Chief Executive Officer Major Medical & Dental Benefits Summary (Effective January 1, 2011)

Contract Categories: Human Resources › Compensation Agreements
Summary

This document outlines the major medical, dental, and vision benefits provided to the Chief Executive Officer, effective January 1, 2011. Coverage includes expenses under the PCS U.S. Flexible Benefits Plan and an additional company-provided insurance policy that reimburses certain out-of-pocket costs. Key terms include individual and family deductibles, annual out-of-pocket maximums, copays for various services, and specific coverage limits for medical, dental, and vision care. The agreement details reimbursement percentages, maximum benefit amounts, and conditions for specific services.

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EX-10.JJ 7 o67673exv10wjj.htm EXHIBIT 10(JJ) exv10wjj
Exhibit 10(jj)
Effective January 1, 2011
CHIEF EXECUTIVE OFFICER
MAJOR MEDICAL & DENTAL BENEFITS
Benefits include all medical, dental and vision expenses covered under (i) the PCS U.S. Flexible Benefits Plan (the “Plan”) and (ii) a company-provided fully-insured “wrap around” policy that reimburses the chief executive officer for certain out-of-pocket expenses that exceed the reimbursed costs under the Plan.
     
Individual Deductible Amount
   $250
Family Deductible Amount
   $500
Annual Out of Pocket Maximum
  $1,250 individual
 
  $2,500 family
 
    
Percentage Reimbursements
   90%
Office Visits
    
          Primary Doctor
  $15 Copay
          Specialist
  $15 Copay
Emergency Room
  $150 Copay
Urgent Care
  $50 Copay
 
    
MEDICAL
    
 
    
Maximum Aggregate per Individual
  None
Maximum Medical Travel Amount (per Individual)
  None
Preventive & Wellness
   100%
 
    
DENTAL
    
 
    
Maximum Dental Amount per Individual
  $8,000 per calendar year
 
    
OTHER SPECIFIC LIMITS & MAXIMUMS ARE LISTED BELOW:
    
 
    
STANDARD COVERED EXPENSES
    
Maximum Nursing Services Amount
  Subject to medical necessity
 
    
HOSPITAL COVERED EXPENSES
    
Hospital Daily Amount (private room)
  90% after deductible
 
    
PRESCRIPTION DRUG COVERED EXPENSES
  $10/$20 copay
 
    
PARAMEDICAL COVERED EXPENSES
    
 
    
Chiropractic Services
  Subject to medical necessity
Physiotherapist Services
  Subject to medical necessity
Acupuncturist Services
  Only when used for anesthesia
Podiatrist Services
  Subject to medical necessity
Speech Therapist Services
  Subject to medical necessity
 
    
EXTRACARE COVERED EXPENSES
    
Convalescent Hospital Daily Amount
  90% after deductible
Maximum Number of Days of Convalescent Hospital Confinement
  Subject to medical necessity
Maximum Visits to Psychologist or Social Worker
  Subject to medical necessity
Maximum Eye Examination Amount
  Reasonable and customary
 
  Once every 12 months
Eyeglass, Frame or Contact Lens Amount
  $1,000 per 24 consecutive months