2023 Benefit Summary

3/1/23, 11:27 AM Benefit Summary
Manulife Financial
Benefits Booklet
Unijet Industrial Pipe Ltd.

Plan Number: G0052326
Class: All Employees
https://wwwec6.manulife.com/gbadmin/pa_EPAKVirtual.jsp?FormName=booksumeB# 1/35
Table Of Contents
Introduction
Dental
Extended Health Care Benefit
Counselling Services [Workplace Advisor]
Health Service Navigator®
Long-Term Disability
Life Insurance
Survivor Benefit
Accidental Death and Dismemberment Insurance
Critical Illness
Conversion Option
FollowMeTM Health
A message from your plan sponsor

Unijet Industrial Pipe Ltd. is pleased to be able to offer you medical and financial security by sponsoring your group benefits program. We have selected
Manulife Financial as a partner to help us deliver the program. They are committed to providing excellent service for us.
At this point, you will have received some basic information about how you can connect with Manulife Financial and how to submit claims. Now, I would
encourage you to spend a few moments reviewing our plan's coverage so you can better understand what's available. You'll learn about not only the
more routine things, but also about some of the benefits available that you may need to draw on in a time of crisis. Your plan is here to offer you some
support in the event you encounter unforeseen circumstances in the future.
After reviewing the coverage, if you have any questions, check in with our plan administrator.
Planning for Financial Security

You may be interested in developing a personalized financial plan that will help you achieve your goals. The benefits representative who helped us
arrange your group benefits program can also work with you to help determine your need for individual insurance or personal savings and investments. If
you're interested, contact Corey Pelland.
Core Coverage and Services

Your plan sponsor has chosen to offer the following benefits to form the coverage in this program:
Dental
Benefit Details Your Plan's Coverage
Waiting Period 3 months
Deductible None
Dental Fee Guide Current Manitoba Fee Guide for General Practitioners
Coverage ends At the earlier of age 75 or your retirement
Combined Maximum applies to:

Level I
Level II $1,500 per calendar year
Level III
Level IV
Level I - Basic Services
Includes items such as:

complete oral exam, one per 2 calendar years
full-mouth x-rays, one per 2 calendar years
one unit of light scaling and one unit of polishing once every 6
months, when the service is performed outside Quebec, or
prophylaxis once every 6 months, when the service is performed in
Quebec
bitewing x-rays, two films, once every 6 months
recall exams, and fluoride treatments, once every 6 months
routine diagnostic and laboratory procedures
fillings, retentive pins and pit and fissure sealants
Replacement fillings are covered provided:
- the existing filling is at least 12 months old and must be replaced 80% to a combined maximum of $1,500 per calendar year
either due to significant breakdown of the existing filling or recurrent
decay, or
- the existing filling is amalgam and there is medical evidence
indicating that the patient is allergic to amalgam
pre-fabricated full coverage restorations (metal and plastic)
space maintainers (appliances placed for orthodontic purposes are
not covered)
minor surgical procedures and post surgical care
extractions (including impacted and residual roots)
consultations, anaesthesia, and conscious sedation
denture repairs, relines and rebases, only if the expense is incurred
later than 3 months after the date of the initial placement of the
denture
injection of antibiotic drugs when administered by a Dentist in
conjunction with dental surgery
Level II - Supplementary Services 80% to a combined maximum of $1,500 per calendar year

surgical procedures not included in Level I (excluding implant

surgery)
periodontal services for treatment of diseases of the gums and other
supporting tissue of the teeth, including:
- scaling not covered under Level I, and root planing, up to a
combined maximum of 6 units per calendar year(s) ;
- provisional splinting; and
- occlusal equilibration, up to a maximum of 8 units per calendar
year(s)
endodontic services which include root canals and therapy, root
amputation, apexifications and periapical services
root canals and therapy are limited to one initial treatment plus one
re-treatment per tooth per lifetime
re-treatment is covered only if the expense is incurred more than 12
months after the initial treatment
Level III - Dentures

initial provision of full or partial removable dentures
replacement of removable dentures, provided the dentures are
required because:
- a natural tooth is extracted and the existing appliance cannot be 50% to a combined maximum of $1,500 per calendar year
made serviceable;
- the existing appliance is at least 60 months old; or
- the existing appliance is temporary and is replaced with the
permanent dentures within 12 months of its installation
dentures required solely to replace a natural tooth which was missing
prior to becoming insured for this eligible expense, are not covered
Level IV - Major Restorative Services

