W.A.N.T.E. Members ~ Winnipeg School Division

For those members on our Extended Health or Dental Plan Blue Cross is our carrier.  Once you are enrolled in the plan a benefits card will be mailed out to you by Blue Cross.  The only time you can opt out of the plan is within 90 days of a life event.  If you have any questions please contact Benefits at Winnipeg School Division 204-775-0231 or contact the W.A.N.T.E. office.

What are Life Events?

  • You must notify your employer within 90 days of change in your own or your dependents’ status resulting from marriage, divorce, separation, termination of conjugal relationship, death, change of residence, birth or legal adoption.
  • The majority of status changes may be reported using the “Notice of Change” form available from your employer.
  • If you have opted out of the plan due to alternate group coverage that subsequently terminates, you must advise your employer within 90 days of losing coverage if you wish to be covered under this plan. This does include when the loss of coverage is due to a retirement.

Note: Once enrolled in this group plan, you will not be permitted to opt out while still employed by your employer except in the event of alternate group coverage. If this situation arises, your request to cancel must be received by Manitoba Blue Cross within 90 days of the effective date of the new plan.

NEW Blue Cross Website

mybluecross®  is the new self-service website available to Manitoba Blue Cross plan members.  If you already have an existing Customer E-Service or Bluelink account you can sign on using the same email and password.  If you don’t have an account, register for a new mybluecross account to access plan coverage information, submit claims online, set up direct deposit of claims or receive information about improving your health and BlueAdvantage (discount provider program).  Visit the new website at www.mb.bluecross.ca to take a tour and to learn more about my bluecross® .

Benefit Booklets

The  booklets are posted on this site and hard copies are available by request only.

Extended Health Downloads –

 

Extended Health premiums effective September 1, 2017 are:

  • Active – (rates reflect premium payment of 10 months)
    • Single – $53.40
    • Family – $114.60
  • Actives (age 65+) – rates reflect premium payment of 10 month)
    • Single – $50.34
    • Family – $108.48
  • Retiree –  (rates reflect premium payment over 12 months)
    • Single – $57.65
    • Family – $115.30

Benefit Summary

  • Premiums for Active Members are deducted over 10 months (12 months of premiums spread over 10 months)
  • Premiums for Retired Members are deducted over 12 month basis.
  • Benefits are mandatory participation for new members who have 25 hours or more per week.
  • Benefits are optional participation for members who are less than 25 hours per week.
  • $50 annual deductible – single or family
  • 100% reimbursement for ambulance expenses
  • 80% reimbursement for all other expenses
  • *Definition of Dependent includes coverage for same sex spouse

Ambulance:

  • Reimbursement of reasonable and customary charges within Manitoba
  • Reimbursement of up to $250 per trip outside of Manitoba
  • Non-emergency medical transfer service: $250 lifetime maximum

Prescription Drugs:

  • Reimbursement of eligible drugs listed on the Manitoba Provincial formulary to a maximum of $1500 per person per calendar year for Active members.
  • Reimbursement of eligible drugs listed on the Manitoba Provincial formulary to a maximum of $1000 per person per calendar year for Retiree members.
  • Active & Retiree members have a Blue Net card

Eye Exams**INCREASED Sept. 1, 2015** $100 every two years Professional Services:$350 maximum per calendar year / per insured / per practitioner for:

  • New for September 1, 2016 – add Acupuncture services and vaccines for Hepatitis A/B and shingles.
  • Chiropodist, Psychologist, Physiotherapist, Dietician, Chiropractor, Massage therapist, Naturopath, Occupational health therapist, Osteopath, Speech therapist and Audiologist
  • A doctor’s referral, or prescription, is not required for paramedical services.
  • $100 maximum per calendar year / per insured / per practitioner for:
    • Athletic Therapist
    • Psychologist/Social Worker

Medical Services and Supplies:

  • Private Duty Nursing – $3,000 per calendar year
  • Cardiac Rehabilitation treatment – $300 per lifetime per insured
  • Breast Prosthesis and Surgical Bras – $100 per single prostheses or bra per calendar year
  • Artificial limbs and eyes, surgical stockings, braces (other than foot brace), trusses, collars, casts and splints
  • Orthopedic Shoes – 1 pair per calendar year when part of a brace, if not part of a brace 50% of the cost of 1 pair per calendar year
  • Orthotics $400 per calendar year
  • Charges for the treatment of accidental injuries to natural teeth or jaw, provided the treatment is rendered with 90 days of the accident, excluding injuries due to biting or chewing
  • Wigs or hairpieces due to illness or accidental injury to a lifetime maximum of $1000
  • Eye Exam once every 2 years

Medical Equipment:

  • Iron lung, Wheelchair, Hospital Bed, Respirator and Oxygen Equipment – $1000 lifetime maximum
  • other rental equipment – $250 lifetime maximum

The following benefits are applicable to employees under age 65:

  • Out-of-Province/Out-of-Canada Travel
    • Emergency medical treatment of a sickness or injury which occurs while temporarily outside the province of residence, provided that treatment is also covered by Provincial Plan during the absence from province of residence.
    • Physician’s services, hospital room and board, cost of special hospital services, hospital charges for out-patient services
    • unlimited maximum
    • referral outside of Canada for treatment which is available in Canada – 50% reimbursement, to a maximum of $3000 every 3 calendar years

Emergency Travel Assistance (Out-of-Province/Country)Assistance is provided for both Medical and Non-Medical travel emergencies.

  • Medical Emergency Assistance:
    • Interruption/Delay
    • After Hospital Convalescence
    • Visit of Family Member
    • Vehicle Return
    • Identification of Deceased
  • Non-Medical Assistance:
    • Return of Deceased to Province of Residence
    • Lost Document and Ticket Replacement
    • Legal Referral
    • Interpretation Service
    • Message Service
    • Pre-trip Assistance Service

The following benefit is applicable to employees age 65 and over:

  • Out-of-Province/Out-of-Canada Travel
    • Emergency medical treatment of a sickness or injury which occurs while temporarily outside the province of residence, provided that treatment is also covered by Provincial Plan during the absence from province of residence.
    • Physician’s services, hospital room and board, cost of special hospital services, hospital charges for out-patient services
    • $2500 maximum per per, per calendar year

This information is only a brief summary of the provisions of  Group# 7133. In the event of a discrepancy between this and the Contract, the terms of the Contract will apply. Detailed Employee Benefit booklets may be obtained by contacting the Benefits Department at the Winnipeg School Division.