Flexible and clear options so you can make the right healthcare choice:
Included in all plans: Extended Health Benefits
Benefits include:
- Vision Care
- Hearing Aids
- Private Duty Nursing
- Prosthetics and Orthapaedic
- Paramedical treatment including: physiotherapist, massage therapist, naturopath, psychologist, chiropractor, etc.
And much more!
For a full list of all your basic benefits, please see the Full Plan Details section.
Then choose either:
+ 
Combo Plan*
(Dental Care and Prescription Drug Plan)
The Combo Plan is your best value and most comprehensive option. It includes Extended Health Benefits plus Prescription Drug and Dental Care coverage.
- More Info
For Dental Care Benefits, expenses incurred within the first 3 months from the effective date are not payable.
Plan Highlights:
Lifetime maximum of up to $350,000! (with the Enhanced option)
Basic dental treatment, including regular checkups, preventative services, and cleanings.
Maintenance of existing crowns, dentures, and bridgework.
Up to $5,000 per year of prescription drug coverage. (with the Enhanced option).
Select the Enhanced option to increase your maximums for a number of major benefits, including private duty nursing, prosthetics, and hearing aids.
The only plan that includes hospital benefits for private/semi-private rooms. (with the Enhanced option)
For more details about the Combo Plan, please see our Full Plan Details section.
Dental Care Plan
This plan includes Extended Health Benefits and Dental Care Coverage.
- More Info
For Dental Care Benefits, expenses incurred within the first 3 months from the effective date are not payable.
Plan Highlights:
Lifetime maximum: $100,000
Basic dental treatment, including regular checkups, preventative services, and cleanings.
Maintenance of existing crowns, dentures, and bridgework.
Select the Enhanced option and your annual dental coverage increases from $400 to $700 plus increased maximums for other health and dental care benefits.
For more details about the Dental Care Plan, please see our Full Plan Details section.
Prescription Drug Plan*
This plan includes Extended Health Benefits and Prescription Drug coverage.
- More Info
Plan Highlights:
Lifetime maximum: $100,000
Up to $5,000 of prescription drug coverage. (with the Enhanced option)
Coverage for drug dispensing fees at the pharmacy, often with next day re-imbursement using your Health Benefits Card.
Select the Enhanced option to increase your maximums for a number of major benefits, including private duty nursing, prosthetics, and hearing aids.
For more details about the Prescription Drug Plan, please see our Full Plan Details section.
Standard or Enhanced?
Choose the Enhanced Plan Option, and increase your coverage on a number of benefits! This allows you to scale your coverage to your needs. Think you'll be spending more at the dentist? Selecting the Enhanced option for the Dental Care or Combo Plan increases your annual maximums by 75%.
*Important information for Quebec residents
Quebec residents must be registered under the Public Prescription Drug Insurance Plan administered by the Régie de l’assurance maladie du Québec (RAMQ), unless they are required to enroll under a private plan (usually made available through employment, professional order or professional association, or through their spouse or parents). The Extended Health and Dental Insurance being offered to alumni members will only top up the basic drug plan coverage mandated by Quebec provincial health insurance.
Please note, Quebec residents will not be able to use the Health Benefit Card for automatic reimbursement of prescription drug claims. They must submit prescription drug claims manually to iA Financial Group. If you have any questions about the Extended Health and Dental Insurance being offered, please contact an iA Financial Group Client Service Specialist by email at solutions@ia.ca or call toll free 1 (800) 266-5667.
This is a summary only. Clients will receive a detailed Benefit Booklet once their application has been processed.
Eligibility
Mount Royal University Alumni Association members and their spouses under age 65, who are covered under the Government Health Insurance Plan of their province of residence are eligible to apply.
Alumni members may also apply for their dependent children.
We offer a 30 day money back guarantee. If you are not fully satisfied, you can cancel your coverage and return the Certificate within 30 days of the effective date. You'll receive a full refund of any premiums already paid.
Lifetime Maximums
The lifetime maximum is the maximum amount of reimbursement for all services provided under the insurance plan selected for any one insured member or spouse.
