Employee Benefits Program
(Flex) Handbook
For regular full-time and part-time team members
January 2024
Table of Contents
Your Benefits At-A-Glance ..................................................................................................................... 1
Introduction ............................................................................................................................................. 7
Who Is Covered? .................................................................................................................................... 7
You ........................................................................................................................................................... 7
Your Dependents ................................................................................................................................... 8
Spouse/Partner ............................................................................................................................... 8
Dependent Children ...................................................................................................................... 8
What Coverage Is Offered? ................................................................................................................... 9
Cost Sharing .......................................................................................................................................... 10
Benefits Program Overview ......................................................................................................... 11
How can I manage the cost of my claims under the plan? ...................................................... 12
Enrolling in the Plan ............................................................................................................................. 12
Choosing your coverage ..................................................................................................................... 13
Flex Benefits Team ................................................................................................................................ 15
Changing Your Coverage .................................................................................................................... 20
Designating Your Beneficiary .............................................................................................................. 21
How Do I Make a Claim? ..................................................................................................................... 22
Submitting Claims Online ................................................................................................................... 22
Direct Billing with Your Health Care Service Provider ...................................................................... 23
Prescription Drug Expenses ................................................................................................................ 23
Other Health Claims............................................................................................................................. 23
Dental Claims ........................................................................................................................................ 24
Claims Reimbursement........................................................................................................................ 24
Coordinating Benefits With An Alternate Plan .................................................................................. 24
Family Planning ..................................................................................................................................... 25
Adoption and Surrogacy ..................................................................................................................... 25
Supporting Documentation ................................................................................................................ 26
Carepath ................................................................................................................................................ 27
Flex Credits ............................................................................................................................................ 28
Wellness Credits ................................................................................................................................... 28
Health Spending Account ................................................................................................................... 29
Personal Spending Account ................................................................................................................ 31
Health Coverage ................................................................................................................................... 32
Maximum Coverage ............................................................................................................................. 32
Health At-A-Glance .............................................................................................................................. 33
Out-of-Pocket Maximum ..................................................................................................................... 38
Eligible Expenses .................................................................................................................................. 38
Drug Plan, Reformulary and DrugFinder ........................................................................................... 39
Three-tier pricing formulary................................................................................................................. 39
Prior Authorization ............................................................................................................................... 40
Dispensing Fee ..................................................................................................................................... 41
Pay Direct Drug Card ........................................................................................................................... 42
Medication Used to Treat Infertility .................................................................................................... 42
Trial and Maintenance Program ......................................................................................................... 42
Wellness Practitioners .......................................................................................................................... 44
Vision...................................................................................................................................................... 45
Other Expenses ............................................................................................................................. 46
Travel Benefit ......................................................................................................................................... 46
How can I obtain my Travel Benefit Card? ................................................................................. 47
Dental Coverage................................................................................................................................... 48
Dental At-A-Glance .............................................................................................................................. 48
Eligible Dental Expenses ..................................................................................................................... 49
Basic Services................................................................................................................................. 49
Major Services ............................................................................................................................... 50
Orthodontic Services .................................................................................................................... 50
Basic Life Insurance .............................................................................................................................. 51
Basic Life ................................................................................................................................................ 51
Optional Life Insurance ........................................................................................................................ 52
Basic Accidental Death and Dismemberment Insurance ............................................................... 53
Critical Illness Insurance (Part-time Employees Only) and Optional Critical Illness Insurance .... 55
Vacation Buy Program for full-time team members ......................................................................... 57
Survivor Benefits.................................................................................................................................... 58
Leaving Rogers ..................................................................................................................................... 59
Contact Information ............................................................................................................................. 60
Glossary ................................................................................................................................................. 61
Your Benefits At-A-Glance
Your Benefits At-A-Glance section provides a summary of our Employee Benefits Program
(Flex). Please refer to the remaining sections in this handbook for further details.
Health Coverage
Includes a variety of services that are not covered or are only partially covered by your provincial
health plan. Unless indicated otherwise, coverage applies to both full-time and part-time
employees.
Medical Services, Supplies and Equipment
Coverage to rent or purchase medically necessary supplies, mobility equipment, and medical
equipment, up to the plan maximums.
Core
Enhanced
Premium
• 70% reimbursement,
limited to:
o Ground ambulatory
services
o Dental accidents
o Medical imaging
services – up to $1,000
combined maximum
per benefit year
• 80% reimbursement
• 90% reimbursement
1 Plan provisions apply to active full-time and part-time employees who meet eligibility requirements. Employee benefit
coverage may differ for inactive and/or ineligible employees. If there is a conflict between this information and a collective
agreement, the terms and provisions of the collective agreement apply to employees covered by the collective agreement.
Flex credits
Rogers provides you flex credits that are used to purchase increased coverage in the Employee
Benefits Program. Once you’ve made your elections, any excess flex credits can be allocated to
your Health Spending Account (HSA), Personal Spending Account (PSA), Global RRSP and
Rogers TFSA.
Annual Flex Credits
Full-time: Team Member only $200, Team Member +1 eligible dependent $340,
Team Member +2 or more eligible dependents $580.
Part-time: Team Member only $130, Team Member +1 eligible dependent $220,
Team Member +2 or more eligible dependents $375.
Flex credits are pro-rated for team members joining the program throughout the year.
Prescription drugs
• Prescription drug options cover eligible drugs that require a written prescription by a
physician or dentist and are dispensed by a licensed pharmacist. Some drugs are subject to
prior authorization by Sun Life, prior to receiving a reimbursement.
1
Core
Enhanced
Premium
Tier 1
• 70%
• 80%
• 90%
Tier 2
• 40%
• 50%
• 60%
Tier 3
• 20%
• 20%
• 30%
Dispensing Fee
Maximum
• $4
• $5
• $6
Sexual Dysfunction
Drugs
• N/A
• $1000 max per
benefit year
• $1000 max per
benefit year
Out of Pocket
Maximum
• N/A
• Once the amount of
expenses not
reimbursed under this
plan as a result of the
application of the
dispensing fee or the
reimbursement level
has reached $10,000
for a family in a
benefit year, eligible
expenses incurred by
that family will be paid
at 100% for the
remainder of the
benefit year.
• Once the amount of
expenses not
reimbursed under
this plan as a result of
the application of the
dispensing fee or the
reimbursement level
has reached $10,000
for a family in a
benefit year, eligible
expenses incurred by
that family will be
paid at 100% for the
remainder of the
benefit year.
Paramedical Practitioners
Services of qualified wellness practitioners, such as registered massage therapists,
physiotherapists, chiropractors, naturopaths, and acupuncturists.
Core
Enhanced
Premium
• No coverage
• 100% reimbursement
• Combined max of $1,000
for various practitioners,
including massage
therapists, speech therapists,
physiotherapists,
naturopaths, acupuncturists,
osteopaths, chiropractors,
podiatrists, chiropodists,
audiologists, dieticians, and
occupational therapists.
• 100% reimbursement
• Combined max of $1,200 for
various practitioners
including massage
therapists, speech therapists,
physiotherapists,
naturopaths, acupuncturists,
osteopaths, chiropractors,
podiatrists, chiropodists,
audiologists, dieticians, and
occupational therapists
2
Mental Health
Services of qualified mental health practitioners including licensed psychologists or social
workers, licensed psychotherapists or family therapists, or psychotherapists or family therapists
who are active members of a provincial association approved by Sun Life or clinical counsellors
who are active members of a provincial association approved by Sun Life.
This benefit also includes Beacon digital therapy.
Core
Enhanced
Premium
• 100% reimbursement
• Up to $2,500 annually
• 100% reimbursement
• Up to $2,500 annually
• 100% reimbursement
• Up to $5,000 annually
Vision care
Coverage for eye exams and to purchase contact lenses or eyeglass lenses that are prescribed
by a licensed physician or optometrist for the correction of impaired vision.
Core
Enhanced
Premium
• No coverage
• 100% reimbursement
• Up to $300 every 24
months for eyeglasses and
contact lenses
• 80% - One eye exam every
12 months per participant
under age 21, one every
24 months per participant
aged 21 or over
• 100% reimbursement
• Up to $400 every 24
months for eyeglasses and
contact lenses
• 100% - One eye exam
every 12 months per
participant
under age 21, one every
24 months per participant
aged 21 or over
Dental Coverage
Helps you pay for routine dental expenses that are incurred by you and your dependents and
performed by a licensed dentist or dental surgeon.
Basic services
Coverage for services, such as examinations: emergency or initial oral examinations (once per
dentist), recall oral examinations, scaling, etc.
Core
Enhanced
Premium
• 70% reimbursement
• Annual maximum: $500
per year
• 80% reimbursement
• Annual maximum: $1,500
per year (combined with
major services)
• 100% reimbursement
• Annual maximum: $1,500
per year
3
Major services
Coverage for services, such as bridgework, root canals, etc.
Core
Enhanced
Premium
• No coverage
• 50% reimbursement
• Annual maximum: $1,500
per year (combined with
basic services)
• 60% reimbursement
• Annual maximum: $1,500
per year
Orthodontic services
Coverage for orthodontic services for dependent children under age 19 only.
Core
Enhanced
Premium
• No coverage
• No coverage
• 60% reimbursement
• Lifetime maximum: $2,500
Short-term Disability (STD) Benefits (available to full-time employees only)
Replaces a portion of your income if you are totally disabled and unable to work due to
non-occupational illness or injury.
Please refer to the detailed plan document on HR Connect.
Long-term Disability (LTD) Benefits (available to full-time employees only)
Provides with monthly income if you remain totally disabled and are unable to return to work
after 182 calendar days of illness or injury.
Please refer to the detailed policy document on HR Connect.
4
Basic Life Insurance
Provides a lump-sum payment to you, your beneficiary(ies), or your estate in the event of death.
Benefit amount
Basic Employee Life Insurance
Core
Enhanced
Premium
• Full-time: 1x regular
earnings
• Part-time: $30,000
• Full-time: 2x regular
earnings
• Part-time: Core only
• Full-time: 3x regular
earnings
• Part-time: Core only
Optional Life Insurance
Supplements the coverage provided by Basic Life Insurance.
Benefit amount
Optional Employee Life Insurance and Optional Spousal Life Insurance
• You may purchase additional coverage for yourself and your spouse in units of $10,000 up to
a maximum of $500,000
Basic Accidental Death & Dismemberment (AD&D) Insurance
Provides you with a lump-sum payment if you are injured in an accident. If you die as the result
of the accident, the lump sum is paid to your beneficiary(ies) or estate. The benefit paid will
depend on the degree of your injury and based on the plan option chosen.
Benefit amount
Core
Enhanced
Premium
• Full-time: 1x regular
earnings
• Part-time: $30,000
• Full-time: 2x regular
earnings
• Part-time: Core only
• Full-time: 3x regular
earnings
• Part-time: Core only
Critical Illness Insurance
Provides you with a lump-sum payment if you are diagnosed with a covered critical illness and
complete the survival period of 30 consecutive days after the diagnosis of the covered
condition.
Benefit amount
Basic Critical Illness (part-time team members only)
• $10,000 lump sum benefit
Employee and Spousal Optional Critical Illness Insurance
• Purchase units of $5,000, up to $50,000 of coverage
5
Healthcare Assist by Carepath
This program provides individualized chronic disease case management for many types of
medical conditions and fully navigates employees & their families before, during, after or all the
way through their diagnosis, treatment & ongoing care. To access this service, contact
Carepath at 1-866-883-5956.