crowns and onlays when the function of a tooth is impaired due to
cuspal or incisal angle damage caused by trauma or decay
inlays, covering at least 3 surfaces, provided the tooth cusp is
missing
initial provision of fixed bridgework
50% to a combined maximum of $1,500 per calendar year
replacement of bridgework, provided the new bridgework is required
because:
- a natural tooth is extracted and the existing appliance cannot be
made serviceable;
- the existing appliance is at least 60 months old; or
- the existing appliance is temporary and is replaced with the
permanent bridge within 12 months of its installation
bridgework required solely to replace a natural tooth which was
missing prior to becoming insured under this Plan is not covered
Exclusions
No Dental Care benefits will be payable for expenses resulting from:

war, insurrection, the hostile actions of any armed forces or participation in a riot or civil commotion
the committing of or the attempt to commit an assault or criminal offence
injuries sustained while operating a motor vehicle while under the influence of any intoxicant or if blood contains more than 80 milligrams of alcohol
per 100 millilitres of blood at the time of injury.
dental care which is cosmetic, unless required because of an accidental injury which occurred while the patient was insured under this benefit
anti-snoring or sleep apnea devices
broken dental appointments, third party examinations, travel to and from appointments, or completion of claim forms
services which are payable under any other part of this policy, by any government plan or legally mandated program

services or supplies provided by an employer, association or trade union's medical or dental department
services or supplies for which no charge would normally be made in the absence of insurance
treatment rendered for a full mouth reconstruction, for a vertical dimension or for a correction of temporomandibular joint dysfunction
replacement of removable dental appliances which have been lost, mislaid or stolen
laboratory fees which exceed reasonable and customary charges
services or supplies which are performed or provided by the insured person, an immediate family member or a person who lives with the insured
person
implants, or any services rendered in conjunction with implants. However, where an implant is the choice of treatment and a denture or bridge
would produce professionally adequate results for the condition, Manulife Financial will pay the cost of the implant expense and any related
services, at a cost equal to the least expensive cost of a denture or bridge
treatment which is not generally recognized by the dental profession as an effective, appropriate and essential form of treatment for the dental
condition
services or supplies which are not specified as a covered expense under this benefit
If you anticipate charges for any treatment to exceed $500, please submit a pre-treatment plan before receiving the service so you can understand what portion your plan may
cover.
Your plan will pay benefits for the least expensive course of treatment when there are two or more courses of treatment covered that would produce professionally adequate results
for a given condition. Manulife's professional dental consultant will aid in evaluating the various courses of treatment available to determine which is professionally adequate.
If you apply for coverage for Dental insurance late, Late Dental Application insurance will be limited to $125 for each insured person for the first 12 months of coverage.
All claims must be submitted within 12 months after the date the expense was incurred. However, upon termination of your insurance, all claims must be submitted no later than 90
days from the termination date.
Extended Health Care Benefit

This benefit has many components that extend your coverage to a wide variety of health care providers and services. Under the broad category there may
be coinsurances, deductibles, maximums and limitations that apply to specific components of the coverage.
This plan will not automatically assume eligibility for all drugs, services and supplies. New drugs, existing drugs with new indications, services and
supplies are reviewed by Manulife Financial using the due diligence process. Once this process has been completed, the decision will be made by
Manulife Financial to include as a covered expense, include with prior authorization criteria, exclude or apply maximum limits.
Maximum Unlimited
$25 Individual, $50 Family, per calendar year(s)
Not applicable to:

Drugs
Deductible
Out-of-Canada Emergency Medical Treatment
Covered expenses used to satisfy the deductible in the last 3 months of

the calendar year may also be used to satisfy the deductible in the
following calendar year.
Co-insurance 100% for Hospital Care, Medical Services & Supplies,

Professional Services, Drugs
Coverage Ends At the earlier of age 75 or your retirement
Exclusions
No Extended Health Care benefits are payable for expenses related to:
(not applicable to Health Service Navigator®)
for Medical Travel Emergencies and Emergency Travel Assistance only, self-inflicted injuries, unless medical evidence establishes that the injuries
are related to a mental health illness
war, insurrection, the hostile actions of any armed forces or participation in a riot or civil commotion
committing or attempting to commit an assault or criminal offence
injuries sustained while operating a motor vehicle while under the influence of any intoxicant or if blood contains more than 80 milligrams of alcohol
per 100 millilitres of blood at the time of injury.
an illness or injury for which benefits are payable under any government plan, workers' compensation or legally mandated program
charges for periodic check-ups, broken appointments, third party examinations, travel for health purposes, or completion of claim forms
services or supplies provided by an employer, association or trade union's medical or dental department
services or supplies for which no charge would normally be made in the absence of insurance
services and supplies where reimbursement would have been made under a government-sponsored plan, in the absence of insurance
services or supplies which are not permitted by law to be paid
services or supplies which are required for recreation or sports
services or supplies which would have been payable by the Provincial Plan if proper application had been made
medical treatment which is not usual or customary, or is experimental or investigational in nature
medical or surgical care which is cosmetic
services or supplies which are performed or provided by the insured person, an immediate family member or a person who lives with the insured
person
services or supplies which are provided while confined in a hospital on an in-patient basis