For dependent children, the lifetime maximum indicated below is the maximum for all children combined.
| | Maximums |
|---|
| | Standard Option | Enhanced Option |
|---|
| Extended Health & Dental Care Plan | $100,000 | $100,000 |
| Extended Health & Prescription Drug Plan | $100,000 | $100,000 |
| Extended Health Combo Plan | $250,000 | $350,000 |
Extended Health Benefits Summary Table
The following benefits are available under all plans. Coverage details vary by plan option as indicated.
| | Reimbursement percentages & maximums |
|---|
| Benefit | | Standard Option | Enhanced Option |
|---|
| Accidental Dental Treatment | Maximum per accident | $2,000 | $3,000 |
| Percentage covered | 100% | 100% |
| Ambulance | Ground Ambulance
Percentage covered | 100% | 100% |
Air Ambulance
Maximum per incident | 100% up to a maximum of $5,000 | 100% up to a maximum of $5,000 |
| Diagnostic Services | Maximum per year | $200 | $200 |
| Percentage covered | 100% | 100% |
| Durable Medical Equipment | Maximum per year | $3,000 | $4,000 |
| Percentage covered | 80% | 90% |
| Hearing Aids | Maximum per 4 years | $300 | $500 |
| Percentage covered | 100% | 100% |
Paramedical
includes acupuncturist, chiropodist, podiatrist, chiropractor, naturopath, osteopath, physiotherapist, massage therapist, psychologist, speech therapist, audiologist, dietician, homeopath, kinesitherapist, orthotherapist, psychoanalyst, psychiatrist, social worker | Maximum per year | $300 | $600 |
| Percentage covered | 100% | 100% |
| Maximum amount per visit | $25 | $30 |
| Private Duty Nursing | Maximum per year | $3,000 | $4,000 |
| Percentage covered | 80% | 90% |
| Prosthetic Appliances and Orthopaedic Equipment | Maximum per year | $3,000 | $4,000 |
| Percentage covered | 80% | 90% |
| Vision Care | Maximum per 2 years | $150 | $150 |
| Percentage covered | 100% | 100% |
Hospital Benefit – Acute CareIf you are insured for the Combo Plan under the
Enhanced Option, you are also eligible for the Hospital Benefit.
The Hospital Benefit includes a choice of:
a) private/semi-private room
- which provides coverage for a maximum of $150 per day up to 120 days
b) ward
- which provides $40 daily cash starting on day 3 for 120 days in lieu of private/semi-private accommodation
Includes:
This benefit reimburses the insured member for eligible expenses as described below, subject to the applicable Benefit Maximum.
Eligible expenses are:
Acute CareIf an Insured Person is hospitalized in a Hospital as a result of illness, injury and/or pregnancy, iA Financial Group will pay for daily room charges in excess of the hospital’s standard ward rate for semi-private room or private room accommodation, up to the amount stated in the Benefit Table.
If the Insured Person has only obtained standard ward accommodation, iA Financial Group will pay the daily cash amount shown in b) above, starting on the third (3rd) consecutive day of hospitalization. The date of admission to standard ward accommodation in a Hospital will be used to determine eligibility of benefits.
Limitations and Exclusions:
The Hospital Benefit is only available if the insured member has selected the
Combo Plan with the Enhanced Option.The benefit does not provide payment for charges incurred for convalescence care, accommodation in a private hospital, a chronic care facility, or a transition ward of a Hospital.
In addition to the individual benefit exclusions set out in this document, benefits are not payable for:- expenses which are payable under any Government Health Insurance Plan or legally mandated program, including workers’ compensation plans;
- care, services or supplies which are for cosmetic purposes, except when in connection with reconstructive surgery to repair or replace tissue damaged by disease or bodily injury;
- charges for medical care which is experimental or not necessary according to generally accepted standards of medical practice in Canada;
- charges in excess of those deemed by iA Financial Group to be usual, Reasonable and Customary charges in the geographic region of the Insured Person’s residence;
- charges incurred during a period of Hospital confinement which began before the Insured Person became covered under the plan. This limitation will not apply to a child who became covered at birth.