6
Introduction
At Rogers, we’re committed to helping keep you and your family healthy and at your best –
both at work and at home. Our Employee Benefits Program gives you the flexibility to choose
options that support the personal health and wellness needs of you and your family.
Our program includes comprehensive benefits to help you pay for a wide variety of expenses
that are not covered by government plans. So, whether you need life insurance, health care,
dental care, or financial protection when you are unable to work due to an illness or injury, we
have you covered.
We encourage you to read this handbook and fully understand the coverage details.
TIP
Who Is Covered?
Terms that you see in bold and italic
are defined in the glossary at the end
of the handbook.
You
You are eligible to participate in the Employee Benefits Program (Flex) if you meet the
following criteria:
• You are a regular full-time or part-time employee of Rogers
• For full-time employees: Coverage is available as of your date of hire if you have a regular
work schedule of at least 30 hours per week
• For part-time employees: You’re eligible for benefit coverage if you’re part of a benefit
eligible class and have completed three (3) months of continuous service. At time of hire
or transfer into a part-time position, each employee will be classified in one of the below
benefit classes:
Part-time regular: You’re eligible for the Employee Benefits Program (Flex).
You work an average of 20 hours or more, per week. To maintain your eligibility, you must
work an average of 20 hours per week over the 12-month eligibility period (from the first
pay period in October to the last pay period in September). Your eligibility will be
reassessed each year, to determine your eligibility for the upcoming year.
Part-time casual: You are not eligible for the Employee Benefits Program (Flex).
You work less than 20 hours on average, per week. Your eligibility will be reassessed the
following year in November, based on the hours paid (plus eligible leave hours) from the
first pay period in October to the last pay period in September, to determine your
eligibility for the upcoming year.
7
For more information, please visit HR Policy 4.1: Group Benefits and Wealth Accumulation –
General Eligibility on HR Connect and search for “part-time benefit eligibility”.
Note, regular full-time employees are eligible for short-term disability benefits after completing
90 consecutive days of continuous service. Part-time employees are not eligible for short-term
disability benefits.
To be eligible for coverage under the Employee Benefits Program (Flex), employees and their eligible
dependents must reside in Canada on a full-time basis. To enroll in the Rogers health plan, employees
and eligible dependents must be enrolled in their provincial healthcare plan or have equivalent alternate
coverage.
Your coverage ends on the earliest of:
• the date your employment with Rogers ends;
• the date you retire; or
• the date you no longer qualify for benefits coverage (e.g., a part-time employee who
hasn’t met the average hours required, an employee who has hit the age maximums, etc.).
Your Dependents
Your dependents – your spouse/partner and your children – can also be covered by the
Employee Benefits Program (Flex), as long as they qualify as eligible dependents.
Any coverage for your dependents ends on the earliest of the date your employment ends, you
retire, or you and/or they no longer meet the eligibility rules.
Spouse/Partner
Your spouse/partner is eligible for coverage if he or she is the person (of the same or opposite
sex) to whom you are legally married, or the person who has continuously resided with you for
a period of at least twelve months in a common-law relationship outside marriage. You can
only cover one person as your spouse at any given time.
Dependent Children
Your dependent children are eligible for coverage if they are unmarried, under age 22, not
actively employed, dependent on you for support, and if they are:
• a child related to you by blood or marriage and for whom you are the legal guardian;
• a child of the person with whom you are living in a common-law relationship, provided
that child is living with you; or
• a child you have legally adopted.
8
Your unmarried child who is over the age of 22 is also eligible for coverage if he or she is:
• under age 25 (age 26 in Quebec for prescription drug coverage only), a full-time student
attending an accredited educational institution, and dependent on your financial support;
or
• dependent on your financial support as a result of a mental or physical disability incurred
before reaching age 22.
Note, if your dependent is a full-time student over the age of 22, you are required to certify
their full-time student status annually with HR Connect for them to continue to be eligible for
benefits. Periodically, Rogers may ask team members to provide proof of eligibility.
What Coverage Is Offered?
To help keep you and your family healthy and at your best – both at work and at home, the
Rogers Employee Benefits Program (Flex) offers you:
• Health coverage (including travel emergency medical coverage)
• Dental coverage
• Short-term disability (STD) coverage (full-time team members only)
• Long-term disability (LTD) coverage (full-time team members only)
• Basic life insurance
• Basic accidental death and dismemberment (AD&D) insurance
• Optional life insurance for yourself and your spouse
• Critical Illness insurance (part-time team members only)
• Optional critical illness insurance for yourself and your spouse
• Wellness credits allocated to a personal spending account
• Flex credits to purchase increased coverage levels
9
When is the benefits plan year?
The benefits plan year matches the
calendar year – January 1 to December 31.
This means that any out-of-pocket
maximums and any plan provisions with
annual reimbursement maximums are
reset on January 1 of each year.
Cost Sharing
Rogers pays for your Core benefits coverage (with exception to LTD for full-time team
members) plus your flex credits and your wellness credits. You use your flex credits and payroll
dollars (depending on your elections) to pay for increased coverage. For full-time team
members, Rogers will cover 100% of the cost of our short-term disability benefits and 60% of
LTD premiums with you paying the remaining 40%.
Your per-pay costs depend on a number of factors, including:
• Your employment status (full-time, part-time, active, or on-leave)
• Your salary
• The level of coverage you select (team member only, team member +1 eligible
dependent or team member +2 or more eligible dependents)
• The benefits you participate in, including any optional coverage that you may choose
In addition to the cost of your participation in the Employee Benefits Program (Flex), which you
pay through payroll deductions, you may have expenses throughout the year when you visit a
health care practitioner. The amount you pay out of your own pocket depends on the eligibility
of the expense, the reimbursement level of the benefit you are using, as well as any
maximums that may apply. For more information, refer to the sections that describe each
individual benefit.
10
Benefits Program Overview
For full-time team members
For part-time team members
11
How can I manage the cost of my claims under the plan?
Since you pay a portion of some of your benefits claims, here are some useful tips to help you manage
your costs:
• Choose the coverage option that best suits your personal needs. Determine if you need
Core, Enhanced or Premium coverage
• Coordinate your benefits with an alternate plan. If you have alternative benefits coverage
(through a spouse/partner or another plan), coordinating benefits coverage is an effective
way to minimize your out-of-pocket costs for health and dental expenses. You can be
reimbursed under one plan, then submit any eligible unpaid expenses to the alternate plan.
See more information in the “Co-ordinating Benefits with An Alternate Plan” section
• Make sure that your pharmacy is competitive by discussing dispensing fees with your
pharmacist or by shopping around for lower fees
• Reduce unnecessary prescription drug costs by speaking with your doctor about the option
of using generic drugs as opposed to brand-name drugs
• Understand the provisions of your plan and check with Sun Life if you are unsure about a
specific expense. You can confirm treatment and eligibility with Sun Life by requesting a
predetermination prior to incurring expenses of more than $500 to avoid claims being
declined due to ineligibility
Enrolling in the Plan
When you first become eligible to participate in the Rogers Employee Benefits Program (Flex),
you will be directed to complete the benefits enrollment process, through HR Connect. You
will be defaulted to Core coverage for yourself only, with flex credits allocated to your health
spending account, if you don’t make an election within 31 calendar days of eligibility.
Each year in November, you will have an opportunity to make changes to your benefits
coverage, for January 1, through the annual enrollment period. Outside of this annual period
or an eligible life event, you are not able to make any updates to your coverage.
Team members that are newly eligible for coverage during the months of October, November
and December are locked in and restricted from changing Health and Dental options until the
annual reenrollment period in the upcoming year. This applies to new hires, rehires and team
members who have a life event. For example, if you were hired in October and enrolled in
health and dental coverage in October, you will not be able to make updates until the next
reenrollment period in November, for updated coverage effective the following January 1st.
12
Choosing your coverage
During your enrollment, you will need to:
• Choose your level of coverage:
Team member only
or
Team member + 1 eligible
dependent
or
Team member + 2 or
more eligible
dependents
• Personalize your benefits coverage to fit the unique needs of you and your family, using the
options available to you
• Use your flex credits and/or payroll dollars to purchase increased coverage.
• Allocate your excess flex credits (if applicable) to your Health Spending Account (HSA),
Personal Spending Account (PSA), Global RRSP and the Rogers TFSA
• Complete your beneficiary designation
Core coverage is mandatory for eligible team members. If you are enrolled in alternate
health and dental coverage and would like to opt out of Rogers core health and dental
benefits, you may do so. In exchange for the opt out, full-time team members will receive
$1,000 in flex credits and part-time team members will receive $800. These amounts will be
prorated for team members hired throughout the year. Basic life, basic AD&D, LTD (full-time
team members only) and basic critical illness benefits (part-time team members only) are
mandatory benefits.
If you live in Quebec, and you opt-out of our health benefits, you will be required by RAMQ to
provide proof of alternate coverage digitally through the enrollment tool. You will be asked to
include the following details:
• Employer or plan name
• Insurer
• Policy Number
• Certificate or identification number
13
Here are a few questions you may want to ask yourself when determining your coverage needs:
1. Do you or your dependents require regular prescriptions or wellness practitioner services?
2. What dental services do you use most often?
3. Are there any hereditary medical conditions that run in your family that you want to protect
yourself against?
4. Are you currently covered or eligible for benefits through your spouse’s plan?
5. How risk adverse are you? For example, how much would you pay out-of-pocket for health
expenses and could you manage a big expense on your own if one came up?
6. If something was to happen to you, what type of financial support would you want to leave
behind for your family and other loved ones?
A few things to keep in mind
• When enrolling, you will need to select the same level of coverage for health and dental
benefits (e.g., team member only, team member +1 eligible dependent or team member
+2 or more eligible dependents).
• You can select different options, based on your needs (e.g., premium health, core dental,
enhanced life, core AD&D, etc.)
14
Flex Benefits Examples
With added choice and flexibility, it’s important to select the coverage that fits the personal
health and wellness needs of you and your family.
While your situation is unique to you, it may be helpful to get to know a few team members
and the flexible coverage they’ve considered based on their needs when choosing your own
options.
Skye
Based on her needs, Skye has made the following elections:
Level of Coverage: Team Member Only
Health
Opt-out – received $800 in opt-out credits
Dental
Opt-out – received $800 in opt-out credits
Basic Life Insurance
Core
Basic Critical Illness and AD&D Insurance
Core
Optional Life
No coverage elected
Optional Critical Illness
No coverage elected
Excess Spending Credits
Personal Spending Account (PSA),
Rogers TFSA
Additional Vacation Days
No additional days purchased
• Because Skye has alternate coverage, she opted out of health and dental benefits and
receives $800 in credits, and she allocated these credits to her PSA and her Rogers TFSA.
• She plans on using her PSA credits to purchase her gym membership and will use the credits
allocated to her Rogers TFSA to pay off student loans.
