TRIUMF’s Supplementary Health Benefits program is designed to enhance the existing health benefits provided by BC Medical and Sun Life Assurance by assisting you in paying for a number of medical services, supplies, drugs or equipment that may not be covered or partially covered by Provincial Health or Sun Life plans. This plan is administered by TRIUMF's Human Resources Department.
Coverage
Drugs, Equipment, Services, & Supplies Reimbursements are limited to the following:
- Hearing Exams: when performed by an audiologist once every 24 months to a maximum of $65.00 per person for employee and spouse only
- Hearing Aids: (not covered by WorkSafe BC) once in a lifetime for employee and spouse; $3,000 maximum per person
- Diagnostic and Refractive Services: for intraocular lens implant following cataract surgery if not covered by the provincial health or Sun Life plan; once in a lifetime for employee and spouse; 80% reimbursement to a maximum of $4,000
- 80% of Toric contact lenses for Astigmatism if not covered by Sun Life (employee only) every 24 months
- Travel Immunization: for the following: Yellow Fever; Hepatitis A; Polio; Typhoid; Tetanus; Malaria; and Diphtheria. Employee and spouse; 80% reimbursement per person; one time only)
- Smoking Cessation requiring a written prescription from a medical physician, maximum $200, one time only (employee only). No chewing gums or edible products; no patches covered by provincial health
- Outpatient Rehabilitative Services requiring a physician referral (employee and spouse only) maximum $500 per service per calendar year.
- Pharmaceutical Prescription Drug top up for drugs covered partially by Pharmacare and SunLife for renal disease, neurological disorders, cancer, bone disease, or arthritis for employee and spouse; maximum $500 per year
Paramedical Services for services covered by Sun Life for a paramedical practitioner are limited to the following:
- Licensed Speech Therapists when referred by a physician (upon submission of Sun Life’s maximum reimbursement receipt, an additional $300; (dependent children only)
- Licensed Physiotherapist or Licensed Massage Therapist when referred by a physician, (upon submission of Sun Life’s maximum reimbursement receipt, an additional $400; (for employee and spouse)
Medical Procedures reimbursement (employee only) for medical procedures partially covered by Sun Life and/or BC Medical, performed by a para-medical practitioner, or by an opted-out medical practitioner will be limited to:
- Non-emergency medically required surgical procedures (employee only; to a combined Sun Life / BC Medical / TRIUMF maximum of $1250; payable upon submission of the Sun Life / BC Medical reimbursement receipts; once every 5 years). Elective, and cosmetic procedures are not eligible.
Medical Supplies reimbursement for (employee and spouse) medical supplies not covered or partially covered by Sun Life and/or BC Medical, performed by a para-medical practitioner, or by an opted-out medical practitioner will be limited to 80% of the cost to a maximum of $1,000 every 4 years.
TRIUMF shall reserve the right to discontinue any of the above reimbursements should similar coverage be introduced to either the MSP or SunLife plans. Reimbursement or partial reimbursement for benefits not listed above may be considered on an adhoc basis based on reasonableness of the claim, or under certain circumstances such as, but not limited to: elimination of a covered expense by MSP or Sun Life.
To qualify for reimbursement you must be covered under the Provincial Medical Plan AND the SunLife Extended Health plan. In the case of those TRIUMF employees whose extended health plan is covered by another TRIUMF member university, the coverage under the applicable extended health plan will be the guiding factor for any reimbursement, based on the applicable plan’s exclusions or limitations.
Claims Reimbursement Procedures
Eligible employees must pay the provider and then submit the original itemized paid receipt through Workday in order to be reimbursed. The original receipt must include the following:
- Employee’s Name
- Patient’s name
- Servicel provider’s name and address
- Description of the drugs, procedure, service, supply etc
- Date and charge for the service; and /or reimbursement amount already received by SunLife (Claims Statement) or MSP
- Copy of debit/credit card slip, if applicable
Note: Cancelled cheques, credit card and or debit card slips alone are not enough to consider or process a claim.