services or supplies which are not specified as a covered expense under this benefit
All claims must be submitted within 12 months after the date the expense was incurred. However, upon termination of your insurance, all claims must be submitted no later than 90
days from the termination date.
EHC - Drugs
100% Co-insurance
Direct Drugs
Includes the following drug classes:
drugs for the treatment of an illness or injury which by law or

convention requires the written prescription of a physician or dentist
when prescribed in writing by a physician or dentist and dispensed by
a licensed pharmacist
oral contraceptives
injectable medications There is a limitation on quantity of drugs that can be
life-sustaining drugs dispensed and claimed at one time, to the lesser of:
diabetic supplies (excluding cotton swabs, rubbing alcohol, automatic
jet injectors and similar equipment) a) the quantity prescribed by the Physician or Dentist; or
No coverage for / excludes:
b) a 34 day supply; or
preventive vaccines and medicines (oral or injected) c) up to a 100 day supply may be payable in long term
fertility drugs therapy where the larger quantity is recommended as
anti-smoking drugs
appropriate by the Physician and the Pharmacist.
anti-obesity drugs
sexual dysfunction drugs
drugs, biologicals and related preparations which are administered in If you are a Quebec resident, your plan's coverage will
hospital on an in-patient or out-patient basis coordinate with RAMQ.
drugs determined to be ineligible as a result of due diligence
cotton swabs, rubbing alcohol, automatic jet injectors and similar
equipment used in the treatment of diabetes
charges to administer serums, vaccines & injectable drugs
experimental or investigational drugs not approved as an effective,
appropriate and essential treatment of an illness or injury
natural health products (products with a NPN)
EHC - Health Care Professionals (Professional Services)

100% Co-insurance
$500 per calendar year(s) for Chiropractor
$500 per calendar year(s) for Osteopath
$500 per calendar year(s) for Podiatrist/Chiropodist
$500 per calendar year(s) for Massage Therapist
$500 per calendar year(s) for Naturopath
$500 per calendar year(s) for Speech Therapist

Services provided by the following licensed practitioners:
$1,000 per calendar year(s) for Physiotherapist
Chiropractor, Osteopath, Podiatrist/Chiropodist, Massage
Therapist, Naturopath, Speech Therapist, Physiotherapist
Expenses for some of these professional services may be
payable in part by provincial plans. Coverage for the
balance of such expenses prior to reaching the provincial
plan maximum may be prohibited by provincial legislation.
In those provinces, expenses under this benefit program
are payable after the Provincial Plan's maximum for the
benefit year has been paid.
Recommendation by a physician for Professional Services

is not required.
EHC - Medical Supplies and Services

100% Co-insurance (unless otherwise stated)
For all medical equipment and supplies, coverage is limited to the cost of the device or item that adequately meets the patient's fundamental medical
needs.
Private Duty Nursing Services
Provided by a registered nurse or registered nursing

$10,000 per calendar year(s)
assistant who has completed an approved medications
training program
Excludes:
custodial care, homemaking duties or supervision
services performed by a nurse practitioner who is an immediate

family member or who lives with the patient
Submit a detailed treatment plan estimate before Private
services performed while confined to a hospital, nursing home or Duty Nursing services begin so we can advise you of what
other similar institution benefit may be provided.
services that could be performed by a person with lesser

qualifications, a relative, a friend or a member of the patient's
household
$500 per 5 calendar year(s)

Hearing Aids
Includes cost, installation, repair and maintenance of
Hearing Aids (including charges for batteries)
$150 per calendar year(s) for Stock-item Orthopaedic

Shoes
Custom Made Shoes which are required because of a

medical abnormality that, based on medical evidence,
cannot be accommodated in a stock-item orthopaedic
shoe or a modified stock-item orthopaedic shoe, up to a
Orthopaedic Shoes/Orthotics
maximum of 1 pair per calendar year (must be constructed
by a certified orthopaedic footwear specialist)
$400 per 3 calendar year(s) for Custom Made Orthotic