15
Sheila
Based on her needs, Sheila has made the following elections:
Level of Coverage: Team Member + 2 or more eligible dependents
Health
Enhanced
Dental
Enhanced
Basic Life Insurance
Enhanced
Basic Critical Illness and AD&D Insurance
Enhanced
Optional Life
No coverage elected
Optional Critical Illness
No coverage elected
Excess Spending Credits
N/A – no credits left based on her elections
Additional Vacation Days
5 Days
• With an active and healthy family of 3, Sheila feels like that she doesn’t require our highest
level of coverage but would like more than what the Core benefit provides. Based on her
family needs, she has elected to go with the Enhanced option across all benefits.
• Given her passion for travel, she wants to take advantage of purchasing additional
vacation days.
16
Mei
Based on her needs, Mei has made the following elections:
Level of Coverage: Team Member + 2 or more eligible dependents
Health
Premium
Dental
Premium
Basic Life Insurance
Premium
Basic Critical Illness and AD&D Insurance
Premium
Optional Life
No coverage elected
Optional Critical Illness
$25,000 of coverage elected
Excess Spending Credits
N/A – no credits left based on her elections
Additional Vacation Days
No additional days purchased
• With a family of 4 with varying medical needs and a desire to manage her monthly finances
tightly, Mei believes that a higher level of coverage will best suit her needs to cover her family
holistically.
• Mei selected critical illness insurance to provide some additional financial support in the
event she is diagnosed with an eligible condition and is required to be off work for an
extended period of time.
17
Jamal
Based on his needs, Jamal has made the following elections:
Level of Coverage: Team Member + 1 eligible dependent
Health
Premium
Dental
Enhanced
Basic Life Insurance
Enhanced
Basic Critical Illness and AD&D Insurance
Enhanced
Optional Life
No coverage elected
Optional Critical Illness
No coverage elected
Excess Spending Credits
N/A – no credits left based on her elections
Additional Vacation Days
No additional days purchased
• Given the hereditary health issues that run in both his and his husband’s family, Jamal wants
to ensure they have the highest level of protection in case they are diagnosed with the same
issues, which can be costly to treat.
• Jamal selected enhanced basic life and AD&D to ensure his husband can pay off the
mortgage if something were to happen to him. He increased his AD&D coverage above the
Core because there is a higher rate of accidents in his profession.
18
Erik
Based on his needs, Erik has made the following elections:
Level of Coverage: Team Member + 2 or more eligible dependents
Health
Premium
Dental
Premium
Basic Life Insurance
Enhanced
Basic Critical Illness and AD&D Insurance
Core
Optional Life
No coverage elected
Optional Critical Illness
No coverage elected
Excess Spending Credits
N/A – no credits left based on her elections
Additional Vacation Days
No additional days purchased
• Erik selected the highest level of health and dental coverage based on his personal
healthcare needs and to minimize his out-of-pocket expenses if claims come up for his
children. He’d rather pay a bit more every pay for higher coverage, than having to pay a
higher amount at the time of a claim.
• Erik selected enhanced life insurance to cover the costs of what’s left on his mortgage and to
provide support for his young children.
These profiles are for illustration purposes only. If you need help choosing the coverage that’s
right for you, check out the decision support tool when electing your coverage during enrollment.
19
The following table summarizes the default coverage levels for team members who do not
actively enroll in the Employee Benefits Program (Flex) within 31 days of eligibility.
Benefit
Default Coverage
Health coverage
Core, team member only
Dental coverage
Core, team member only
Flex Credits
Allocated to a Healthcare Spending Account (HSA)
Short-term disability coverage
(Full-time team members only)
Covered. Refer to the plan document for further details.
Long-term disability coverage
(Full-time team members only)
Covered. Refer to the policy for further details.
Basic life insurance
Full-time team members: Core (1 X times your regular
annual earnings)
Part-time team members: $30,000 flat benefit
Basic critical illness insurance
(part-time team members only)
$10,000 flat benefit
Optional employee/spousal
critical illness insurance
No coverage
Once you enroll, you should review your benefit elections and bi-weekly deductions on HR
Connect to ensure accuracy.
Following your enrollment in the Employee Benefits Program (Flex), you will not be able to
update your coverage until the next annual enrollment period or if you experience an eligible
life event.
Changing Your Coverage
After you enroll in the Employee Benefits Program (Flex), your coverage levels will continue to
stay in effect unless you experience a life event change. If you experience a life event change
that requires a change in benefits coverage, you will have a 31-day period (or a 90-day period
for the birth/adoption/legal guardianship of a child) during which you can add or remove
dependents and change your coverage.
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Life event changes include:
• Marriage or establishment of a common-law relationship
• Breakdown of marriage or common-law relationship
• Death of a spouse/partner or child
• Birth, adoption, or becoming a legal guardian of a child
• Gain or loss of coverage under your spouse’s/partner’s plan
Note, it is important to retain copies of documents related to your life event change for future
reference and for proof, should it be requested.
Have you experienced a life event?
To inform Rogers of a life event and to initiate changes to your benefits coverage, go to
HR Connect and search for “Life event”.
Designating Your Beneficiary
Certain benefits, such as life insurance and accidental
death and dismemberment (AD&D) insurance, are paid
to the beneficiary(ies) that you designate, so it is
important to ensure that this information is kept current.
You can change or add beneficiaries at any time
(subject to provincial legislation) online through HR
Connect. Alternatively, if you do not designate a
beneficiary, certain benefit payments may be directed
to your estate.
Important information for team members residing
in Quebec:
If you live in Quebec and designate your spouse as the
beneficiary, the designation is considered irrevocable.
This means that you can’t change your beneficiary
designation without the consent of your spouse unless
you specifically indicated otherwise during the original
beneficiary designation process.
Not sure who your beneficiary is?
To view and confirm your current beneficiary(ies), go to HR Connect and search for
“beneficiary”.
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How Do I Make a Claim?
For questions about submitting claims, contact Sun Life, Rogers benefit provider (see the
Contact Information section for details). You must submit claims for health and dental
expenses to Sun Life no later than 90 days following the end of the year in which the expense
was incurred (i.e., if a claim was incurred on December 31, you must submit the expense for
reimbursement by March 31 – or March 30 if a leap year – of the following year).
For Travel Benefit claims, you must contact Global Excel Management (GEM) immediately once
the emergency arises and they will coordinate the payments, as needed. If you are unable to
contact GEM at the time of the emergency, you must contact them as soon as possible.
If you pay for any expenses that GEM is not aware of, you must advise them within 30 days of
returning to your province of residence.
See the Travel Benefit section for additional details. As a precaution, always keep copies of your claim
documentation for your own records.
Submitting Claims Online
You’re able to submit your health and dental claims online using Sun Life’s plan member
website or mobile app. You’ll also be able to submit your claim information online, track the
progress of your claim, and receive faster reimbursement.
Lost Your Drug Card?
You can print a paper copy of your Pay Direct Drug Card through Sun Life’s plan member
website.
Note, claims submitted online are subject to random audit by Sun Life, so always keep your
original receipts in the event you’re requested to submit them. If you fail to submit receipts,
you’ll be subject to further audit and may lose the ability to submit claims online moving
forward. You are responsible for all claims submitted online using your account. You
understand that any fraudulent online claims submitted using your account, by you or anyone
else – including, but not limited to, your spouse or dependents – may subject you to discipline
up to and including termination of employment.
Fraud
Submitting a false benefit claim or a claim for someone that is not covered under your plan is
a criminal offence and could result in your termination of employment. If you suspect claims
fraud occurring on your account, call the STAR hotline to report it immediately by visiting
https://netnowprod.service-now.com/star.
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Direct Billing with Your Health Care Service Provider
Direct billing allows Dentists, Wellness Practitioners (physiotherapists, message therapy, etc.)
and Vision Service Providers to submit your claims on the spot to our health plan, for quicker
processing. Not all healthcare service providers use directly billing. To confirm if your
healthcare service provider uses direct billing or to find one that does, check out the provider
look up tool on the Sun Life Plan Member website. Some healthcare service providers may
collect your reimbursement directly from Sun Life – in this case, you’ll only pay your portion of
the claim.
Before electronic claims can be sent on your behalf, you’ll have to complete an Electronic
Transmission Consent form with your healthcare service provider.
Prescription Drug Expenses
As part of the Rogers Employee Benefits Program (Flex), you will receive a pay direct drug card
– a fast and convenient way to pay for prescription drugs. When you purchase eligible
prescription drugs and use your pay direct drug card, you will only need to pay the pharmacy
for your share of the cost.
For most drug claims, there is no paperwork to send to Sun Life and you do not have to wait to
be reimbursed. If you forget your pay direct drug card when you visit your pharmacy, you can
submit a paper claim form to Sun Life with a copy of your receipt for reimbursement. You can
access the Health Claim form online on HR Connect by searching “Health Claim Form”.
Other Health Claims
You can submit your claims online – please see the Submitting Claims Online section. You can
also complete the appropriate paper claim form and send it directly to Sun Life, along with
your original receipts for reimbursement. Receipts must show the patient’s name, the provider
of the service (including his or her credentials and/or registration number), an itemized list of
the charges, and proof of payment.
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Dental Claims
Dentists can bill Sun Life electronically, which means you can either pay the dentist for the full
treatment and Sun Life will reimburse you for the portion covered by the plan, or Sun Life can
send payment of the covered portion directly to the dentist. If Sun Life sends the payment
directly to the dentist, you are responsible for paying any amounts not covered.
If your dentist cannot bill Sun Life electronically,
your dentist will complete the appropriate
section of a paper claim form. You will pay the
full treatment cost and fill in the personal
information required and send it, with your
original receipts, to Sun Life for processing. Sun
Life will then reimburse you for the portion
covered by the plan. You can access the Dental
Claim form online on HR Connect by searching
“Dental Claim Form”.
Claims Reimbursement
Claim reimbursements will be deposited directly into the same bank account used for payroll
purposes. After a claim is processed, Sun Life will send a notification to the email account on
file advising you to log in to the Sun Life member website to view the claim statement.
Coordinating Benefits with An Alternate Plan
If you and your eligible dependents have coverage under another health or dental plan, such
as your spouse’s/partner’s plan, you may be able to coordinate benefits coverage with that
plan to receive reimbursement for up to 100% of your eligible expenses. Coordinating
benefits coverage is an effective way to maximize reimbursement for health and dental
expenses. If you are covered by your spouse’s/partner’s benefits coverage, you can be
reimbursed under the Rogers plan first, and then submit the unpaid portion of eligible
expenses to an alternate plan.
Here’s how coordination of benefits coverage works:
Your expenses:
• Submit claims for yourself through the Rogers Employee Benefits Program (Flex) first
• Any unpaid eligible claim amounts can then be submitted to your alternate plan for
reimbursement
Your spouse’s/partner’s expenses:
• Your spouse or partner should submit claims for himself or herself to his or her plan first
• Any unpaid eligible claim amounts can then be submitted to the Rogers Employee Benefits
Program (Flex) for reimbursement
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Your dependent children’s expenses:
• Claims for your dependent children should be submitted first to the plan of the parent
whose birth date falls earlier in the year (regardless of the age of the parent)
Keep in mind that should availability of alternate coverage change; you must notify Sun Life to
update this information on their records. You should also advise your pharmacist and/or dentist
to update their records.
Here’s an example to illustrate how coordination of benefits works:
Jennifer (a full-time team member) and her spouse both have benefit plans. Jennifer submitted
a $200 drug claim to the Rogers Employee Benefits Program (Flex) by using her pay direct
drug card. She was reimbursed for 90% of the cost ($180), so her portion of the claim was $20.
