet for Plan Members to obtain a personalized claim form or obtain form M5432 (Statement of Claim Out-of-Country Expenses form) from your plan sponsor. Unless you are a resident of the Territories you must also obtain the Government Assignment form, and residents of British Columbia, Quebec and Newfoundland & Labrador must also obtain the Special Government Claim form. The Great-West Life Out-of-Country Claims Department will forward the appropriate government forms to your attention when required. If you are a resident of the Territories, you must submit your out-of-country claims to your territorial government for processing before submitting the claim to Great-West Life. When you receive your Explanation of Benefits back from the territory, please send the following to the Great-West Life Out-of-Country Claims Department (be sure to keep copies for your own records): - a copy of the payment from your territory a completed Statement of Claim Out-of-Country Expenses form (form M5432) Residents of the provinces should complete all applicable forms, making sure all required information is included. Attach all original receipts and forward the claim to the Great-West Life Out-of-Country Claims Department. Be sure to keep a copy for your own records. The plan will pay all eligible claims including your Provincial Medical Plan portion. Your Provincial Medical Plan will then reimburse the plan for the government’s share of the expenses. Out-of-country claims must be submitted within a certain time period that varies by province. For the claims submission period applicable in your province or territory or for any other questions or for assistance in completing any of the forms, please contact Great-West Life’s Out-of-Country Claims Department at 1-800-957-9777.  Claims for expenses incurred in Canada, for paramedical services and visioncare, may be submitted online. To use this online service you will need to be registered for GroupNet for Plan Members and signed up for direct deposit of claim payments with eDetails. For online claim submissions, your Explanation of Benefits will only be available online. Claims must be submitted to Great-West Life as soon as possible, but no later than 15 months after you incur the expense. You must retain your receipt for 12 months from the date you submit your claim to Great-West Life as a record of the transaction, and you must submit it to Great-West Life on request.  For all other Healthcare claims, access GroupNet for Plan Members to obtain a personalized claim form or obtain form M635D from your plan sponsor. Complete this form making sure it shows all required information. Attach your receipts to the claim form and return it to the Great-West Life Benefit Payment Office as soon as possible, but no later than 15 months after you incur the expense.  For drug claims, your plan sponsor will provide you with a
prescription drug identification card. Present your card to the pharmacist with your prescription. Before your prescription is filled, an Assure Claims check will be done. Assure Claims is a series of seven checks that are electronically done on your drug claim history for increased safety and compliance monitoring. This has been designed to improve the health and quality of life for you and your dependents. Checks done include drug interaction, therapeutic duplication and duration of therapy, allowing the pharmacist to react prior to the drug being dispensed. Depending on the outcome of the checks, the pharmacist may refuse to dispense the prescribed drug. When your coverage ends, return your direct pay drug identification card to your plan sponsor. PREFERRED VISION SERVICES (PVS)

Preferred Vision Services (PVS) is a service provided by Great-
West Life to its customers through PVS which is a preferred
provider network company.

PVS entitles you to a discount on a wide selection of quality eyewear
and lens extras (scratch guarding, tints, etc.) when you purchase these
items from a PVS network optician or optometrist. A discount on laser
eye surgery can be obtained through an organization that is part of the
PVS network.
PVS also entitles you to a discount on hearing aids (batteries, tubing,
ear molds, etc.) when you purchase these items from a PVS network
provider.
You are eligible to receive the PVS discount through the network
whether or not you are enrolled for the healthcare coverage described in
this booklet. You can use the PVS network as often as you wish for
yourself and your dependents.
Using PVS:
 Call
PVS Information Hotline at 1-800-668-6444 or visit the
PVS Web site at www.pvs.ca for information about PVS locations
and the program
 Arrange for a fitting, an eye examination, a hearing assessment or a  Present your group benefit plan identification card, to identify your preferred status as a PVS member through Great-West Life, at the time the eyewear or the hearing aid is purchased, or at the initial consultation for laser eye surgery  Pay the reduced PVS price. If you have vision care coverage or hearing aids coverage for the product or service, obtain a receipt and submit it with a claim form to your insurance carrier in the usual manner. DENTALCARE

