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Health Plans for
Retired Educators

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Health Plans for Members of The Retired
Teachers of Ontario
Health & Insurance Benefits for Members of The Retired
Teachers of Ontario
RTO/ERO provides a cost effective, high quality and
competitive Group Health Insurance Plan that meets the needs of the majority
of members. The plans are affordable, well-established and financially
stable.
The RTO/ERO Health Plans are owned and managed by our
members, administered by Johnson Inc., and underwritten by Manulife
Financial.
Full and Associate RTO/ERO members who
permanently reside in Canada are eligible to participate in our Health
Plans.
The RTO/ERO Health Plans include a full spectrum of
benefits including Extended Health
Care, Semi-Private Hospital and Dental
coverage which can be purchased separately as needed.
Coverage is available in the following categories:
- Single (member only)
- Couple (member plus one dependent – either spouse,
partner or a dependent child)
- Family (member plus two or more dependents)
Dependents include a legal, common-law or same-sex
spouse; or dependent children up to age 21 or age 30 if they are unmarried
and in full-time attendance at an accredited post-secondary institution.
Join your colleagues and
have access to the largest retired educator health plan in Canada.
Our members benefit from comprehensive and affordable
health plans, a social network, a customized travel program, political
advocacy, quality bilingual services and much more.
Full Membership (Teacher, school and board
administrators): $1.20 per $1,000 of gross pension, deducted annually by the
Ontario Teachers’ Pension plan.
Associate Membership (educational sup-port staff,
university and college faculty): Contact us for fees.
Contact Us
RTO/ERO:
For information on RTO/ERO
membership and eligibility requirements to apply for RTO/ERO Health Plans,
contact RTO/ERO at 416.962.9463 or 1.800.361.9888 or visit
www.rto-ero.org.
Johnson Inc.:
For information on the RTO/ERO
Health Plans, contact Johnson Inc. at 416.920.7248 or 1.877.406.9007; or
visit
www.rto-ero.org.
Johnson Inc. serves as Consultant, Administrator and
Claims Payor for RTO/ERO’s Health Plans.
votre service...pour le soin de votre avenir.
Depuis 1968.
Here for you now ... Here for your future.
Since 1968.
REV 01/09
Health Plans for Retired Educators
and Educational Support Staff
Highlights of the Plans
Guaranteed acceptance with no medical evidence required
or late restrictions applied if you enroll within 60 days of the termination
of:
- Guaranteed acceptance with no medical evidence
required or late restrictions applied if you enroll within 60 day of the
termination of:
- School Board plan
- Spouse’s/partner’s group plan
- Any other group plan
- RTO/ERO Health Services and Insurance Committee
oversees the operation of the Health Plans
- Each of our Districts has a Health Services and
Insurance representative to assist members
- Reserves are owned by RTO/ERO
- Reserves are established to protect the RTO/ERO
Health Plans in a pandemic
- RTO/ERO is a not for profit organization. Surpluses
are "refunded" to the Health Plans for plan improvement and premium
stability
- Premium rates and coverage are the same for all ages
- Members range in age from 50 to over 100, and 99%
keep their plans for life
- Convenience services include:
- Direct payment to pharmacies (drug card)
- Electronic submission of dental claims
- Claim payments deposited directly to your
bank account
- Electronic notification of your claim
payments
- Annual Benefit Statement/Premiums and
Claims Summary Letter
- Secure, online access to Claims and
Benefit Information
- Walk-in service for administration and
claim services in the Greater Toronto Area
The largest Canadian retired
educator plan providing
with over
63,000 members
and dependents.
A Plan
that is owned and managed by RTO/ERO members.
Coverage and Rate Details
COMPREHENSIVE, COMPETITIVE &
AFFORDABLE
Join the largest Canadian retired educator plan, providing health
coverage to over 68,000 members and dependents. The RTO/ERO plan is owned
and managed by RTO/ERO members.