The pharmacy she uses charges a $6 dispensing fee, which is fully reimbursed by the plan.
Jennifer is also covered under her husband Fred’s prescription drug plan. She submitted the
receipt for the $20 balance of the prescription cost to Fred’s plan for reimbursement. Using
coordination of benefits, Jennifer was able to submit the claim to both plans for
reimbursement of the full $200 cost.
Family Planning
Adoption and Surrogacy
At Rogers, we are committed to supporting families and promoting inclusion and equality
through our Life Cycle Benefits. As part of this, we offer the Adoption and Surrogacy Benefit to all
regular full-time and part-time team members with 12 or more months of continuous service.
This benefit covers expenses associated with the adoption or birth of a child through surrogacy.
• Eligible expenses are reimbursed at 100%, up to a lifetime maximum of $15,000
• Team members must submit their claims for expenses within 6-months of the completion
of the adoption or surrogacy
• Reimbursements are provided through payroll
To submit your claims, please complete the Adoption and Surrogacy Benefit Claim Form that can be
found on HR Connect. Your completed claim form and supporting documentation must be submitted
directly to HR Connect for processing.
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The following items are eligible expenses.
Eligible Expenses
Adoption
Surrogacy
1. Adoption agency fees
2. Legal fees
3. Court fees
4. Travel & lodging expenses*
5. Immigration fees associated
with adoption
6. Psychology/counselling
associated with adoption
1. Legal fees
2. Court fees
3. Travel & lodging expenses*
4. Immigration fees associated with adoption
5. Psychology/counselling associated with adoption
6. Surrogate expenses (travel, pre-natal vitamins and
medical costs associated with surrogacy)
*Travel in relation to an adoption/surrogacy. Lodging will be covered to a maximum of $350/per night, for a maximum of
3 days. Flights are covered for economy only.
Supporting Documentation
Proof of Adoption or Surrogacy
1. Confirmation of adoption records
2. Surrogacy agreement
3. Adopted child's birth certificate
4. Receipt of payment
5. Proof of applicability of the expense. For example, a letter/email confirming the relatedness
to the adoption/surrogacy (i.e., letter from the Adoption agency confirming a meeting
took place)
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Carepath
This exclusive partnership combines Carepath’s team of highly trained and caring nurse
navigators with Cleveland Clinic’s global network of physicians and specialists. This program
provides individualized chronic disease case management for many types of medical
conditions and fully navigates employees & their families before, during, after or all the way
through their diagnosis, treatment & ongoing care.
How does it work?
• Works in parallel with the public health care system to navigate team members and their
families through the system, providing a single point of contact throughout diagnoses and
treatments to ensure continuity of care
• Personal nurse advocate supports the team members and their families medically and
emotionally, every step of the way - allowing for an enhanced bond between the nurse
and patient
• Oversees the entire journey to ensure the right care is received, at the right place, at the right
time, every step of the way
Every patient’s expectation and need are different. Carepath provides a very individualized and
personal service so you will get the support based on your situation.
Carepath offers:
• Doctor-to-doctor consults with patient/local treating physicians after completing medical
second opinions
• In-depth assessments of treatment plans and options proposed by the local treating
physicians to ensure they are consistent with medical best-practice
• Explanation of options for tests/treatments in their particular case
• Facilitate access to diagnostic tests, treatments, and clinical trials
• Guide patients to alternate treatment locations, when requested or required
• Nurses provide ongoing coaching as to how best to manage their chronic condition
For more information or to access this service, contact Carepath at 1-866-883-5956 (representatives are
available Monday to Friday from 9am-5pm EST) or visit www.carepath.ca.
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Flex Credits
At each enrollment period, you’ll receive flex credits that can be used to purchase increased
coverage options for Health, Dental and Insured benefits. This allows you the added choice
and flexibility to select benefits that are tailor-made for you and your family. The amount of flex
credits you receive depends on the level of coverage you select (e.g., team member only, team
member + 1 eligible dependent or team member + 2 or more eligible dependents) and if you
are full-time or part-time. Flex credits will be prorated based on when you become eligible for
the Employee Benefits Program (flex).
Annual Flex Credit Allocations
Level of Coverage
Full-time Team Members
Part-time Team Members
Team Member Only
$200
$130
Team Member Only + 1
Eligible Dependent
$340
$220
Team Member Only + 2 or
more Eligible Dependents
$580
$375
Once you’ve made your elections, any excess flex credits can be allocated to your Health
Spending Account (HSA), Personal Spending Account (PSA), Global RRSP* and Rogers TFSA*.
*You must be enrolled in the Global RRSP and/or Rogers TFSA if you would like to allocate your flex credits to your savings. If
you do not have an account, your credits will be allocated to your Health Spending Account. Refer to the Global RRSP and
Rogers TFSA member booklets on HR Connect for more information.
Wellness Credits
In addition to the flex credits you receive to purchase increased benefits coverage or allocate
to any of your other eligible accounts, you will also receive wellness credits that will be
allocated to a Personal Spending Account (PSA) at Sun Life. These credits are dedicated to
your life and wellness needs. The number of credits you will receive is based on whether you
are a full-time or part-time team member and will be prorated based on when you become
eligible for the Employee Benefits Program (flex).
Annual Wellness Credit Allocations
Full-time Team Members
Part-time Team Members
$200
$75
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Health Spending Account
A health spending account (HSA) can be used to cover the costs of a wide range of healthrelated expenses, including:
• Co-insurance payments for health and dental expenses
• Health or dental expenses in excess of maximum coverage amounts; and
• Health-related expenses not covered by our program that qualify as a medical expense
under the Income Tax Act (ITA)
Some examples of things you can claim through the HSA:
• Drug costs not fully covered by your plan
• Vision care expenses, like eyeglasses or contact lenses
• Wellness practitioner services, like acupuncture, massage
therapy or chiropractic
• Dental services are not fully covered by your plan
• Medical supplies and equipment, like hearing aids,
wheelchairs or crutches
Under CRA guidelines, claims to an HSA for employees in Quebec are a taxable benefit.
Taxable benefits for any claims made will be noted on your T4.
You will be able to see the current balance in your HSA through the Sun Life plan member
website or the Sun Life mobile app. If you have a claim that exceeds the balance in your HSA,
the claim would be reimbursed up to the amount in your HSA. You must pay the remaining
balance.
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If you don’t use your full HSA balance in a given plan year, it carries forward to the next year.
If you don’t use the carryover in year two, it will be forfeited as per ITA guidelines - it can’t be
transferred or cashed out.
For Example: Unused 2023 health credits can be carried forward into 2024. When you submit a claim
in 2024, the 2023 credits will be used first.
IMPORTANT: If there are still HSA credits remaining from 2023 as of December 31, 2024, they will be
forfeited.
Activity
Activity date
Transaction
amount
HSA account balance
Excess Flex Credits
allocated to the HSA
January 1, 2023
$60
$60
Health claim
June 1, 2023
($20)
$40
Year-end balance
December 31, 2023
N/A
$40 (carried forward
to 2024)
Excess Flex Credits
allocated to the HSA
January 1, 2024
$50
$90 ($40 from 2023 and
$50 for 2024)
Health claim
March 2, 2024
($30)
$60
December 31, 2024
N/A
$60 ($10 from 2023
and $50 from 2024)
December 31, 2024
($10)
$60, however, if the
balance of $10 from
2023 is not claimed by
March 31, 2025,
for eligible claims
incurred in 2024, it will
be forfeited
January 1, 2025
$30
$80 ($50 from 2024
and $30 for 2025)
Year-end balance
HSA forfeiture
If you choose to deposit
your excess Flex Credits
into your HSA
If I leave Rogers, what happens to the unused health credits in my HSA?
Any eligible expenses must be submitted for payment through your HSA on the earlier of:
90 days from your termination of coverage; or 90 days following the year in which the expense
was incurred. Following this, any remaining health credits in your HSA will be forfeited.
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Personal Spending Account
A Personal Spending Account (PSA) has more flexibility and covers life and wellness expenses
not covered by an HSA, such as fitness equipment and gym membership fees, childcare,
and personal development expenses. Visit the Sun Life member website for a full list of
eligible items.
Under CRA guidelines, claims to a PSA are a taxable benefit. Taxable benefits for any claims
made will be noted on your T4.
You will be able to see the current balance in your PSA through the Sun Life plan member
website or the Sun Life mobile app. If you have a claim that exceeds the balance of your PSA,
the claim will be reimbursed up to the amount in your PSA. You must pay the remaining
balance.
If you don’t use your full PSA balance in a given plan year, the credits in your PSA will be
forfeited. They can’t be transferred or cashed out. For example, your 2024 wellness credits
must be used in 2024 or they will expire. You will have 90 days following the calendar year end
to submit incurred expenses. For example, you can submit PSA claims incurred in 2024 up to
March 31, 2025.
Example: Illustration of how Wellness Credits are allocated to the PSA and how a claim impacts the PSA
balance.
IMPORTANT: Unused Wellness Credits remaining in the PSA will be forfeited at the end of the year.
Activity
Activity date
Transaction
amount
PSA account
balance
Wellness Credits allocated
to your PSA
January 1, 2024
$200
$200
PSA claim
June 1, 2024
($50)
$150
December 31, 2024
($150)
$0
January 1, 2025
$200
$200
PSA forfeiture as a
result of unused
Wellness Credits
Wellness Credits allocated
to your PSA at the
beginning of the year
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Health Coverage
Although health coverage in Canada varies by province, most provincial health plans cover the
costs of doctors’ bills, standard hospital accommodation, and the expenses associated with a
typical hospital stay. Rogers offers health coverage to help you pay for a wide range of health
expenses that are not covered by your provincial health insurance plan. In the event that a
provincial plan discontinues or reduces payment for any service, treatment or medical supply,
this plan will not automatically assume coverage.
Examples of covered expenses include prescription drugs, wellness services such as those
provided by chiropractors and physiotherapists, and miscellaneous medical supplies such as
crutches or splints.
If you live in Quebec, Rogers contributions to your health coverage premiums are considered a
taxable benefit and will be reported on your Relevé 1.
Your health coverage ends on the earliest of the date your employment ends, your retirement
or when you are no longer eligible based on the plan rules. There is no age limitation on health
coverage.
Maximum Coverage
The plan has no maximum limit on prescription drugs and overall health expenses; however,
some items may have caps and/or frequency limits while other items may be subject to
reasonable and customary pricing limits. A summary of some of these provisions is set out in
the following chart.
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Health At-A-Glance
Prescription drugs
Core
Enhanced
Premium
Tier 1
• 70%
• 80%
• 90%
Tier 2
• 40%
• 50%
• 60%
Tier 3
• 20%
• 20%
• 30%
Dispensing Fee
Maximum
• $4
• $5
• $6
Sexual Dysfunction
Drugs
• N/A
• $1000 max per
benefit year
• $1000 max per
benefit year
Out of Pocket
Maximum
• N/A
• Once the amount of
• Once the amount of
expenses not
reimbursed under this
plan as a result of the
application of the
dispensing fee or the
reimbursement level
has reached $10,000
for a family in a
benefit year, eligible
expenses incurred by
that family will be paid
at 100% for the
remainder of the
benefit year.
expenses not
reimbursed under
this plan as a result of
the application of the
dispensing fee or the
reimbursement level
has reached $10,000
for a family in a
benefit year, eligible
expenses incurred by
that family will be
paid at 100% for the
remainder of the
benefit year.