- services, equipment and supplies provided in a chronic care or psychiatric hospital or institution, chronic care unit of a hospital, psychiatric unit of a hospital or when a patient is confined to a long term care facility or a transition ward of an acute hospital;
- charges incurred for medical care to the extent that the applicable government jurisdiction prohibits the payment of any benefits;
- duplicate, or replacement prosthetic appliances, devices or durable medical equipment, except where replacement is required because the existing item can no longer be made serviceable due to normal wear, or as a result of a pathological change in the patient’s condition;
- charges incurred from any attempted suicide or self-inflicted injuries or illness while the Insured Person is sane or insane;
- medical care charges resulting from riot, insurrection, war or hostilities of any kind, or any act incident thereto whether war be declared or not and whether or not the Insured Person was participating therein;
- drugs, medicines, services or supplies which have been self-prescribed, or prescribed by or for family members.
- charges for which the Insured Person is entitled to indemnity or compensation under any Workplace Safety and Insurance Board (WSIB) or similar legislation;
- charges resulting from the committing of or attempt to commit a criminal offence including, without restriction, an assault;
- services or supplies received outside Canada except Vision Care Services;
- charges paid under any Welfare Act, and Act respecting Workmen’s Compensation, care and services provided in municipal, provincial or federal clinics as well as charges incurred for cosmetic purposes or for treatment of mental illnesses which would normally be paid by public organizations;
- services and supplies not shown in the included list of benefits; and
- services or supplies for which an Insured Person is entitled without charge by law or for which a charge is made only because such person has insurance.
Prescription Drug Benefits Summary Table*
The Prescription Drug Benefit is available under the following plans:
- Extended Health & Prescription Drug Plan
- Extended Health Combo Plan
| | Reimbursement percentages & maximums |
|---|
| Benefit | | Standard Option | Enhanced Option |
|---|
Prescription Drug Coverage
excludes smoking cessation and fertility drugs for all plans | Maximum per year | $2,500 | $5,000 |
| Dispensing Fee | $7.00 | $8.00 |
| Oral Contraception | Not Available | Covered |
Percentage
covered | 70% | 80% |
Includes:
The insured member will be reimbursed for charges for the cost of drugs identified below subject to the reimbursement percentage and benefit maximum indicated above as applicable.
All eligible children of a family who are also covered for the Prescription Drug Benefit will share the benefit maximum indicated above.
For Quebec residents, it is acknowledged that iA Financial Group will limit the out-of-pocket contribution made by an Insured Person to the amount set by the Quebec government under the Public Prescription Drug Insurance Plan administered by Regié de l’assurance maladie du Québec (RAMQ) and where applicable will abide by the terms of this legislation.
The insured member will only be reimbursed for the lowest priced substitutable drug, as provided for in the Provincial Drug Benefit Formulary. The cost of the following drugs and medicines are eligible expenses when prescribed by a physician or dentist and dispensed by a licensed pharmacist:
- prescribed vitamins;
- prescribed medications falling into Federal and Provincial Schedules and bearing a Drug Identification Number (D.I.N.) on their labels;
- all injectible drugs including serums, vaccines and injectible vitamins;
- all extemporaneous preparations or compounds;
- all needles and diagnostic tests for diabetics and testing material for glycemia;
- oral contraceptives (only if you are insured for the Enhanced Option);
- products containing the following drugs: Acetylcysteine, Atopine, Belladonna Alkaloids, Benzonatate, Colchicine, Coltracine Ointment, Cyclopentolate, Edrophonium Chloride, Ephedrine, Gold and Gold Compounds, Haloprogin, Heparin, Homatropine, Hyoscine and Hyocyamus, Niclosamide, Nikethamide, Nitroglycerin Ointment, Oxtriphyiline, Oxytocin, Pilocarpine, Placebo, Potassium Perchlorate, Potassium Supplement, Prenylamine, Probenecid, Proguanil, Pyrimethamine, Silver Sulfadiazine, Topical Application, Sodium Polystyrene, Sulfonate, Topical Enzymatic, Debriding Agents, Triethanolamine Polypeptide, Oleate, Tyloxapol, Vasopresin
- The quantity of drugs which may be dispensed for any one prescription will be limited to that amount sufficient for up to a 34-day period, except in the case of drugs for long term therapy (maintenance drugs) for which up to a 100 day supply is allowable.
