Group Insurance Plans
63. (1) The Supplementary Health and Hospital Insurance Plan shall provide to every judge who joins the Plan the following benefits in respect of expenses incurred on behalf of the judge, the judge’s spouse and the judge’s dependent children: 1. Reimbursement for 90 per cent of the cost of drugs and medicine dispensed by a legally qualified medical practitioner or by a pharmacist within the meaning of Part VI of the Health Disciplines Act on the written prescription of a legally qualified medical practitioner. 2. Reimbursement for charges for private or semi-private room hospital care by a hospital within the meaning of the Public Hospitals Act or by a hospital that is licensed or approved by the governing body in the jurisdiction in which the hospital is located, but not exceeding $75 above the charge by the hospital for standard ward room hospital care. 2.1 Reimbursement for charges incurred after the 31st day of December, 1992 for private or semi-private room hospital care by a hospital within the meaning of the Public Hospitals Act, without the limitation set out in paragraph 2. 3. Reimbursement for such other health and hospital expenses as may be covered by the Plan resulting from treatment and services recommended or approved by a legally qualified medical practitioner. O. Reg. 67/92, s. 63 (1); O. Reg. 762/92, s. 2; O. Reg. 28/00, s. 10 (1); O. Reg. 283/05, s. 10 (1). (2) Subject to subsection (8), the Crown shall pay the premiums for every judge who joins the Supplementary Health and Hospital Insurance Plan. O. Reg. 67/92, s. 63 (2). (3) A judge may elect to participate in the Supplementary Health and Hospital Insurance Plan, (a) on appointment; (b) in December of any year, for coverage commencing on the 1st day of January next following, if the judge has satisfied the waiting period of the Plan and the judge, (i) did not join the Plan on appointment, or (ii) previously opted out of the Plan; or (c) on providing evidence that similar coverage available to the judge under the plan of another person has been terminated, for coverage commencing on the 1st day of the month coinciding with or following the presentation of the evidence. O. Reg. 67/92, s. 63 (3). (4) A judge may elect in December of any year to opt out of the Supplementary Health and Hospital Insurance Plan and coverage shall cease at the end of that month. O. Reg. 67/92, s. 63 (4). (5) The Supplementary Health and Hospital Insurance Plan shall provide to every judge who elects to participate in the Plan’s additional coverage for vision care and hearing aids the following benefits in respect of expenses incurred on behalf of the judge, the judge’s spouse and the judge’s dependent children: 1. Reimbursement for the cost of vision care, to a maximum of $100 every twenty-four months per person. 2. Reimbursement for the cost of purchase and repair of a hearing aid, other than the replacement of a battery, to a maximum of $200 per person. O. Reg. 67/92, s. 63 (5); O. Reg. 28/00, s. 10 (2); O. Reg. 283/05, s. 10 (2). (6) The additional coverage under subsection (5) shall be subject to a deductible amount in each calendar year of $10 for a judge with single coverage and $10 per person to a maximum of $20 for a judge with family coverage. O. Reg. 67/92, s. 63 (6). (7) For the additional coverage under subsection (5), the Crown shall, subject to subsection (8), pay 60 per cent of the premiums for each participating judge and the judge shall pay the balance of the premiums by deduction from salary. O. Reg. 67/92, s. 63 (7). (8) The Supplementary Health and Hospital Insurance Plan and the Plan’s additional coverage for vision care and hearing aids shall not be provided to a judge during a leave of absence without pay unless the judge arranges through the payroll branch of the Ministry of the Attorney General to pay the full premiums and pays the premiums at least one week before the first of each month of the leave of absence. O. Reg. 67/92, s. 63 (8). (9) Subsection (8) does not apply during a pregnancy leave or during the first eighteen weeks of a parental leave. O. Reg. 67/92, s. 63 (9). (10) Within a reasonable time after the Ministry of the Attorney General is informed that a leave of absence to which subsection (8) applies has been granted to a judge, the Ministry shall inform the judge of the provisions of subsection (8). O. Reg. 67/92, s. 63 (10). (11) This section also applies to every person who is receiving a pension or a survivor allowance under Part II. O. Reg. 67/92, s. 63 (11). (12) In this section, “vision care” means eyeglasses, frames and lenses for eyeglasses and contact lenses prescribed by a person with a licence to practice medicine or optometry under the Health Disciplines Act, and includes the fitting of eyeglasses, frames, lenses and contact lenses, but does not include eyeglasses for cosmetic purposes or sunglasses. O. Reg. 67/92, s. 63 (12).