Hospital accommodation
Reimbursement for the difference between the cost of ward and semi-private accommodation
(applies to rehab only).
Core
Enhanced
Premium
• No coverage
• 80% reimbursement of
eligible expenses
• 100% reimbursement of
eligible expenses
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Ambulance
Charges for licensed ambulance service to the nearest hospital where adequate treatment
is available.
Core
Enhanced
Premium
• 70% reimbursement of
eligible expenses
• 80% reimbursement of
eligible expenses
• 90% reimbursement of
eligible expenses
Diagnostic services
Charges by a licensed medical laboratory for diagnostic services not covered by a
government plan.
Core
Enhanced
Premium
• 70% reimbursement of
eligible expenses,
• $1,000 annual maximum
• 80% reimbursement of
eligible expenses
• 90% reimbursement of
eligible expenses
Out-patient services
Charges for services furnished by a hospital or for supplies prescribed by a physician or
surgeon obtained from a hospital’s out-patient department or from a surgical supply company.
Core
Enhanced
Premium
• No coverage
• 80% reimbursement of
eligible expenses
• 90% reimbursement of
eligible expenses
Private duty nursing
Fees for medically necessary, out-of-hospital private duty nursing by a registered nurse or
registered nursing assistant up to the plan option maximum.
Core
Enhanced
Premium
• 70% reimbursement of
eligible expenses; up to
$5,000 annually
• 80% reimbursement of
eligible expenses; up to
$10,000 annually
• 90% reimbursement of
eligible expenses; up to
$15,000 annually
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Wellness practitioner services
Reimbursement for the services of qualified practitioners and Beacon Cognitive Behavioral
Therapy (CBT).
Reasonable and Customary limits in your geographical area apply.
Core
Enhanced
Premium
• 100% reimbursement
• $2,500 maximum annually
for mental health
practitioners, including
licensed psychologists or
social workers, licensed
psychotherapists or family
therapists, or
psychotherapists or family
therapists who are active
members of a provincial
association approved by
Sun Life or clinical
counsellors who are active
members of a provincial
association approved by
Sun Life.
• 100% reimbursement
• Combined maximum of
$1,000 annually for various
practitioners, including
massage therapists,
speech therapists,
physiotherapists,
naturopaths,
acupuncturists,
osteopaths, chiropractors,
podiatrists, chiropodists,
audiologists, dieticians,
and occupational
therapists
• $2,500 for mental health
practitioners, including
licensed psychologists or
social workers, licensed
psychotherapists or family
therapists, or
psychotherapists or family
therapists who are active
members of a provincial
association approved by
Sun Life or clinical
counsellors who are active
members of a provincial
association approved by
Sun Life.
• 100% reimbursement
• Combined maximum of
$1,200 annually for various
practitioners, including
massage therapists,
speech therapists,
physiotherapists,
naturopaths,
acupuncturists,
osteopaths, chiropractors,
podiatrists, chiropodists,
audiologists, dieticians,
and occupational
therapists
• $5,000 for mental health
practitioners, including
licensed psychologists or
social workers, licensed
psychotherapists or family
therapists, or
psychotherapists or family
therapists who are active
members of a provincial
association approved by
Sun Life or clinical
counsellors who are active
members of a provincial
association approved by
Sun Life.
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Vision care
Reimbursement for eye exams
• One every 12 months per insured person under age 21
• One every 24 months years per insured person aged 21 or over
Reimbursement for prescription glasses and contact lenses.
Core
Enhanced
Premium
• No coverage
• • 100%; $300/24 months
for eyeglasses/contact
lenses; 80% - 1 eye exam
every 24 months (12
months for children under
21)
• • 100%; $400/24 months
for eyeglasses/contact
lenses; 100% - 1 eye exam
every 24 months (12
months for children under
21)
Accidental dental care
Charges by a dentist to repair or replace natural teeth damaged as a result of a direct external
accidental blow to the mouth. Recommended treatment must be received by Sun Life within
90 days of the accident and treatment completed no later than one year after the accident.
Core
Enhanced
Premium
• 70% reimbursement of
eligible expenses up to a
maximum of $2,000 per
person
• 80% reimbursement of
eligible expenses up to a
maximum of $2,000 per
person
• 100% reimbursement of
eligible expenses up to a
maximum of $2,000 per
person
Hearing aids
Hearing aids prescribed by an ear, nose, and throat specialist, up to the maximum indicated in
the Benefit Summary. Installation, repairs, and maintenance are included in this maximum.
Batteries are included with initial purchase only.
Core
Enhanced
Premium
• Not covered
• 80% reimbursement of
eligible expenses to a
maximum of $500 per
person in any 48-month
period
• 90% reimbursement of
eligible expenses to a
maximum of $750 per
person in any 48-month
period
Prosthetic appliances
Charges for certain prosthetic appliances (artificial limbs, splints, and braces).
Core
Enhanced
Premium
• Not covered
• 80% reimbursement of
eligible expenses
• 90% reimbursement of
eligible expenses
36
Custom-made orthopedic shoes
One pair per calendar year per insured person, when prescribed by a physician.
Core
Enhanced
Premium
• Not covered
• 80% reimbursement of
eligible expenses
• 90% reimbursement of
eligible expenses
Custom-made orthotics
Amount every 60 months per insured person or every 12 months for dependent children
under age 22 when prescribed by a Physician, Podiatrist or Chiropodist.
Core
Enhanced
Premium
• Not covered
• 80% reimbursement of
eligible expenses, $300
maximum
• 90% reimbursement of
eligible expenses, $350
maximum
Medical aids, appliances, and supplies
Charges to rent or purchase medically necessary supplies (e.g., medicated dressings, surgical
stockings, continuous glucose monitor for type 1 diabetes, oxygen), mobility equipment (e.g.,
wheelchairs, crutches, walkers), and durable medical equipment (e.g., manual hospital beds,
respiratory and oxygen equipment).
Core
Enhanced
Premium
• Not covered
• 80% reimbursement of
eligible expenses
• 90% reimbursement of
eligible expenses
Gender affirmation procedures
Costs for eligible procedures for gender transitioning.
Core
Enhanced
Premium
• Not covered
• 80% reimbursement of
• 90% reimbursement of
eligible expenses to a
eligible expenses to a
$50,000 lifetime maximum
$50,000 lifetime maximum
Travel Benefit (out-of-province/ out-of-Canada coverage)
Reimbursement for reasonable and customary costs associated with treatment required as a
result of a medical emergency that occurs while traveling outside the province of residence.
Expenses are covered for up to 60 consecutive days per trip, up to a maximum of $1,000,000
per insured person.
Core
Enhanced
Premium
• 100% reimbursement of
eligible expenses
• 100% reimbursement of
eligible expenses
• 100% reimbursement of
eligible expenses
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Out-of-Pocket Maximum
Once the amount of prescription drug expenses not reimbursed under this plan as a result of
the application of the dispensing fee or the reimbursement level has reached $10,000 for a
family in a benefit year, eligible expenses incurred by that family will be paid at 100% for the
remainder of the benefit year.
Eligible Expenses
Your health expenses are covered under the benefits plan if they are:
• Considered an eligible expense, as determined by Sun Life
• Reasonable and customary, as determined by Sun Life
• Medically necessary for the treatment of sickness or injury and recommended by a physician
where required
• Incurred while you and/or your dependents were enrolled under the plan
• Not covered under the provincial plan or any other government-sponsored plan
Minimum RAMQ drug requirements will be adhered to for participants who reside in Quebec.
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Drug Plan, Reformulary and DrugFinder
3-tier pricing formulary
Your benefits program will reimburse you for prescriptions based on the pricing
formulary outlined in the table below. This approach is about providing you with
the best medical outcome at the most reasonable cost while ensuring you and
your dependents have access to a wide range of prescription drugs.
Core
Enhanced
Premium
Tier 1
70%
80%
90%
Tier 2
40%
50%
60%
Tier 3
20%
20%
30%
Coverage description
• Drugs are placed into tiers based on a combination of their medical effectiveness and cost
• The most preferred drugs are rated as “Tier 1” and the less effective drugs (less preferred
drugs) rated as “Tier 2 or 3”. The most effective drugs (rated as Tier 1) cost the least amount
for employees. Tier 2 and 3 drugs, which are less effective, will cost employees the most outof-pocket expenses.
To find out if a drug is covered under Tier 1, Tier 2 or Tier 3:
1. The pharmacist can check which tier a drug is covered under using your drug card; or
2. You can use the drug look-up tool on the Sun Life plan member website or the
mobile app. This tool will provide you with how much it’s covered for, if there are drug
alternatives and further information on the drug, such as what form(s) it comes in,
how to use the medication, etc.
Web:
From the Sun Life plan member website, select coverage > Drug coverage > DrugFinder or
Drug Look Up
Mobile:
From the mobile app, select my coverage > Drug > Drug coverage
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What’s the difference between a brand name and a generic drug?
There is no difference as far as quality, purity, effectiveness, and safety between generic
drugs and higher-priced brand name drugs. All drugs sold in Canada must be approved by
Health Canada. Generic drugs are simply cheaper copies of brand name drugs whose patents
have ended.
Many drugs are available in generic form and can help treat you in the same way as the
brand version. As always, you should consult with your doctor and pharmacist to discuss the
treatment that is right for you.
Special and Prior Authorization
Prior authorization (PA) requires Sun Life to pre-approve coverage for certain drug therapies
based on medical criteria. This ensures that specialty drugs are covered when they are most
needed – it does not include drugs that are time sensitive.
Treatments for the following disease categories that commonly require PA:
• Ankylosing spondylitis
• Asthma
• Oral cancer drugs
• Crohn’s disease
• Hepatitis
• Lupus
• Multiple sclerosis
• Muscle-nerve disorder
• Osteoporosis
• Plaque arthritis
• Psoriatic arthritis
• Pulmonary arterial
hypertension
• Rare diseases
• Rheumatoid arthritis
The PA drug listing is updated on a quarterly basis – drugs may be added or removed at
Sun Life’s discretion.
When you take your prescription to the pharmacy, the pharmacist will advise if PA is required.
Also, if you have a condition for which drugs commonly require PA, you can:
• Contact the Sun Life Customer Care Center to confirm coverage requirements
• Use Sun Life’s drug look-up tool:
Web:
From the Sun Life plan member website, select coverage > Drug coverage > Drug look up
Mobile:
From the mobile app, select my coverage > Drug > Drug coverage
40
Process for submitting a Special and Prior Authorization request
1. When you take your prescription to the pharmacy, the pharmacist will advise if
PA is required
2. Upon notification, visit the Sun Life plan member website and print the applicable form for
completion by you and your doctor
3. Once completed, send the form to Sun Life for processing. Sun Life will review the request
and will notify you of the decision by mail. If you’d like to check the status of your PA request
you can contact the Sun Life Customer Care Centre
The Employee Benefits Program (Flex) will not cover the cost associated with the completion of
forms by doctors. Expenses can be submitted through the health spending account (HSA), if
you have credits available.
Forms will be available on the Sun Life plan member website. Visit HR Connect and select
“My Rogers Employee Benefits Account” from the Quick Links menu. From the plan member
website, select My coverage > Drug coverage > Drug look up.