Exclusions
Benefits are not payable for:
- Atomizers, appliances and prosthetic devices and first aid and/or diagnostic supplies;
- Diaphragms, condoms, contraceptive jellies, or appliances normally used for contraception whether or not such prescription is given for a medical reason;
- Proprietary and patent medicines which are defined as products registered under Division Ten (10) of the Food and Drug Act, Canada, and which bear a General Public (G.P.) number on their label and do not also bear a Drug Identification Number (D.I.N.) on their label;
- Prescriptions dispensed in any physician or dentist office, unless otherwise directed;
- Prescriptions dispensed in any hospital, unless otherwise directed;
- Alcohol swabs and cotton;
- Items deemed cosmetic (even if a prescription is legally required);
- Any medication which the Insured Person is eligible to receive under various Provincial Drug Benefit Plans.
*Important information for Quebec residents
Quebec residents must be registered under the Public Prescription Drug Insurance Plan administered by the Régie de l’assurance maladie du Québec (RAMQ), unless they are required to enroll under a private plan (usually made available through employment, professional order or professional association, or through their spouse or parents). The Extended Health and Dental Insurance being offered to alumni members will only top up the basic drug plan coverage mandated by Quebec provincial health insurance.
Please note, Quebec residents will not be able to use the Health Benefit Card for automatic reimbursement of prescription drug claims. They must submit prescription drug claims manually to iA Financial Group. If you have any questions about the Extended Health and Dental Insurance being offered, please contact an iA Financial Group Client Service Specialist by email at solutions@ia.ca or call toll free 1 (800) 266-5667.
Dental Care Benefits Summary Table
Dental Care benefits are available under the following plans:
- Extended Health & Dental Plan
- Extended Health Combo Plan
| | Reimbursement percentages & maximums |
|---|
| Benefit | | Standard Option | Enhanced Option |
|---|
Dental Care
includes diagnostic services (examination, radiographs, etc), preventive services (fluoride, polishing, scaling, etc) endodontics and periodontics. | Maximum
per year | $400 | $700 |
| Percentage covered | 70% | 80% |
| Recall | 9 months | 9 months |
Note: For Dental Care Benefits, expenses incurred within the first three months from the effective date of coverage are not payable.
Dental Care Benefits Detailed Description
The following provides a more detailed description of the individual benefits available. Benefits are subject to the reimbursement percentages and benefit maximums outlined in the Benefits Summary Table.
| Benefits | Description |
|---|
| Diagnostic Services | - one complete examination every thirty-six months
- one recall examination every nine months
- two specific examinations every twelve consecutive months
- two emergency examinations every twelve consecutive months
- one complete series of radiographs or panoramic radiograph every thirty-six consecutive months
- one bite-wing radiograph every twelve consecutive months
- cytological tests and analyses
- histopathological tests and analyses
- microbiological tests and analyses
- occlusal radiographs
- periapical radiographs
|
| Preventative Services | - one fluoride treatment every nine months
- one oral hygiene instruction per lifetime
- one unit of polishing every nine months
- 4 units of time per Policy Year of scaling or root planning
- interproximal disking
- pit and fissure sealants
- space maintainers and maintenance of space maintainers
|
Minor Restorative
Services | - amalgamation restorations. Bonded amalgam restorations limited to the cost of non-bonded amalgam restorations
- prefabricated restorations (prefabricated crowns) for primary teeth only
- tooth coloured restorations limited to anterior and bi-cuspid teeth only. Tooth coloured restorations performed on molar teeth are limited to the cost of non-bonded amalgam restorations
- caries, trauma and pain control
- prefabricated posts
- retentive pins
|
Minor Oral Surgical
Services | - simple alveloplasty
- antral surgery
- extractions and residual root removal
- fractures
- frenectomy
- surgical excision, exposure and incision
- treatment of salivary glands
- vestibuloplasty
- hemorrhage control
|
| Crowns/Bridges/Denture Maintenance Services | - one denture rebase per arch every thirty-six months
- one denture reline per arch every thirty-six months
- denture repair
- recementation or repair of crowns and bridgework
|
| Adjunctive Services | - deep sedation
- general anaesthesia
- nitrous oxide
- nitrous oxide with oral sedation
- parenteral conscious sedation
- therapeutic injections
|
| Endodontic Services | - routine initial root canal therapy. Complicated root canal therapy is limited to the cost of routine root canal therapy. Retreatment of root canal is covered only if at least thirty-six (36) consecutive months have elapsed from the date of the initial root canal therapy. There is no coverage for root canal therapy for primary teeth.