Foot Appliances
Must be recommended by a physician or podiatrist.
Medical Equipment
4 per calendar year for surgical brassieres
$250 per lifetime for wigs and hairpieces
ambulance (licensed including air ambulance, provided in province of

residence)
mobility equipment (crutches, canes, walkers, wheelchairs) Medical equipment dispensed by a hospital is not an
manual hospital beds
eligible expense.

respiratory and oxygen equipment
other equipment usually found only in hospitals
non-dental external prostheses In the province of Quebec, microscopic and other similar
diagnostic tests and services rendered in a licensed
braces (other than foot braces), trusses, collars, leg orthosis, casts
and splints laboratory are included, up to a maximum of $1,000 per
calendar year.
ileostomy, colostomy and incontinence supplies
medicated dressings and burn garments
oxygen Accidental dental treatment to the natural teeth or jaw must
charges for the treatment required as a result of an injury to natural be provided within 12 months of the accident. Injuries
teeth or jaw sustained while biting or chewing are not covered.
surgical brassieres
wigs and hairpieces for temporary hair loss associated with medical
treatment
Surgical Stockings $400 per calendar year
EHC - Hospital
100% Co-insurance
in a Semi-Private Room
in excess of the hospital's public ward charge
Charges for any portion of the cost of ward

General or Rehabilitation hospitals accommodation, utilization or copayment fees (or similar
charges) will not be covered.
Manulife Financial will coordinate payment after any

provincial plan coverage has first been applied.
EHC - Medical and Non-Medical Travel Emergencies
100% with a lifetime maximum of $5,000,000
Coverage is limited to 60 days per trip.
Stable means in the 90 days before departure, the insured person has
not:
been treated or tested for any new symptoms or conditions;
had an increase or worsening of any existing symptoms;
Emergency medical coverage changed treatments or medications (other than normal adjustments
for ongoing care);
Conditions: been admitted to the hospital for treatment of the condition.
Coverage is not available if you (or your dependent) have

Coverage is for immediate medical treatment required for: scheduled non-routine appointments, tests or treatments
- a sudden, unexpected injury or a new medical condition which
occurs while an insured person is travelling outside of their province for the condition or an undiagnosed condition.
of residence; or
- a specific medical problem or chronic condition that was diagnosed A medical emergency ends when the attending physician
but medically stable prior to departure.
feels that, based on the medical evidence, a patient is
Coverage is available for medical emergencies related to pregnancy stable enough to return to their home province or territory.
as long as travel is completed at least 4 weeks before the due date.
Valid Government Health Insurance Plan (GHP) coverage is required
for you and your dependents.
You are typically responsible for payment of medical
expenses amounting to less than $200 CDN. When you
return from your trip, you can submit a claim to be
reimbursed for those expenses through the normal claim
submission process.
For charges over $200 CDN, contact the service partner

shown on your benefits card as soon as possible to
arrange for payment directly to the treating physician or
facility.
Non-Emergency medical coverage
Conditions:
50% with a maximum of $3,000 every 3 calendar year(s)

recommendation by a practicing physician in Canada is required
suggests that you submit a detailed treatment plan with cost
estimates before treatment begins. You will then be advised of any
benefit that will be provided.
Emergency Travel Assistance 100% with all maximums below stated in Canadian Funds.
Including:
24 hour access to multi-lingual service representatives $1,000 for return of vehicle

referral to local medical care and treatment monitoring
$2,000 for meals and accommodations
payment of medical bills, medical transportation, return home of
dependent children, visit by a family member, trip interruption/delay

coverage, support through convalescence after hospital discharge, $5,000 for return of deceased
identification and/or return of a deceased traveller, meals and
accommodation, vehicle return, pre-trip advice on passport, visa,
vaccination and inoculation requirements for a destination, assistance
in replacing lost documents and tickets, referral to legal assistance in
your foreign destination, telephone interpretation service, emergency
message service, and
after-hours medical advice phone support
See Emergency Travel Assistance for additional information, a
list of phone numbers for frequent Canadian travel
destinations and for participating countries.
Counselling Services [Workplace Advisor]

Your plan also includes access to services and information you will use to help you live a healthier life. You can access these services on the Plan Member
Secure Site.
Approximately 4 to 6 hours of short-term counselling for an