Forms are also available at http://www.sunlife.ca/priorauthorization. Enter our contract number
(150302) and select the appropriate PA form.
Dispensing Fee
You will be reimbursed the dispensing fee for a prescription drug up to a maximum of $4 per
prescription under the core plan, $5 under the enhanced plan and $6 under the premium plan.
The dispensing fee is the professional fee a pharmacist charges, and these fees vary widely
from pharmacy to pharmacy.
Here’s an example to illustrate how dispensing fees work:
Bob is a full-time Rogers team member enrolled in the premium health plan. His pharmacist
charges a $12 dispensing fee. Since the premium plan pays a maximum dispensing fee of $6,
the portion of the fee Bob is responsible for is $6 ($12 – $6 = $6).
Bob uses this pharmacy, although they charge a fee higher than $6, because he values the
services it provides. At some point, Bob may decide he wants to reduce his share of medical
expenses and negotiate a lower fee with his current pharmacy or shop around and find a
pharmacy that charges a dispensing fee under $6.
41
Pay Direct Drug Card
The Rogers Employee Benefits Program
(Flex) provides you with a pay direct drug
card. The pay direct drug card makes
claiming simpler and easier. When you
are purchasing prescription drugs and
you give your pay direct drug card to the
pharmacist, your share of the cost is
calculated right away, and you pay only
that amount at the pharmacy. The
pharmacist uses the information on your
drug card to bill expenses directly for
reimbursement on your behalf.
Medication Used to Treat Infertility
Our drug plan covers prescription medication for the treatment of infertility, up to a lifetime
maximum of $15,000 (up to 6 cycles). To confirm if your prescribed medication is covered
under the plan, use the drug lookup tool on the mobile app or plan member website.
Web:
From the Sun Life plan member website, select coverage > Drug coverage > Drug look up
Mobile:
From the mobile app, select my coverage > Drug > Drug coverage
Trial and Maintenance Program
This program is optional – the pharmacist will ask the member if they would like to participate.
Members that elect to not participate will have to cover any additional expenses.
Trial program
Maintenance program
Allows you to have a small quantity (usually
7 days worth) of a new prescription dispensed
so that you can try it out and see if it works for
you. If the drug works for you, then the
pharmacist can dispense the rest of the
prescription. If the drug is not suitable, then
you’ve saved money and reduced waste by
not having the full prescription filled.
Encourages plan members to get a threemonth supply of their drugs at a time.
Purchasing a larger quantity at one time will
save you time by not having to make
repeated trips to the pharmacy and will also
save you money on dispensing fees. This
program includes acute drugs (drugs that
are typically taken for short term conditions)
if they are being taken for a prolonged
basis (3+ months).
42
Drugs Not Covered
Drugs not covered under the benefits plan include, but are not limited to:
• Vitamins or food supplements
• Drugs or items that can be purchased over the counter without a prescription
• Drugs intended for experimental purposes or where the treatment has not been approved
by Health Canada
• Drugs themselves that have not been approved by Health Canada
• Drugs covered by your provincial health plan
• Drugs used for weight loss or anti-obesity treatment
• Vaccines not legally requiring a prescription
• Smoking cessation aids
• Hair growth stimulants
How can I manage my prescription drug costs?
Prescription drugs are a good example of where you can manage your expenses within
the Employee Benefits Program (Flex). There are several ways to manage your prescription
drug costs:
• If you are currently using a brand name drug, talk to your doctor to see if generic drugs are a
possible option for you
• Discuss dispensing fees with your pharmacist or shop around for lower fees, as they can vary
between pharmacies
• Talk to your doctor and/or pharmacist about:
o A 90-day supply of any maintenance drugs (i.e., drugs taken for a longer period of time).
This way, the dispensing fee will be paid only once for a three-month supply
o Trial prescriptions (i.e., smaller quantities of new medications to determine effectiveness
and suitability for treatment)
43
Wellness Practitioners
A variety of wellness practitioner services are covered based on the health option you select.
Reimbursement levels and maximums apply to each participant enrolled under your plan, per
calendar year. For example, if you regularly visit a registered massage therapist, chiropractor,
and podiatrist, each covered person in your family may be reimbursed up to the maximum
based on the option you select.
Charges for some wellness practitioner services may be payable in part by your provincial
health plan. In those provinces, eligible expenses under the benefits plan are payable only
after the provincial plan’s maximum for the benefit year has been paid.
Eligible Practitioners
Core
Enhanced
Premium
Mental Health
Practitioners*
$2,500 annual
maximum
Physiotherapist
Not covered
Acupuncturist
Not covered
Audiologists
Not covered
Chiropodist
Not covered
Chiropractor
Not covered
Dieticians
Not covered
Registered massage
therapist
Not covered
Naturopath
Not covered
Occupational
therapist
Not covered
Osteopath
Not covered
Podiatrist
Not covered
Speech pathologist
Not covered
$2,500 annual
maximum
Annual combined
maximum of $1000
Annual combined
maximum of $1000
Annual combined
maximum of $1000
Annual combined
maximum of $1000
Annual combined
maximum of $1000
Annual combined
maximum of $1000
Annual combined
maximum of $1000
Annual combined
maximum of $1000
Annual combined
maximum of $1000
Annual combined
maximum of $1000
Annual combined
maximum of $1000
Annual combined
maximum of $1000
$5,000 annual
maximum
Annual combined
maximum of $1200
Annual combined
maximum of $1200
Annual combined
maximum of $1200
Annual combined
maximum of $1200
Annual combined
maximum of $1200
Annual combined
maximum of $1200
Annual combined
maximum of $1200
Annual combined
maximum of $1200
Annual combined
maximum of $1200
Annual combined
maximum of $1200
Annual combined
maximum of $1200
Annual combined
maximum of $1200
* Licensed psychologists or social workers, licensed psychotherapists or family therapists, or psychotherapists or family
therapists who are active members of a provincial association approved by Sun Life or clinical counsellors who are active
members of a provincial association approved by Sun Life. This also includes Beacon Cognitive Behavioural Therapy (CBT).
44
TIP
Before receiving any services from a practitioner be sure to confirm that their
credentials meet the eligibility requirements to be covered by the plan.
Beacon is a confidential mental well-being treatment option that provides Cognitive
Behavioural Therapy (CBT) and support. It’s a self-directed, therapist-assisted program
that is accessible on the digital platform of your choice (computer or mobile device).
Beacon is available to employees and eligible dependents who are covered under the
Health Plan. To utilize this service and find out additional details, visit:
http://www.mindbeacon.com/rogers.
Vision
If you or your eligible dependents incur expenses for contact lenses or eyeglass lenses that are
prescribed by a licensed physician or optometrist for the correction of impaired vision, the plan
will reimburse you for the reasonable charges, based on the option you select up to the
following maximums:
Core
Enhanced
Premium
No coverage
• 100% reimbursement of
eligible expenses; glasses,
frames, contact lenses and
laser eye surgery are
covered to a maximum of
$300 per covered person
• 80% reimbursement of
eligible expenses,
Eye exams are covered
once every 24 months
for each covered person
(once every 12 months
for dependents under
age 21)
• 100% reimbursement of
eligible expenses;
Glasses, frames, contact
lenses and laser eye
surgery are covered to a
maximum of $400 per
covered person
• 100% reimbursement of
eligible expenses,
Eye exams are covered
once every 24 months
for each covered person
(once every 12 months
for dependents under
age 21)
The following vision care expenses are not covered by the plan:
• Safety glasses
• Non-corrective glasses or sunglasses
• Any other vision care expense that is covered by your provincial health plan
45
Other Expenses
For a summary of other health expenses covered by the Employee Benefits Program (Flex), see
the At-A-Glance Chart. If you require a more detailed explanation of expenses that are eligible
under the Employee Benefits Program (Flex), see the Contact Information section for
additional details.
Travel Benefit
Rogers Travel Benefit Coverage is
provided to you in association with
Sun Life’s Travel Assistance provider,
Global Excel Management.
A Medical Emergency is an acute illness or accidental injury that requires immediate,
medically necessary treatment (for you and/or your eligible dependents) prescribed by a
doctor while travelling outside your province of residence. Emergency services include any
reasonable medical services or supplies including advice, treatment, medical procedure, or
surgery, required as a result of an emergency. When you or your covered dependents have a
chronic condition, emergency services do not include treatment provided as part of an
established management program (treatment plan) that existed prior to leaving your province
of residence.
Important details related to your Travel Benefit include:
• Coverage is only available for a maximum of 60 consecutive days (including the departure
date) and limited to $1,000,000 per covered person per trip
• The Global Excel Management (GEM) 24-hour Operations Centre must be contacted before
receiving medical care, if possible. The contact information for the centre can be found on
the back of your Travel Card. Please note, any invasive and investigative procedures (e.g.,
surgery, angiogram, MRI) must be pre-authorized by GEM, except in extreme circumstances.
If GEM is not contacted, your claim(s) could be reduced or declined
• GEM will facilitate and monitor the course of your treatment and deal directly with your
health care providers to ensure you are receiving the appropriate care
• Eligible health expenses include but not limited to: all services and supplies while in hospital,
outpatient and physician services, ground ambulance service to the nearest hospital,
transportation to the province where you live for medical treatment (as appropriate), etc.
46
• Additional Emergency Support Services include: referrals in locating a physician,
pharmacists and/or medical facilities, hotel accommodation and meals for you or your
dependents (if applicable), facilitating payments to a hospital or medical provider
(if possible), assistance with replacing lost or stolen travel documents and luggage,
translation services, repatriation, etc.
• Expenses will be coordinated with your provincial health insurance plan and will be subject
to reasonable & customary limits
• Expenses will only be covered while deemed medically necessary. Expenses are no longer
medically necessary when medical evidence supports you, or your dependent’s ability to
return to your province of residence
• Coverage may be subject to limits and/or exclusions and you are encouraged to familiarize
yourself with these before you begin your trip
How can I obtain my Travel Benefit Card?
• You can obtain your pre-populated Travel Benefit Card
by visiting the Sun Life plan member site through the
Quick Links menu on HR Connect. Select Print Travel
Card from Quick Links on the Group Benefits page.
• It’s crucial that you carry the card when travelling
outside your province of residence.
• You can also use your smartphone as your Travel Card by downloading the free app, my Sun
Life Mobile, from the Apple App Store or Google Play. To access your Travel Card, sign into
my Sun Life Mobile using your access ID and password, from the main menu. Select my
health and well-being, followed by my coverage card, and select Travel Card
Print your Travel Card or download the Sun Life mobile app to access your Travel Card
before travelling.
Upon contacting GEM, ensure you’re able to provide the following information:
• Your full name and Certificate number (Rogers person number and Plan/Group number
(150302). This information is on your Travel Card.
• Name, location, and provincial health plan number of the individual for whom the treatment
is required
• Details of your emergency regarding both the emergency and the type of assistance needed
• Contact information of where you can be reached during the medical emergency
• Date of when the emergency occurred, departure date, your province of residence and your
scheduled return date
• Please note, this is a summary of your eligible Travel Benefit coverage. For additional details,
please contact GEM by referring to the Contact information section of this Handbook.