RTO/ERO provides:
- Extended Health, Semi-Private Hospital and Dental Plans,
all offered independently so you pay only for what you need
- Premium rates and benefits that are the same at any age
- Single, couple or family coverage
Semi-Private Hospital Plan
Dental Plan
-
Fee Guide
-
Basic and Preventive Benefit
-
85% reimbursement
-
Unlimited annual maximum per person
-
Includes one standard oral examination, cleaning and recall
examinations every nine months, in addition to other services
-
Endodontics and Periodontics Benefit
-
Major Restorative Benefit
-
50% reimbursement
-
$700 annual maximum per person, for crowns, including those on
implants
-
$700 annual maximum per person, for fixed bridges and partial
dentures, including those on implants
Supplemental Travel Plan
-
Provides for coverage beyond the 62 days of travel coverage under the
Extended Health Care Plan
-
Available in 15 day units up to a maximum trip
duration of 212 days. For those who only need a few extra days of coverage, a
five day unit is available immediately following the first 62 days of travel
-
Guaranteed acceptance for all Extended Health
Care Plan
Extended Health Care Plan
-
Prescription Drug Benefit
-
$0 deductible
-
$2,300 annual maximum per person
-
85% reimbursement of ingredient costs
-
Covers eligible drugs for all ages, including those not covered
by the Provincial Drug Benefit Plan for participants and dependents age 65 and
over
-
The $100 Ontario Drug Benefit Program deductible is reimbursed
based on 85% of ingredient costs
-
Covers erectile dysfunction drugs to an annual maximum of $350
per person
Paramedical Practitioners Benefit
-
80% reimbursement
-
$700 annual maximum per person (for all practitioners combined)
-
Covers 15 practitioners including acupuncturists, chiropodists,
chiropractors, dieticians, herbalists, homeopaths, naturopaths, nutritionists,
osteopaths, physiotherapists, podiatrists, psychologists, registered massage
therapists, speech therapists and shiatsu therapists
-
Physician authorization is not required
Aids and Appliances Benefit
-
80% reimbursement
-
Covers the purchase or repair of hearing aids up
to a maximum of $1,000 overall, in any three consecutive calendar years8
Custom-made orthopaedic shoes and orthotics up to a maximum of $500 per person,
in any two consecutive calendar years
-
Prostheses including artificial limbs or eyes, or breast
prosthesis (including two mastectomy bras per calendar year)
-
Supplies including trusses, splints, braces and casts
-
Medical supplies, including surgical support stockings up to an
annual maximum of $300 per person, incontinence supplies up to an annual maximum
of $400 per person, and post-surgical comfort and convenience items (e.g., sock
reacher, shoe lacer) up to $100 per person in any two consecutive calendar years
-
Mobility aids including wheelchairs, canes, walkers, and
crutches
Vision Care Benefit
-
80% reimbursement
-
$300 maximum per person in any two consecutive calendar years
-
Covers eyeglasses, contact lenses and laser eye surgery
-
Eye examinations subject to a maximum of $75 for one eye exam
every two consecutive calendar years. Eligible dependent children are covered on
an annual basis
-
New lenses if required due to eye surgery are covered up to a
lifetime maximum of $300 per person
Diagnostic Services Benefit
-
80% reimbursement
-
Covers diagnostic services, subject to your Government Health
Insurance Plan offset
-
Diagnostic procedures, including PSA testing for cancer, and
radiology
Private Duty Nursing Benefit
Transportation/Ambulance Benefit
Accidental Dental Benefit
Educational Program Benefit
Out-of-Province/Canada Travel Benefit
-
100% reimbursement
-
$1,000,000 coverage for eligible medical emergency expenses per
person/trip
-
Covers an unlimited number of trips, each up to 62 days in
duration
-
Emergency expenses incurred due to an accident or sudden illness
while travelling outside your province of residence or outside Canada
-
Pre-existing medical conditions are covered, subject to a 90-day
medical stability clause
-
$6,000 trip cancellation per person/trip
-
$6,000 trip interruption per person/trip
Monthly Rates
February 1, 2008 to January 31, 2009 inclusive
| RTO/ERO Monthly Rates* –
February 1 2009 to January 31 2010 inclusive
|
|
Single |
Couple |
Family |
| Extended Health Care |
$67.46 |
$134.94 |
$161.94 |
| Semi-Private Hospital |
$16.26 |
$32.49 |
$38.18 |
| Dental |
$50.46 |
$99.50 |
$124.08 |
| * These amounts do not include Retail Sales Tax
(8% in Ontario). |

Suite 300, 18 Spadina Road, Toronto, ON M5R 2S7
416.962.9463 - 1.800.361.9888
www.rto-ero.org
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