Short term counselling for you and any dependents for a unlimited number of issues.
wide range of issues from psychological problems to
addictions, and from family and marital concerns to You can receive counselling by phone, online or in person.
nutritional counselling for example.
Online self-help courses on a variety of topics including but

not limited to: To access counselling services online:
Embracing Workplace Change
Taking Control of Stress / Taking Control of Your Mood
Visit the Plan Member Secure Site
Taking Control of Job Loss / Taking Control of Your Career
To access any of the Workplace advisor services by
Taking Control of Alcohol Use phone:
Foundations of Effective Parenting
Resolving Conflict in Intimate Relationships Call 1-866-644-0326 to reach a representative any time,
24 hours a day.
Database to search for childcare or eldercare resources in your area
If you use a TTY/TDD device, call 1-888-384-1152.
Personalized information and tools that are selected by counselling professionals with your best interests in mind.
Health Service Navigator®
Whether you or a family member have been diagnosed with a critical or chronic health condition, or you are simply
curious about the services available in your area, Health Service Navigator® points you to agencies or resources that
may be able to provide the information you need, including:
tips and tools you can use to navigate through the Canadian health care landscape
a national physician search database
provincial health plan information
health, medical condition, treatment plan options and medication information you can trust, and
a second medical opinion service for times when you may want to double check a serious medical diagnosis you, your spouse or your child has
received
With the exception of the second opinion service (which is available by phone only), Health Service Navigator tools are all
available for you or your spouse or children any time on the Plan Member Secure Site.
Long-Term Disability
Benefit Amount 66.7% of monthly basic earnings to a maximum of $2,500
Qualifying Period 119 days
Totally Disabled means a restriction or lack of ability due to

an illness or injury which prevents you from performing the
essential duties of:
your own occupation, during the Qualifying Period and the 2 years
immediately following the Qualifying Period
any occupation for which you are qualified, or may reasonably
become qualified, by training, education or experience, after the 2
years specified above
Definition of Disability
The availability of work will not be considered by Manulife

Financial in assessing your disability.
If you must hold a government permit or license to perform

the duties of your job, you will not be considered Totally
Disabled solely because your permit or license has been
withdrawn or not renewed.
Maximum Benefit Period To age 65
Non-Evidence Limit $2,500
Age 65 less the Qualifying Period, or your retirement,

Termination
whichever is earlier
The tax position of any payments you receive under this

benefit depends on whether you or your employer pays the
cost of the benefit.
Tax Status
If your employer pays any portion of the premium for this
benefit, then any payments you receive will be taxable. If
you pay the full cost of the benefit, then any disability
benefit payments you receive will be non-taxable.
The premium for your Long Term Disability benefit will be

Waiver of Premium waived during any period you are entitled to receive Long
Term Disability benefit payments.
Entitlement To be entitled to disability benefits, you must meet the

following criteria:
you must be continuously Totally Disabled throughout the Qualifying
Period. If you cease to be Totally Disabled during this period and then
become disabled again within 3 weeks due to the same or related
illness or injury, your Qualifying Period will be extended by the
number of days during which you ceased to be Totally Disabled

Manulife Financial must receive medical evidence documenting how
your illness or injury causes restrictions or lack of ability, such that
you are prevented from performing the essential duties of:
- your own occupation, during the Qualifying Period and the following
2 years, and
- any occupation for which you are qualified, or may reasonably

you must be receiving from a physician, regular, ongoing care and

treatment appropriate for your disabling condition, as determined by
Manulife Financial
At any time, Manulife Financial may require you to submit
to a medical, psychiatric, psychological, functional,
educational and/or vocational examination or evaluation by
an examiner selected by Manulife Financial.
No benefits are payable for any disability related to:

self-inflicted injuries, unless medical evidence establishes that the
injuries are related to a mental health illness
war, insurrection, the hostile actions of any armed forces or
participation in a riot or civil commotion
medical or surgical care which is not medically necessary
the committing of or the attempt to commit an assault or criminal
offence
Exclusions injuries sustained while operating a motor vehicle while under the
influence of any intoxicant, including alcohol
abuse of addictive substances, including drugs and alcohol, unless
you are actively participating and co-operating in an in-patient
medical treatment program for substance abuse which has been
approved by Manulife Financial
a Pre-Existing Condition which causes disability within the first 12
months of your Long Term Disability coverage. A Pre-Existing
Condition is any injury or illness (whether diagnosed or not) for which
you were treated or attended by a physician, or for which drugs were
prescribed, within 90 days prior to the effective date of your coverage
When you are:

not receiving from a physician, regular, ongoing care and treatment
appropriate for your disabling condition, as determined by Manulife
Financial
receiving EI (Employment Insurance) maternity or parental benefits
Periods for which you are not entitled to benefits
on lay off
(Unless your employer is required to provide coverage on leave of absence
because of legislation, regulation, or by law) receiving benefits under an employer sponsored salary continuance
plan
working in any occupation, except as provided for under the
Rehabilitation Assistance provision
incarcerated
Amount of Disability Benefit Payable The amount of disability benefit payable to you is the
Benefit Amount shown above reduced by any amount you
receive or are entitled to receive from the following sources
for the same or related disability:
Workers' Compensation or similar coverage
Canada or Quebec Pension Plans