47
Dental Coverage
The dental coverage is designed to help you pay for the cost of routine dental services – such
as regular check-ups, fillings, and extractions – and major dental work, such as dentures,
crowns, and bridges. The plan pays according to the current year’s dental fee guide. If you live
in Quebec, Rogers contributions to your dental coverage premiums are considered a taxable
benefit and will be reported on your Relevé 1.
Your dental coverage ends on the earliest of the date your employment ends, your retirement
or when you are no longer eligible based on the plan rules. There is no age limitation on dental
coverage.
What is a dental fee guide?
Dental fee guides are publications prepared by most provincial dental associations. They
provide guidelines about reasonable and customary dental fees for the current year, for either
the province in which you live or the province in which you incurred the dental expense.
Dental At-A-Glance
Flexible Benefits
Basic services
Core
Enhanced
Premium
• 70% reimbursement
of eligible expenses
• Annual maximum: $500
per year, per covered
person
• Recall exam: recall oral
examinations, complete
oral or specific
examinations (once every
12 months for adults and
once every 6 months for
a child under age 18)
• 80% reimbursement of
eligible expenses
• Annual maximum: $1,500
per year, per covered
person, combined with
major services
• Recall exam: recall oral
examinations, complete
oral or specific
examinations (once every
9 months for adults and
once every 6 months for a
child under age 18)
• 100% reimbursement of
eligible expenses
• Annual maximum: $1,500
per year, per covered
person
• Recall exam: recall oral
examinations, complete
oral or specific
examinations (once every
9 months for adults and
once every 6 months for a
child under age 18)
48
Major services
Core
Enhanced
Premium
• No coverage
• 50% reimbursement of
eligible expenses
• Annual maximum: $1,500
per year, per covered
person, combined with
basic services
• 60% reimbursement of
eligible expenses
• Annual maximum: $1,500
per year, per covered
person
Core
Enhanced
Premium
• No coverage
• No coverage
• 60% reimbursement
• Lifetime maximum: $2,500
per covered child underage 19
Core
Enhanced
Premium
• No lock-in period
• No lock-in period
• 2-year lock in period.
Orthodontics
Lock in period
Premium dental coverage has a 2-year lock-in period. This means that if you choose premium
dental, you cannot reduce coverage to core or enhanced for 2 calendar years.
Eligible Dental Expenses
Eligible expenses are those which are recommended as necessary by a physician or dentist and
are not in excess of the dental fee guide. Dental treatments are considered eligible if
performed by a dentist or denturist who practices within the scope of his or her license. You
must confirm treatment and eligibility with Sun Life by requesting a predetermination of
benefits prior to incurring expenses of more than $500 to avoid claims being declined due to
ineligibility.
Basic Services
Eligible basic services are reimbursed by the dental plan based on the option you select. You
pay the remainder of the expense as well as all amounts above the maximum.
Eligible basic services include:
• Complete X-ray series once every 24 months
• Fillings
• Extractions
• Oral surgery
49
• Scaling of 12 units per year (this includes one unit of scaling and one unit of polishing
covered under the preventive care benefit)
• Periodontics (including periodontal surgery and root planning)
• Endodontics (including root canal therapy)
• Space maintainers and retainers for missing primary teeth
• Anesthesia in conjunction with covered dental services
• Emergency or initial oral examinations (once per dentist)
• Bitewing X-rays
• Cleaning
• Oral hygiene instruction – once per lifetime
Major Services
Eligible major services are reimbursed by the dental plan based on the option you select. You
pay the remainder of the expense as well as all amounts above the maximum.
Eligible major services include:
• Inlays and onlays
• Crowns
• Bridgework and repairs to bridgework
• Dentures (one denture per arch every 5 years, including remakes)
• Rebasing, relining, and repair of dentures
Orthodontic Services
Eligible orthodontic services are covered under the premium option for dependent children
under 19 only and are reimbursed at 60% to a lifetime maximum of $2,500 per dependent
child. You pay the remainder of the expense as well as all amounts above the maximum.
Dependent children must be under 19 years of age for the duration of treatment.
For further details on health and dental coverage, limitations, and exclusions, contact Sun Life.
See the Contact Information section of this Handbook.
Get an early estimate for expensive dental treatments
If you are going to receive dental treatment that costs $500 or more, you must have Sun Life
complete an advance review to determine eligibility and reimbursement level for your
treatment. This will help you find out before proceeding how much the benefits plan will cover
and how much you will pay out of your own pocket.
To receive an advance review, ask your dentist for a detailed treatment plan – this is called a
“predetermination”. Then submit it to Sun Life before your treatment begins. A
predetermination will identify whether a specific service is covered and clarify the
reimbursement percentages, limits, and the dental fee guide allowance, and will identify what
costs to expect ahead of time.
50
Basic Life Insurance
Basic Life
Basic employee life insurance provides your beneficiary(ies) with a tax-free, lump-sum
payment if you die while covered by this life insurance benefit. This benefit is designed to
provide financial security for your survivors or financial support to any person or organization of
your choice in the event of your death. Rogers contributions to pay for your basic life insurance
premiums are considered a taxable benefit to you.
Benefit
Basic Life
Core
Enhanced
Premium
• Full-time: 1x regular
earnings
• Part-time: $30,000
• Reduction: 50% at age 65,
further 50% at age 70 to
75 to a max of $30,000
• Full-time: 2x regular
earnings
• Part-time: Core only
• Reduction: 50% at age 65,
further 50% at age 70 to
75 to a max of $30,000
• Full-time: 3x regular
earnings
• Part-time: Core only
• Reduction: 50% at age 65,
further 50% at age 70 to
75 to a max of $30,000
“Regular annual earnings” includes your annual base pay plus any sales commissions (if
applicable), but excludes overtime pay, bonuses, and other special compensation. Your basic
life insurance coverage will increase along with your earnings, effective on the date that your
earnings change.
During your initial enrolment window, you may elect between core and enhanced coverage
without having to provide proof of good health up to $1,000,000. The premium option
coverage will require evidence of good health during the initial enrollment period. Following
your initial enrollment, you can change your option during the annual enrolment period or
within 31 days of a life event change (90 days for birth, adoption, or legal guardianship of a
child). Evidence of good health is required for any increase in coverage following your initial
enrollment.
To initiate a claim or if you have any questions, contact HR Connect.
51
What’s a beneficiary?
A beneficiary is a person or organization that has a
right to proceeds from a benefits plan. You are
encouraged to designate a beneficiary to receive any
benefit amount due in the event of your death. If you
die, benefits are paid to the beneficiary(ies) you have
chosen. If you do not select a beneficiary, benefits will
be paid to your estate. You are the automatic
beneficiary for optional life insurance that you purchase
for your dependents.
If you designate a minor as your beneficiary, you should
consider assigning a trustee for them (as provincially
required). If a trustee is assigned, the benefit can be
paid to the trustee. If no trustee is assigned, the benefit
will not be paid until the minor attains age of majority.
You can designate or change your beneficiaries online
from the Benefits Election Portal; you are encouraged
to review your beneficiaries often to ensure that they
remain current.
Optional Life Insurance
You may choose to purchase optional life insurance for yourself or your spouse/partner
to supplement the coverage provided by basic life insurance.
Benefit amount
• You may purchase additional coverage for yourself and your spouse/partner in units of
$10,000, up to a maximum of $500,000.
• Reduction 50% reduction at age 70, to a maximum of $30,000 to age 75.
Optional life insurance costs are available on HR Connect. You will notice that rates vary by age,
gender, and smoking status. Rates are higher for smokers. If you have not used nicotine
products of any kind within the past 12 consecutive months, you are considered a non-smoker
under the plan.
You must provide evidence of good health before your application for optional life insurance
can be approved or if you are increasing your coverage. If you purchase optional life insurance
for your spouse/partner, this requirement will also apply to him or her. Note that you are
automatically the beneficiary for any spousal life insurance.
Your optional life insurance coverage ends on the earliest of the date your employment ends,
your retirement, when you are no longer eligible based on the plan rules, or when you reach
age 75.
52
Basic Accidental Death and
Dismemberment Insurance
The benefits plan provides you with a basic level of accidental death and dismemberment
(AD&D) insurance. AD&D insurance provides a tax-free, lump-sum benefit in the case of
accidental death or dismemberment or the loss of use of limbs, sight, speech, or hearing.
AD&D insurance offers you full 24-hour protection against accidents – on or off the job, on
business, on vacation, at home – regardless of your health history.
The benefit is payable to your beneficiary(ies). If you have not named a beneficiary or your
beneficiary is not living at the time of your death, the benefit will be paid to your estate. Any
other benefits, including those provided on behalf of your dependents, are payable to you.
Rogers contributions to pay for your basic AD&D insurance premiums are considered a taxable
benefit to you.
Benefit
Basic AD&D
Core
Enhanced
Premium
• Full-time: 1x regular
earnings
• Part-time: $30,000
• Reduction: 50% at age 65,
further 50% at age 70 to
75 to a max of $30,000
• Full-time: 2x regular
earnings
• Part-time: Core only
• Reduction: 50% at age 65,
further 50% at age 70 to
75 to a max of $30,000
• Full-time: 3x regular
earnings
• Part-time: Core only
• Reduction: 50% at age 65,
further 50% at age 70 to
75 to a max of $30,000
53
The principal benefit amount is payable if you die. For losses other than death, you may receive
a full or partial benefit. The portion paid is based on the severity of the injury, as outlined in the
following table:
Loss or Injury
Percentage of Benefit Amount
Life
100%
Both hands or both feet
100%
Entire sight of both eyes
100%
One hand and one foot
100%
Use of one hand and one foot
100%
One hand and entire sight of one eye
100%
Use of one hand and entire sight of one eye
100%
One foot and entire sight of one eye
100%
Use of one foot and entire sight of one eye
100%
Speech and hearing in both ears
100%
Brain death
100%
Use of both arms, both hands, both legs, or both feet
200%
Quadriplegia
200%
Paraplegia
200%
Hemiplegia
200%
One arm or one leg
75%
Use of one arm or one leg
75%
One hand or one foot
66 2⁄3%
Entire sight of one eye
66 2⁄3%
Use of one hand or one foot
66 2⁄3%
Speech or hearing in both ears
66 2⁄3%
Thumb and index finger of same hand
33 1⁄3%
Use of thumb and index finger of same hand
33 1⁄3%
Four fingers of same hand
33 1⁄3%
Use of four fingers of same hand
33 1⁄3%
Hearing in one ear
33 1⁄3%
All toes of same foot
25%
54
A loss of use must continue for 12 consecutive months and be determined to be permanent
before the benefit for loss of use is payable. AD&D insurance will cover losses shown in the
table above that occur within 12 months of the accident and are a direct result of the accident if
the loss is total and irreversible or irrecoverable. Only one benefit (the larger one) is paid if
more than one loss occurs from the same accident.
To initiate an AD&D claim or if you have any questions, contact HR Connect.
AD&D insurance does not cover any loss that is the result of:
• Loss incurred while traveling to a zone deemed as a war-risk by the insurer (unless travelling
on company business)
• Intentionally self-inflicted injuries, suicide, or any attempted threat, while sane or insane
• War or any act thereof
• Flying in an aircraft owned or leased by your employer, yourself, or a member of your
household, or aircraft being used for any test or experimental purpose, firefighting, powerline
inspection, pipeline inspection, aerial photography, or exploration
• Full-time, active duty in the armed forces
• Flying as pilot or crew member in any aircraft or device for aerial navigation
Your AD&D insurance coverage ends on the earliest of the date your employment ends, your
retirement, when you are no longer eligible based on the plan rules or when you reach age 75.