All expenses will be reimbursed at the level shown in the Benefit
Summary. Benefits may be subject to plan maximums and frequency
limits. Check the Benefit Summary for this information.
The plan covers customary charges to the extent they do not exceed the
dental fee guide level shown in the Benefit Summary. Denturist fee
guides are applicable when services are provided by a denturist. Dental
hygienist fee guides are applicable when services are provided by a
dental hygienist practising independently.
All covered services and supplies must represent reasonable treatment.
Treatment is considered reasonable if it is recognized by the Canadian
Dental Association, it is proven to be effective, and it is of a form,
frequency, and duration essential to the management of the person's
dental health. To be considered reasonable, treatment must also be
performed by a dentist or under a dentist’s supervision, performed by a
dental hygienist entitled by law to practise independently, or performed
by a denturist.
Your dentalcare coverage terminates when you retire.
Treatment Plan
 Before incurring any dental expenses expected to cost at least $200, or beginning any orthodontic treatment, ask your dental service provider to complete a treatment plan and submit it to the plan. The benefits payable for the proposed treatment will be calculated, so you will know in advance the approximate portion of the cost you will have to pay.
Basic Coverage
The following expenses will be covered:
one complete oral examination every 36 months limited oral examinations once every 6 months, except that only one limited oral examination is covered in any 12-month period that a complete oral examination is also performed limited periodontal examinations once every 6 months complete series of x-rays every 36 months intra-oral x-rays to a maximum of 15 films every 36 months and a panoramic x-ray every 36 months. Services provided in the same 12 months as a complete series are not covered polishing and topical application of fluoride each once every 6 months scaling, limited to a maximum combined with periodontal root planing of 16 time units every 12 months A time unit is considered to be a 15-minute interval or any portion of a 15-minute interval pit and fissure sealants on bicuspids and permanent molars every 60 months space maintainers including appliances for the control of harmful habits  Minor restorative services including: amalgam and tooth-coloured fillings. Replacement fillings are covered only if the existing filling is at least 2 years old or the existing filling was not covered under this plan retentive pins and prefabricated posts for fillings  Endodontics. Root canal therapy for permanent teeth will be limited to one course of treatment per tooth. Repeat treatment is covered only if the original treatment fails after the first 18 months root planing, limited to a maximum combined with preventive scaling of 16 time units every 12 months occlusal adjustment and equilibration, limited to a combined maximum of 4 time units every 12 months A time unit is considered to be a 15-minute interval or any portion of a 15-minute interval  Denture maintenance, after the 3-month post-insertion care period, denture relines for dentures at least 6 months old, once every 36 months denture rebases for dentures at least 2 years old, once every 36 months resilient liner in relined or rebased dentures, once every 36 months denture repairs and additions and resetting of denture teeth denture adjustments, once every 12 months
Major Coverage
 Crowns. Coverage for crowns on molars is limited to the cost of metal crowns. Coverage for complicated crowns is limited to the cost of standard crowns  Onlays. Coverage for tooth-coloured onlays on molars is limited to Replacement crowns and onlays are covered when the existing restoration is at least 5 years old and cannot be made serviceable  Standard complete dentures, standard cast or acrylic partial dentures or complete overdentures or bridgework when required to replace one or more teeth extracted while the person is covered. Overdentures and bridgework are covered only when standard complete or partial dentures are not viable treatment options. Coverage for tooth-coloured retainers and pontics on molars is limited to the cost of metal retainers and pontics. Replacement appliances are covered only when: the existing appliance is a covered temporary appliance the existing appliance is at least 5 years old and cannot be made serviceable. If the existing appliance is less than 5 years old, a replacement will still be covered if the existing appliance becomes unserviceable while the person is covered and as a result of the placement of an initial opposing appliance or the extraction of additional teeth. If additional teeth are extracted but the existing appliance can be made serviceable, coverage is limited to the replacement of the additional teeth  Denture-related surgical services for remodelling and recontouring  Denture and bridgework maintenance following the 3-month post-
Orthodontic Coverage
 Orthodontics are covered for persons age 6 or over when treatment
Limitations
No benefits are paid for:
 Duplicate x-rays, custom fluoride appliances, any oral hygiene
 The following endodontic services - root canal therapy for primary teeth, isolation of teeth, enlargement of pulp chambers and endosseous intra coronal implants  The following periodontal services - desensitization, topical application of antimicrobial agents, subgingival periodontal irrigation, charges for post surgical treatment and periodontal re-evaluations  The following oral surgery services - implantology, surgical movement of teeth, services performed to remodel or recontour oral tissues (other than minor alveoloplasty, gingivoplasty and stomatoplasty) and alveoloplasty or gingivoplasty performed in conjunction with extractions. Services for remodelling and recontouring oral tissues will be covered under Major Coverage  Veneers, recontouring existing crowns, and staining porcelain  Crowns or onlays if the tooth could have been restored using other procedures. If crowns, onlays or inlays are provided, benefits will be based on coverage for fillings  Overdentures or initial bridgework if provided when standard complete or partial dentures would have been a viable treatment option. If overdentures are provided, coverage will be limited to standard complete dentures. If initial bridgework is provided, coverage will be limited to a standard cast partial denture and restoration of abutment teeth when required for purposes other than bridgework If additional bridgework is performed in the same arch within 60 months, coverage will be limited to the addition of teeth to a denture and restoration of abutment teeth when required for purposes other than bridgework Benefits will be limited to standard dentures or bridgework when equilibrated and gnathological dentures, dentures with stress breaker, precision and semi-precision attachments, dentures with swing lock connectors, partial overdentures and dentures and bridgework related to implants are provided  Expenses covered under another group plan's extension of benefits  Accidental dental injury expenses for treatment performed more than 12 months after the accident, denture repair or replacement, or any orthodontic services  Expenses private benefit plans are not permitted to cover by law  Services and supplies you are entitled to without charge by law or for which a charge is made only because you have coverage  Services or supplies that do not represent reasonable treatment  Treatment performed for cosmetic purposes only  Congenital defects or developmental malformations in people 19 years of age or over, except orthodontics  Temporomandibular joint disorders, vertical dimension correction or  Expenses arising from war, insurrection, or voluntary participation in
How to Make a Claim
 Claims for expenses incurred in Canada may be submitted online.
Access GroupNet for Plan Members to obtain a personalized claim form or obtain form M445D from your plan sponsor and have your dental service provider complete the form. The completed claim form will contain the information necessary to enter the claim online. To use the online service you will need to be registered for GroupNet for Plan Members and signed up for direct deposit of claim payments with eDetails. For online claim submissions, your Explanation of Benefits will only be available online. Claims must be submitted to Great-West Life as soon as possible, but no later than 15 months after the dental treatment. You must retain your receipt for 12 months from the date you submit your claim to Great-West Life as a record of the transaction, and you must submit it to Great-West Life on request.  For all other Dentalcare claims, access GroupNet for Plan Members to obtain a personalized claim form or obtain form M445D from your plan sponsor. Have your dental service provider complete the form and return it to the Great-West Life Benefit Payment Office as soon as possible, but no later than 15 months after the dental treatment. COORDINATION OF BENEFITS
 Benefits for you or a dependent will be directly reduced by any amount payable under a government plan. If you or a dependent are entitled to benefits for the same expenses under another group plan or as both an employee and dependent under this plan or as a dependent of both parents under this plan, benefits will be co-ordinated so that the total benefits from all plans will not exceed expenses.  You and your spouse should first submit your own claims through your own group plan. Claims for dependent children should be submitted to the plan of the parent who has the earlier birth date in the calendar year (the year of birth is not considered). If you are separated or divorced, the plan which will pay benefits for your children will be determined in the following order: 1. the plan of the parent with custody of the child; 2. the plan of the spouse of the parent with custody of the child; 3. the plan of the parent without custody of the child; 4. the plan of the spouse of the parent without custody of the child You may submit a claim to the plan of the other spouse for any amount which is not paid by the first plan. DIAGNOSTIC AND TREATMENT SUPPORT SERVICES
(BEST DOCTORS® SERVICE)