any government motor vehicle automobile insurance plan or policy,
unless prohibited by law
If necessary, the amount of your benefit will be further
reduced so that your total amount from all sources does
not exceed 85% of your pre-disability gross earnings (net
earnings, if your benefit is non-taxable). All sources include
those sources stated above and:
a) any amount you receive or are entitled to receive from:

any group, association or franchise plan
any retirement or pension plan
earnings or payments from any employer, including severance
payments and vacation pay
self-employment
any government plan, excluding Employment Insurance Benefits
b) any amount of Canada or Quebec Pension Plan

benefits which another member of your family receives or
is entitled to receive by reason of your disability
Once benefits become payable, the amount of your benefit

will not be affected by any subsequent cost of living
increase in benefits you are receiving from other sources.
Manulife Financial will apply the following rules in

determining your disability benefit:
benefits payable from other sources which began before the
commencement of your current Disability will not be taken into
account
benefits payable from other sources will not be adjusted to take into
account any difference between the tax status of those benefits and
the benefit payable by Manulife Financial
subsequent changes in benefits from other sources, other than cost
Rules we use to calculate your benefit of living increases, will be taken into consideration and a new benefit
amount may be established
benefits payable under individual disability income insurance will not
be taken into account
for benefits payable other than on a monthly basis, a monthly
equivalent of such benefit will be estimated by Manulife Financial
if you do not apply for a benefit for which you are eligible, the amount
of such benefit will be estimated by Manulife Financial and assumed
to be paid
If your disability is caused by another person and you have

a legal right to recover damages, Manulife Financial will
request that you complete a subrogation reimbursement
agreement when you submit your Long Term Disability
claim.
Subrogation
On settlement or judgment of your legal action, you will be
required to reimburse Manulife Financial those amounts
you recover which, when added to the disability benefits
that Manulife Financial paid to you, exceed 100% of your
lost income.
Termination of Payments Your disability benefit payments will cease on the earliest
of:
the date you cease to be Totally Disabled, as defined under this

benefit
the date you do not supply Manulife Financial with appropriate
medical evidence documenting how your illness or injury causes
restrictions or lack of ability such that you are prevented from
performing the essential duties of:
- your own occupation, during the Qualifying Period and the following
2 years, and
- any occupation for which you are qualified, or may reasonably

the date you do not attend an examination by an examiner selected

by Manulife Financial
the date on which benefits have been paid up to the Maximum
Benefit Period for this benefit
the date of your death
If you become Totally Disabled again from the same or

related causes within 6 months from the end of the period
for which benefits were paid, Manulife Financial will treat
the disability as a continuation of your previous disability.
You will not be required to satisfy any applicable Qualifying

Period again. The benefit payable to you will be based on
your earnings as at the date of your previous disability.
Benefits for all such recurrent disabilities will not be paid
Recurrent Disability for a combined period longer than the Maximum Benefit
Period for this benefit.
If the same disability recurs more than 6 months after the

end of the period for which benefits were paid, such
disability will be considered a separate disability.
Two disabilities which are due to unrelated causes are

considered separate disabilities if they are separated by a
return to work of at least one day.
Submitting Claims: Please contact your Plan Administrator 6 to 8 weeks prior to the end of your Qualifying Period.
Manulife Financial will contact you to discuss details of your Long Term Disability coverage.
Payments: Disability benefit payments will be made monthly in arrears. Any payment for a period of less than one month
will be made at a daily rate of one-thirtieth of your monthly benefit amount.
Rehabilitation Assistance
Once Manulife Financial determines that you are Totally Disabled, if appropriate, and at Manulife Financial's discretion,
you may be offered rehabilitation to assist you in returning to gainful employment, either to your pre-disability occupation
or to another occupation.
In considering whether Rehabilitation Assistance is appropriate for you, Manulife Financial will take into account:
the nature, extent and expected duration of your disability
your level of education, training or experience
the nature, scope, objectives and cost of a Vocational Plan
Vocational Plan
A Vocational Plan is a training or job placement program that is expected to facilitate your return to gainful employment. If
it is determined that Rehabilitation Assistance is appropriate for you, in partnership with you and your employer, Manulife
Financial will provide a structured Vocational Plan that will prepare you for a return to work, either:
with your employer

with an alternate employer
in a self-employed capacity
Disability Benefits During Rehabilitation
You will continue to be entitled to disability benefits while participating in the Vocational Plan. If you receive any earnings
as part of the plan, your disability benefit will be reduced once your total income (your disability benefit plus your
earnings) exceeds 100% of your pre-disability gross earnings; net earnings if your benefit is not taxable.
If you cease to participate in the Vocational Plan because of a change in your medical status, Manulife Financial will
require medical evidence documenting how your current medical status prevents you from continuing with the Vocational
Plan. If you are not available or do not co-operate or participate in the Vocational Plan, you will no longer be entitled to
disability benefits.
Life Insurance
You may also wish to consider supplementing this coverage by purchasing any available Optional or Personal Benefits coverage available for your plan.
For you as the employee
1 times your annual earnings, to a maximum of $500,000,

