How Your Extended Health
Benefits Work

The Extended Health Plan assists you in
paying for a large number of your medical
costs that are not covered by the B.C.
Medical Plan. You must submit proper
receipt in order to be paid. It is to your
advantage to make certain that you are
familiar with this benefit.

DEDUCTIBLE & AMOUNT OF
REIMBURSEMENT

From the eligible expenses of either a
single person or a family the first $25.00 of
expenses in any one calendar year will be
deducted from your claim. However, exp-
renses incurred in the last three months of
the previous year may be used to reduce or
satisfy the deductible in the following year.

After the deductible has been satisfied you
shall be reimbursed at the rate of 80% of
insured eligible expenses until $1,000.00-of
benefits have been paid in any one calendar
year. Once you have received $1,000.00 in
claim payments you will be reimbursed for
100% of any eligible expenses for the
remainder of that calendar year.

LABOUR HISTORY

Editor’s Note:

This poem is by Stewart (“Curly”, “Whis-
tle Punk”) Houston, who pulled Alberni-
Pacific’s Camp #3 during the 1934 loggers’
strike.

He submitted the poem for publication to
the “Lumberworker” at that time, but ittook
us a while to get around to it.

THE APES OF B.C.

In Africa is where you'll find
The Monkey and the Gibbon
But in B.C. we have the.kind
That fairly takes the ribbon.

The hair grows thick upon his face
His hide is full of fleas

He makes his home almost anywhere
Among the tall fir trees.

No use for brains, he doesn’t think

And socially he’s a joke

Works in the rain and buys strong drink
And is nearly always broke.

Some people think this is not true
That no apes haunt B.C.
But the only thing you have to do
Is try the woods and see.

If you'll go out in the morning
And walk out through the brush
The Apes act very crazy

If they think you are the push.

Just go and take a little walk
Among the falling trees

And watch them dig a choker hole
Down on their hands and knees.

And when they get the choker set

The big ape gives a yell

And the little apes dash through the brush
Like demons out of hell.

Somemtimes they do not holler
And break the haywire junk,

Then they gather round the hooker
And curse the whistle punk.

And when at last the road is done
And the rigging at the pole

The big ape hollers “Straw line”
And the squirrel hunts his hole.

And then he stands jaws full of snoose
Excited as can be

Just rants and tears and shouts abuse
To the apes around the tree.

The strawline whistles through the brush
The big ape gives a roar

Two apes are injured in the rush,

They send to camp for more.

The rigging ape is at the rear
Stands by to holler “Hi”

And dangles in to change the gear
As the haulback whistles by.

The maximum benefit payable under this
Plan is $25,000 for each member and $25,000
for each eligible dependent in any 24-month
period. This maximum may be reinstated
after the plan has paid $1,000 or more for
any one illness or injury provided satisfac-
tory evidence of return to good health is
provided.

HOW A CLAIM IS MADE

e Hold your receipts until the allowable
charges are in excess of $25.00.

e For drug expenses, the original official
Pharmacare Receipt issued by the drug
store is required. If you do not get this
official receipt a copy of the prescription is
required.

© Obtain an E.H.B. claim form from your
employer and follow the instructions on the
form. When properly completed, send the
E.H.B. claim form, together with your
receipts to the address noted on the claim
form.

EXAMPLE OF AN E.H.B. CLAIM

Expenses ,
Prescribed Drugs $ 80.00
Ambulance 27.50
Contact Lenses 125.00
Total eligible expenses $232.50
Deductible $ 25.00
Balance $207.50
80% Reimbursement of $207.50= $166.00
E.H.B. Plan Pays $166.00

All receipts will be returned to you as soon
as the claim has been processed. You may
have to file a claim with Pharmacare too for
reimbursement of prescription drug charges
when your bills total more than $125.

VISION CARE
(Effective June 15, 1982)

The Extended Health Benefit Plan pro-
vides payment to a maximum of $100.00
per person in any 24 consecutive month
period for charges incurred relative to the
purchase of lenses and frames or contact
lenses when prescribed by a person legally
qualified to make such prescription.

The Vision Care Option is subject to the
Plan deductible and co-insurance and is
payable for services as outlined above when
services are ordered, provided and paid for
after June 15, 1982.