Critical Illness Insurance (Part-time Employees Only)
and Optional Critical Illness Insurance
The plan offers a benefit in case of serious illness in the form of critical illness insurance. This
insurance provides you with a one-time, lump-sum benefit if you are diagnosed with one of the
following 22 covered conditions:
• Alzheimer’s Disease
• Aorta Surgery
• Benign Brain Tumour
• Blindness
• Cancer
• Coma
• Coronary Artery Bypass
Surgery
• Deafness
• Dismemberment
• Heart Attack
• Heart Valve Replacement
• Loss of Independence
• Loss of Speech
• Major Organ Failure
• Major Organ Transplant
• Motor Neuron Disease
• Multiple Sclerosis
• Occupational HIV Infection
• Paralysis
• Parkinson’s Disease
• Severe Burns
• Stroke
55
Basic Critical Insurance
• Part-time team members only - $10,000 lump sum benefit
Optional Critical Illness for yourself or your spouse/partner
• Units of $5,000, up to $50,000. Evidence of good health is not required for enrollment
The benefit is paid to you if you survive for 30 consecutive days after the diagnosis of the
covered condition and the claim is approved based on criteria established for each condition.
The benefit is not payable for a pre-existing condition or for a condition that occurs within
12 months after the date you are first covered by optional critical illness insurance. The
pre-existing condition clause does not apply for basic critical illness insurance (part-time
team members only).
Your critical illness insurance coverage ends on the earliest of the date your employment ends,
your retirement, when you are no longer eligible based on the plan rules or when you reach
age 75.
To initiate a critical illness claim or if you have any questions, contact HR Connect.
56
Vacation Buy Program for full-time team members
Through our vacation buy program, you can purchase extra vacation days to add to your annual
vacation entitlement, during our annual enrollment period. Purchased vacation days must be
used in the year they are bought and cannot be carried over into the following year based on
CRA requirements. Vacation days must be used in the following order:
1. Vacation Carryover (if applicable)
2. Vacation Buy (if applicable)
3. Annual Vacation Entitlement
Refer to HR Connect for more details.
You will be able to purchase additional vacation days in increments of 1 day, up to the
maximum of 5 days (or 1 work week). The cost to purchase your additional time off is based on
your salary and is deducted over 26 pay periods. Flex credits cannot be used to purchase
additional days.
Let’s take a look at the cost for Sumeet to buy additional vacation days
(let’s assume Sumeet makes $61,000 per year):
Number of
Vacation Days
Total Cost
Per-pay Deduction
1 day
$233
$9
2 days
$466
$18
3 days
$700
$27
4 days
$932
$36
5 days
$1,165
$45
*Part-time, hourly, and unit-based team members are not eligible to participate in this offering.
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Survivor Benefits
If you die while your dependents are covered under this Employee Benefits Program (Flex),
Rogers will continue health and dental care benefits in force at the time of death without
requiring any additional premium contribution, until the earliest of:
• the date your dependent is no longer a dependent, according to the definition of
dependent
• the date similar coverage is obtained elsewhere
• the date which is 24 months from your death, or
• the date the Plan terminates
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Leaving Rogers
Your Employee Benefits coverage will terminate on your last day of employment. You have the
option to convert some of your existing benefits to an individual plan without submitting
evidence of good health. You will be responsible for paying the premiums at individual
insurance rates directly to the benefit provider. To convert, your application must be submitted
to Sun Life Financial within sixty (60) days for health and dental benefits and thirty-one (31)
days to HR Connect for life insurance, AD&D insurance, and critical illness insurance from the
termination date of coverage.
Any eligible Health & Dental claims incurred by you or your dependents prior to your last day
of employment, must be submitted to Sun Life the earlier of 90 days from the date of
termination from the Employee Benefits Program (Flex) or 90 days following the year in which
the expense was incurred. You will also have 90 days from the date of termination from the
Employee Benefits Program (Flex) or 90 days following the year in which the expense was
incurred to submit eligible expenses for reimbursement through your HSA and/or PSA.
Following this, any remaining credits in your HSA and/or PSA will be forfeited.
For health and dental coverage conversion, you can contact Sun Life toll-free at
1-866-224-3906 to obtain additional information on their individual health and dental
insurance plans.
For life insurance, AD&D conversions and/or critical illness, you can contact the Rogers HR
Connect Support Centre at 1-877-935-7577 for additional details.
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Contact Information
If you have questions about the Rogers Employee Benefits Program (Flex),
you can contact:
Benefit
Contact Information
HR Connect
Contact HR Connect for
questions related to your
coverage and eligibility
and to update your
personal information
(contact info, address,
bank account)
Telephone: 1-877-935-7577
HR Connect representatives are available Monday to Friday
Email: HRConnect@rci.rogers.com
Sun Life Financial
Contact Sun Life for
questions related to your
Health and Dental
coverage and the status
of your claims
Telephone: 1-855-214-3080
Available Monday to Friday, 8 a.m. to 8 p.m. ET
Use the Secure Message feature on the Sun Life plan member
website for any questions
Global Excel
Management (GEM)
Contact GEM regarding
your Out-of-province /
Out-of-Country coverage
Within Canada and the United States: 1-800-511-4610
From anywhere else: 1-519-514-0351
You have the option of calling collect, if available.
From Home: www.RogersHRConnect.com
Enter your Rogers LAN ID and login password
From Home: Quick links menu on HR Connect > My Rogers
Employee Benefits Account or www.sunlife.ca/rogers to sign-in to
the plan member website, enter your Access ID and password to
log-in.
Fax: 1-519-514-0374
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Glossary
Acute drugs
Medications classified as being prescribed for short-term conditions and are typically taken
over a short period of time.
Annual Enrollment Period
A set period of time each year in November, that you may make updates to your coverage,
subject to lock-in and evidence of good health requirements.
Beneficiary
Any person who has the right to receive proceeds from a benefit plan. You designate a person
or an organization as a beneficiary by naming that person on a beneficiary form. More than one
person and/or organization may be named as beneficiary to share in benefit proceeds. Subject
to any legal restrictions or the rights of irrevocably named beneficiaries, you may change this
designation at any time.
Contingent Beneficiary
A named person who becomes the beneficiary if the primary beneficiary dies or is otherwise
disqualified.
Dependent
A person who is your spouse, your common-law partner (same or opposite sex), your child, or
the child of your spouse/partner.
Dependent Child(ren)
Your or your spouse’s/partner’s natural, legally adopted or step-children, who are unmarried,
not engaged in active employment, dependent on you or your spouse/partner for financial
support and under age 22.
Disabled Child(ren)
Natural, legally adopted or step-children who are unmarried, unemployed children 22 years of
age or over who are dependent upon you by reason of a mental or physical disability and have
been continuously disabled since before the age of 22. Unmarried, unemployed children who
become totally disabled while attending an accredited educational institution on a full-time
basis prior to age 25 (26 in Quebec for prescription drug coverage only) and have been
continuously disabled since that time also qualify as an eligible dependent.
Dispensing Fee
The professional fee charged by your pharmacist to fill your prescription. It pays for the service
of dispensing your medication and for other services, such as maintaining a history of your
medications, consulting with your doctor, and providing you with drug-related advice
(including details regarding drug interactions, foods to take/avoid during drug treatment, etc.).
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Employee Benefits Program (Flex)
This program gives you flexibility to choose options that support the personal health and
wellness needs of you and your family by enabling you to select the plan option that meets
your personalized needs.
Evidence of Good Health
A statement or proof of a person’s past and current health events to determine eligibility for
coverage by our insurer, Sun Life.
Flex Credits
You’ll receive an annual allotment of flex credits that can be used to purchase increased
coverage options for Health, Dental and Insured benefits. This allows you the added choice
and flexibility to select benefits that are tailor-made for you and your family. The amount of flex
credits you receive depends on the level of coverage you select.
Full-time Student
Natural, legally adopted or step-children who are older than 22 years of age but less than 25
years of age (26 in Quebec for drug coverage only), attending an accredited educational
institution on a full-time basis.
Health Spending Account
Health spending account (HSA) can be used to cover the costs of a wide range of eligible
health and dental expenses that qualify under the Canadian Income Tax Act.
Life Event
Certain life events may affect your benefits needs. After you enroll in the Employee Benefits
Program (Flex) for the first time, you may add dependents to or remove them from your
benefits coverage if you experience certain qualifying life events. See the Changing Your
Coverage section for more details.
Lock-in Period
The minimum period of time a plan member must remain in an option.
Maintenance Drugs
Medications classified as being prescribed for chronic, long-term conditions and are typically
taken on a regular, reoccurring basis.
Non-smoker
A person who has not used any nicotine products within the past 12 months. Nicotine products
include cigars, cigarettes, vapes, e-cigarettes, cigarillos and chewing tobacco. The “patch” or
nicotine style gum (i.e., smoking cessation products) are not considered tobacco products.
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Out-of-Pocket Maximum
A threshold offering protection in the event that you or a covered dependent incurs significant
expenses in a calendar year. The out-of-pocket maximum ensures that there is a limit on what
someone will pay out of pocket for eligible prescription drugs. Once this threshold is reached,
the plan will pay 100% of eligible prescription drug expenses for the rest of the calendar year.
Personal Spending Account
A Personal Spending Account (PSA) is an account that covers life and wellness expenses not
covered by our health plan or health spending account (HSA), such as fitness (including gym
membership fees), childcare and personal development expenses.
Reasonable and Customary
A range of fees most practitioners in each province charge for services that is used as the basis
for paying claims.
Regular Earnings
Your regular earnings and commissions (where applicable), for full-time employees, are used
to calculate your basic life, AD&D, STD, and LTD benefits. Regular earnings are your base salary
and do not include any bonus or overtime pay.
Reimbursement
Reimbursement is the portion of eligible health and dental costs that are covered by the
benefits plan. You are responsible for the balance of the expense over the amount reimbursed
by the plan. For example, the reimbursement level of eligible prescription drug expenses is
90%. If you submit an eligible prescription drug expense, the plan will reimburse you 90% of
the cost. You will pay the remaining 10%.
Smoker
A person who has used any nicotine related products (cigarettes, cigars, cigarillos, nicotine
patches, nicotine gum, chewing tobacco, and electronic vaping devices) within the past 12
months.
Spouse/Partner
Your legally married spouse, or a person of the same or opposite sex who has lived with you
continuously for a period of at least twelve months in a common-law relationship outside
marriage. You can only cover one person as your spouse at any given time.
Wellness Credits
An annual allotment of credits that Rogers provides you that are allocated to your Personal
Spending Account (PSA) account with Sun Life.
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This booklet summarizes the employee benefits coverage for regular full-time and part-time
employees of Rogers Communications. It does not describe group plan coverage for
employees whose benefit programs are prescribed by Collective Bargaining agreements. Every
effort has been made to ensure that the information contained in this handbook is correct.
However, in the event of a discrepancy between this handbook and the official benefits
program or policy information, the official program or policy information will be deemed to be
correct. Rogers reserves the right to suspend, modify, or terminate any such benefits or
programs described in this handbook at any time without notice.
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