Exhibit 10(jj)
EX-10.JJ 3 o14773exv10wjj.htm EXHIBIT 10(JJ) exv10wjj
Exhibit 10(jj)
March 10, 2005
CHIEF EXECUTIVE OFFICER
MAJOR MEDICAL & DENTAL BENEFITS
Benefits include all medical and dental expenses covered under the PCS US salaried/non hourly employees Plan. Covered expenses include medical and dental expenses incurred for services rendered or supplies purchased in the United States. Coverage outside the United States is provided for emergency services.
Individual Deductible Amount | $250 | |
Family Deductible Amount | $500 | |
Annual Out of Pocket Maximum | $1,250 individual $2,500 family | |
Percentage Reimbursements | 90% | |
MEDICAL | ||
Maximum Aggregate per Individual | $1,000,000 per lifetime | |
Annual Reinstatement Amount | $10,000 | |
Maximum Medical Travel Amount (per Individual) | None | |
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 | 180 day maximum per year | |
HOSPITAL COVERED EXPENSES | ||
Hospital Daily Amount | Reasonable and customary | |
PRESCRIPTION DRUG COVERED EXPENSES | ||
In US | $10/$20 copay | |
In Canada | Only when traveling | |
Out of Country | Only when traveling | |
Maximum Lifestyle Drugs Amount | $500 per calendar year |
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 | Reasonable and customary | |
Maximum Number of Days of Convalescent Hospital Confinement | 180 day maximum per year | |
Maximum Visits to Psychologist or Social Worker | 60 visits per year | |
Maximum Eye Examination Amount | Reasonable and customary Once every 12 months | |
Eyeglass, Frame or Contact Lens Amount | $1,000 per 24 consecutive months |