Benefit Amount
with a minimum benefit of $25,000
Your benefit amount reduces by 50% at age 65 and

Reduction and Termination Age
terminates at age 70 or retirement, whichever is earlier
Qualifying Period for Waiver of Premium 119 days
If you become Totally Disabled while insured and prior to

age 65 and meet the Waiver of Premium Entitlement
Criteria, your Life Insurance will continue without payment
of premium.
Totally Disabled means a restriction or lack of ability due to

an illness or injury which prevents you from performing the
essential duties of:
your own occupation, during the Qualifying Period and the 2 years
immediately following the Qualifying Period
Waiver of Premium
any occupation for which you are qualified, or may reasonably
become qualified by training, education or experience, after the 2
The availability of work will not be considered by Manulife

Financial in assessing your disability.
If you must hold a government permit or licence to perform

the duties of your job, you will not be considered Totally
Disabled solely because your permit or licence has been
withdrawn or not renewed.
If your Group Benefits terminate or reduce, you may be

eligible to convert your Life Insurance to an individual
policy, without needing to provide medical evidence. Your
application for the individual policy along with the first
monthly premium must be received by Manulife Financial
within 31 days of the termination or reduction of your Life
Conversion Privilege Insurance. If you die during this 31-day period, the amount
of Life Insurance available for conversion will be paid to
your beneficiary or estate, even if you didn't apply for
conversion.
See the conversion option details in the Individual plan options

section.
For your spouse and your dependents
$10,000 for your spouse and $5,000 for each dependent

Benefit Amount
child
Termination Age The earlier of Plan member's age 70 or retirement
Qualifying Period for Waiver of Premium 119 days
If you become Totally Disabled while insured and prior to

age 65 and meet the Waiver of Premium Entitlement
Waiver of Premium
Criteria, your Life Insurance will continue without payment
of premium.
If your spouse's Life insurance terminates, you may be

eligible to convert the terminated insurance to an individual
policy, without medical evidence. Your spouse's application
for the individual policy, along with the first monthly
Conversion Privilege premium, must be received by Manulife Financial within 31
days of the termination date.
See the conversion option details in the Individual plan options

section.
Your beneficiary or estate must submit a claim within 90 days of the date of death. He or she can obtain the necessary
paperwork from your plan sponsor. Claims for Waiver of Premium must be submitted within 180 days of the end of the
qualifying period.
If you are terminally ill and not expected to live more than 24 months, and you require financial assistance, you may
qualify for a Compassionate Assistance loan.
You have the right to designate and/or change a beneficiary, subject to governing law. The necessary forms are available
from your Plan Administrator.
You should review your beneficiary designation to be sure that it reflects your current intent.
Survivor Benefit
If you die while your dependents are insured under the Coverage will continue until the earliest of:
program, Manulife Financial will continue coverage for
some benefits without payment of premium: the date your dependent is no longer a dependent
the date similar coverage is obtained elsewhere
Extended Health Care
the date the Group Policy terminates
Dental Care
Accidental Death and Dismemberment Insurance

The amount payable for each loss is a percentage of the Accidental Death and Dismemberment benefit amount which was in effect for you on the date of
your injury.
1 times your annual earnings, to a maximum of $500,000 ,

Benefit Amount
with a minimum benefit of $25,000

Reduction and Termination Age
terminates at age 70 or retirement, whichever is earlier
Covered losses must: Loss of Life - 100%

