The group insurance plan
So far, more than 24,000 participants have subscribed to the group plans and enjoy enviable coverage, benefits and guarantees.
The protection offered by the group plan for retired management personnel of the Québec public and parapublic sectors is as follows:
1. Accident and health insurance
a) Basic Plan:
Percentage reimbursed: 70% until the Régime général d'assurance médicaments (RGAM) annual out-of-pocket is exceeded, 100% of subsequent amounts per certificate.
The basic plan provides the following coverage only, in line with reimbursement guidelines: hospital expenses incurred in Québec, admissible prescription drugs and pharmaceutical services included on the RAMQ list (with compulsory generic substitution), home care, professional nursing services, sclerosing injections (substance), vaccinations and ambulance transportation.
b) Intermediate Plan:
The reimbursement rate is 75% up to the annual maximum out-of-pocket amount under the Régime général d'assurance médicaments (RGAM), and 100% for any excess, per certificate.
This module offers coverage that goes beyond the basic plan, while not including all the protections found in the enriched plan—particularly with respect to eligible expenses for health professionals, as well as travel insurance and the duration of a trip.
b) Expanded Plan:
The reimbursement rate is 80% up to the annual maximum out-of-pocket amount under the Régime général d'assurance médicaments (RGAM), and 100% for any excess, per certificate.
In addition to the benefits of the “basic” plan and according to the reimbursement guidelines, the “enriched” plan includes paramedical expenses and travel insurance, to name just a few.
2. Life insurance
This plan is optional. It provides for the payment of an amount equal to the amount of life insurance held by the participant at the time of death. The spouse and dependents of a participant may be covered by this plan on certain conditions.
See your brochure for a full description.