- apexification;
- apicoectomy;
- pulpectomy;
- pulpotomy;
- retrofilling;
- root amputation
- bleaching of endodontically treated teeth
- hemisection
- isolation of endodontic tooth
- open and drain
|
| Periodontic Services | - periodontal appliances and maintenance limited to one (1) appliance per arch every thirty-six (36) consecutive months
- management of oral disease
- occlusal equilibration
- periodontal abscess or periocoronitis
- periodontal surgery – flap approach - osteoplasty
- periodontal surgery – flap approach - osseous defect
- periodontal surgery - gingival curettage
- periodontal surgery – gingivoplasty
- periodontal surgery – gingivectomy
- periodontal surgery – grafts - soft tissue
- proximal wedge
|
Dental Care Benefit Exclusions
In addition to the individual benefit exclusions set out in this document, benefits are not payable for:
- charges for services provided for cosmetic reasons only
- charges for missed or cancelled appointments, completion of forms, communications, or any other non-treatment services
- charges for services or supplies that are not necessary dental services or do not meet accepted standards of dental practice
- professional fees for an anesthetist
- replacement of lost, stolen or broken prostheses or appliances
- protective appliances for athletic purposes
- implant and any dental service associated with implants
- under this benefit, charges which are covered under any other benefit in this benefit plan
- services covered by any Workplace Safety and insurance board unless prohibited by any Government legislation
- services and supplies not shown in the included list of benefits
- any claim expenses or service provided by an immediate family member
- dental services or supplies required as a result of war, terrorism, rebellion or hostilities of any kind, whether or not the Insured Person is a participant
- dental services or supplies required as a result of participation in a riot or civil disturbance
- dental services or supplies required due to intentional self-inflicted injury.
1. Are my family and I eligible for Extended Health and Dental Insurance?
Mount Royal University Alumni Association members are eligible for coverage.
Provided the member is insured for coverage, their spouse and dependent children are also eligible.
At time of application members and spouses must be under age 65. Dependent children must be between 14 days and 21 years of age. Spouse means the legal spouse of a member, providing there is no separation in effect, or an individual who has been residing in a marriage-like relationship with the member for a period of at least 12 consecutive months.
All family members (member, spouse and/or dependent children) must reside in Canada and be covered under the Government Health Insurance Plan of their province of residence.
If both you and your spouse are eligible members, only one of you may apply for your dependent children.
If you and your spouse are both members, you may apply as a couple.
All family members will be covered under the same plan and plan option.
2. Are there any limitations or exclusions I should be aware of?
There is a 3 month waiting period from the effective date for dental coverage. There are also other exclusions and yearly and lifetime payout maximums. Please refer to the Full Plan Details section for more information.
3. Can I change my current plan to another one?
Yes. If you are changing your plan option from Enhanced to Standard or removing a spouse and/or dependent child(ren), we will need you to send a signed and dated request to our office .If you want to upgrade or change your plan option from Standard to Enhanced, you will have to apply for the coverage, and provide evidence of insurability.
4. Can I select different plans for the different members of my family?
All members of a family must be enrolled in the same plan.