This service is designed to allow you, your dependents and your
attending physician or specialists access to the expertise of world-class
specialists, resources, information and clinical guidance.
If you or your dependents are diagnosed with a serious medical
condition for which there is objective evidence, or if your physician or
you or your dependent suspect you have this condition, you can access
this service. This service is made up of a unique step-by-step process
that may help address questions or concerns about a medical condition.
This may include confirming the diagnosis and suggesting the most
effective treatment plan by drawing on a global database of up to 50,000
peer-ranked specialists.
How it works

 You or your dependent can access diagnostic and treatment support
services by calling 1-877-419-BEST (2378) toll-free.  You will be connected with a member advocate who will be dedicated to your case and will provide support through the process. The member advocate will take the necessary medical history and answer your questions. Any information provided is not shared with either your plan sponsor or the administrator of your health plan.  Based on the information and questions, the member advocate determines the optimal level of service for you or your dependent.  The member advocate may provide information, resources, guidance and advice individually tailored to meet your health needs. They can also help identify individual community supports and resources available.  If it is appropriate, the member advocate may arrange for an in- depth review of your medical file to assist in confirming the diagnosis and help develop a treatment plan. This review may include collecting, deconstructing and reconstructing medical records, pathology retesting and analyzing test results. A written report outlining the conclusions and recommendations of the specialists will be forwarded to you and your physician. On average, this process takes 6 to 8 weeks. Timeframes may vary depending on the complexity of the case and amount of medical records to collect.  If you decide to seek treatment by a different physician, the member advocate can help identify the specialist best qualified to meet your specific medical needs. Expenses incurred for travel and treatment are not covered by this service.  If you decide to seek treatment outside Canada, the member advocate can arrange referrals and can help book accommodations. The member advocate can also access hospital and physician discounts, arrange for forwarding of medical information and monitor the treatment process. Expenses incurred for travel and treatment are not covered by this service.
Note: These services are not insured services. Great-West Life is not
responsible for the provision of the services, their results, or any
treatment received or requested in connection with the services.

Source: http://www.mennonitebrethren.ca/wp-content/uploads/2013/10/Booklet-Employees.pdf