EXPENSES INCLUDED UNDER

YOUR EXTENDED HEALTH PLAN
The Plan pays for the following eligible

expenses when medically required and

ordered by your attending physician:

© Vision Care — Lenses, frames or contact
lenses as described above.

© 80% of hospital room accommodation in

British Columbia, (including $6.50/day

for the normal hospital charge for stand-

ard ward accommodation). The member
or dependent must be under the active
treatment and care of a physician or
surgeon.

© 80% of fees of a private nurse registered
with the Registered Nurses Association of

British Columbia who is not related to or

yesident with the member, and when

ordered by the attending physician or
surgeon for acute care..
© 80% of charges for drugs and medicines

(that are not paid for by Pharmacare)

when prescribed by the attending physi-

cian or surgeon. Charges for oral contra-
ceptives and patent medicines are not
included.

© 80% of the fees of the following services
provided that the particular paramedic or
physician is registered or licensed in the

Province of B.C. ;

(a) Chiropractors and Naturopathic phy-
sicians to a maximum of $200 per
member or dependent, $500 per family
in any one year (X-rays excluded).

(b) Fees of a member of the Association of
Physiotherapists and Massage Practi-
tioners of British Columbia.

(c) Podiatrists.

© 80% of the charges for oxygen, prosthetic
appliances (artificial limbs, eyes),
crutches, splints, casts, trusses, braces
when ordered by the attending physician
or surgeon.

© 80% of the monthly rental fee (not to
exceed the total purchase price) of a
wheelchair, hospital type bed, iron lung or
necessary equipment for therapeutic
treatment when ordered by the attending
physician or surgeon. If more economical,
these items may be purchased subject to
approval.

© 80% of the charges for ambulance services
in an emergency, including emergency
transportation by railroad, boat or sche-
duled airline to and from the nearest
hospital where adquate facilities are
available. In an acute emergency, the
expense of an air ambulance may also be
covered.

© 80% of the fees of a dentist for repairs to,
natural teeth (not dentures) when injuryis
sustained to such natural teeth by extra
oral accidental means and while the
person is covered by this Plan and when
such treatment occurs within one year of
the date of accidental injury.

© 80% of hospital charges for out-patient
emergency ward and short-stay facilities.

© 80% of Extended Care Unit charges for the
differential from standard ward to semi-
private or private room accommodation in
extended care units of acute general
hospitals.

© 80% of cost of orthopaedic shoes when
prescribed by an Orthopaedic Surgeon for
the proper management of unusual, con-
genital or post traumatic foot problems.

e 80% of charges for hearing aids for
dependent children under 16 years of age
when prescribed by the attending certified
Ear, Nose and Throat Specialist. The
maximum benefit during a five year
period shall not exceed $300 per child and
does not include payment for repairs and
maintenance, batteries, or re-charging
devices, or other such accessories.

© Charges made by a physician for medical
examination required by Government
statute or regulation for employment
purposes, provided such charges are not
covered by the employer under a collective
agreement and provided no claim has
been made under the Basic Medical Plan.

OUT-OF-PROVINCE

© 100% of the hospital room charges and/or
supplies for confinement, in the event of
an emergency while travelling or on
vacation, in an acute general hospital
over and above the charges covered by
any other underwriter or the B.C. Hospital
Program.

e 100% of reasonable charges for physi-
cians’ or surgeons’ services in an emer-
gency while travelling or on vacation
outside B.C. over and above the amount
allowed under the Medical Services Act of
British Columbia.

ITEMS NOT PAID FOR BY

YOUR E.H.B. PLAN

Items not covered include:

e Any expenses for which the Medical
Services Act of British Columbia, the B.C.
Hospital Program or Universal Pharma-
care is liable.

© Dental treatment (except as outlined
under “Eligible Expenses”).

e Rest cures, travel for health or health
examinations of any kind.

© Any illness or accident provided for by the
Workers’ Compensation Act or any
government Authority.

© Expenses related to or as a result of war,
riot or insurrection of any kind.

© Expenses of hospitalized patient at the
time of your enrollment in this Plan.

© Services or supplies where itis established
that a third party is liable at law.

10/Lumber Worker/April, 1983