5. How do I file a claim?
There are multiple ways to file claims:
- Download the claim form from the ClaimSecure’s website at www.claimsecure.com.
- Enter your claim online by creating an eProfile account at www.claimsecure.com.
- Prescription Drug and Dental claims can be submitted automatically by presenting your Health Benefit Card at the pharmacist/dentist.
- For Quebec residents, please call 1 (800) 266-5667 when submitting a claim for Prescription Drugs.
*Important information for Quebec residents
Quebec residents must be registered under the Public Prescription Drug Insurance Plan administered by the Régie de l’assurance maladie du Québec (RAMQ), unless they are required to enroll under a private plan (usually made available through employment, professional order or professional association, or through their spouse or parents). The Extended Health and Dental Insurance being offered to alumni members will only top up the basic drug plan coverage mandated by Quebec provincial health insurance.
Please note, Quebec residents will not be able to use the Health Benefit Card for automatic reimbursement of prescription drug claims. They must submit prescription drug claims manually to iA Financial Group. If you have any questions about the Extended Health and Dental Insurance being offered, please contact an iA Financial Group Client Service Specialist by email at solutions@ia.ca or call toll free 1 (800) 266-5667.
6. I lost my Health Benefit Card. Where do I get a replacement?
Please contact one of our Client Service Specialists by email at solutions@ia.ca or call our toll free number at 1 (800) 266-5667 (6:30am to 4:30pm Pacific Time) to request a replacement card. It may take up to 2 weeks to receive your replacement card.
7. If I get married can I add my spouse to this plan? What if we have more children?
Yes, you can add a spouse or dependent children to this plan. Here's how:
- If you already have a dependent child covered under this plan and you acquire another dependent child, you do not need to apply again for that new dependent child. Just fill out the enrolment form (PDF) within 90 days. If we do not receive notification within 90 days, you will have to complete a new application to add an additional child.
- If you are adding your first dependent child, or a spouse, you will need to complete a new application to provide evidence of insurability for these family members.
8. If I have coverage through another plan, how will this plan work?
Coordination of Benefits applies when a person is covered under at least 2 private plans. It also applies when a person is covered under a private and a public plan.
Residents of various provinces can be eligible for coverage under provincially funded drug plans. Those publicly funded plans are based on various eligibility criteria including age, income, or specific diseases. The claim coordination process encourages plan members eligible for provincial coverage to submit their claims to the provincial plan first and then to their private insurer.
In cases where the person is covered under 2 private plans (e.g., plan member’s and spouse’s), he/she has to submit his/her claim to the primary insurer. Then, the balance can be submitted to the other insurer.
9. What happens if I move to a different province?
You must advise us of your new address. As long as you are covered for the provincial health plan with your new province of residence, you may carry this coverage. Note that your premium rates and applicable taxes may be impacted as these differ by province.
10. What if my spouse and I are separated or divorced?
Unfortunately, your spouse cannot continue to be insured under this plan. Please advise our office in writing of your separation or divorce date. We suggest that you advise us immediately as you will only be reimbursed up to 3 months of premium.
11. When does my coverage begin?
Coverage will take effect on the first day of the month coincident with or next following the date that your completed application is approved by iA Financial Group provided your first month’s premium has been paid.
12. When does my coverage end?
Your coverage terminates on the earliest of the following dates:
- end of month that you reach age 65;
- the end of the month in which your written request to cancel your insurance is received;
- the date the Group Master Policy between the Mount Royal University Alumni Association and iA Financial Group terminates;
with respect to your spouse, the end of the policy month in which:
- the member terminates their coverage
- your spouse reaches age 65 or is no longer considered your spouse for the purpose of this group policy.
with respect to your dependent child(ren), the end of the policy month in which:
- the member terminates their coverage
- they no longer qualify as a dependent child under this group policy.
13. Will my premiums change?
Premiums are calculated based on your age and applicable rate at June 1. Premiums will increase as you reach a higher age band.
Please refer to the pricing tab to find out your age band and monthly premium.