be as a direct result of the accidental injury Loss of or Loss of Use of Both Hands or Both Feet - 100%
have occurred within 365 days from the date of the accidental injury Loss of Sight of Both Eyes - 100%
be total and irreversible or irrecoverable Loss of One Hand and One Foot - 100%
Loss of One Hand and Sight of One Eye - 100%
Loss of One Foot and Sight of One Eye - 100%
Exclusions:
Loss of Hearing in Both Ears and Speech - 100%
No Accidental Death & Dismemberment benefits will be Loss of or Loss of Use of One Arm or One Leg - 75%
payable if the loss results from any of the following: Loss of or Loss of Use of One Hand or One Foot- 66 2/3%
suicide or self-inflicted injuries Loss of sight of One Eye - 66 2/3%
war or insurrection, the hostile actions of any armed forces, or Loss of Speech or Hearing in Both Ears - 66 2/3%
Loss of Thumb and Index Finger or at least Four Fingers of One
an infection (except pyogenic infections from an accidental cut or Hand - 33 1/3%
wound), illness or disease, or the medical treatment of any illness or
disease, or bodily or mental infirmity Loss of All Toes of One Foot - 25%
Loss of Hearing in One Ear - 25%
riding in, boarding or leaving, or descending from, any aircraft as a
pilot, operator or member of the crew Hemiplegia, Paraplegia or Quadriplegia - 200%
riding in, boarding or leaving, or descending from, any aircraft which
is owned, operated or leased by or on behalf of your employer
In the case of loss of speech or hearing, or loss of use of
committing or attempting to commit an assault or criminal offence
an arm, hand or leg, the loss must be continuous for 12
injuries sustained while operating a motor vehicle while under the months and determined to be permanent, after which time
influence of any intoxicant, including alcohol
the benefit is payable.
Only one percentage, the largest, will be paid for multiple

losses to the same limb due to any one accident. No more
than 100% will be paid for all losses due to any one
accidental injury, except in the case of hemiplegia,
paraplegia or quadriplegia, where the total amount paid will
not exceed 200% (provided the benefit is paid while you
are living).
Exposure and Disappearance If a loss occurs due to unavoidable exposure to the

elements, after a conveyance in which you were travelling
made a forced landing, or was lost, wrecked, stranded or
sank, a benefit will be payable for that loss. The amount
payable will be determined in accordance with the covered
loss list.

If you disappear after a conveyance in which you were
travelling made a forced landing, or was lost, wrecked,
stranded or sank, a benefit for loss of life will be payable if
your body is not found within 365 days after the incident
occurred.
If your Employee Life Insurance premium is waived

because you are totally disabled, the premium for this
Waiver of Premium benefit will also be waived. Accidental Death and
Dismemberment Waiver of Premium ends if this plan
terminates.
must be submitted within 90 days of the date of injury or death. Necessary paperwork is available from your plan
Claims
sponsor. Claims for Waiver of Premium must be submitted within 180 days of the end of the qualifying period.
You have the right to designate and/or change a beneficiary, subject to governing law. The necessary forms are available
from your Plan Administrator.
You should review your beneficiary designation to be sure that it reflects your current intent.
Critical Illness
You may also wish to consider supplementing this coverage by purchasing: Optional Personal Critical Illness
Your Policy Contract number for Critical Illness benefits is G0122736.
Manulife Financial will apply the following criteria in

determining your entitlement to Critical Illness Benefits:
Manulife Financial receives medical evidence documenting your
diagnosis of a covered Critical Illness condition;
Entitlement Criteria the diagnosis of any Critical Illness is made by a Physician,

practicing medicine in Canada in a specialty relating to the applicable
Critical Illness.
At any time, Manulife Financial may require you to submit to a medical

examination or evaluation by an examiner selected by Manulife
Financial.
Benefit amount $50,000

Comprehensive
The benefit is payable for the first covered condition
diagnosis only and you must survive at least 30 days
following the diagnosis of a covered condition in order to
receive the benefit.

Reduction and Termination Age terminates at the earliest of your retirement, attainment of
age 70, or benefit payout
If you are under age 65 and your group benefits terminate,

you may be eligible to convert the Critical Illness Insurance
to a Personal Critical Illness policy without needing to
Conversion
supply medical evidence. You must apply for the coverage
within 31 days of the termination of your Critical Illness
Insurance.
Exclusions No benefits are payable for any Critical Illness directly or

indirectly related to:
any specific exclusions for a given condition as set out in the
Covered Critical Illness Conditions definitions (available from the Forms
and Brochures section of the Plan Member Secure Site)
self-inflicted injuries or illnesses
abuse of addictive substances, including drugs and alcohol
war, insurrection, the hostile actions of any armed forces or
the committing of or the attempt to commit an assault or criminal
offence
injuries sustained while operating a motor vehicle, either while under
the influence of any intoxicant or if the insured's blood contained more

than 80 milligrams of alcohol per 100 milliliters of blood at the time of
the injury
taking a poisonous substance or inhaling toxic gases or fumes
A pre-existing medical conditions exclusion applies to coverage that is

provided without completion of a detailed medical questionnaire. If you
are diagnosed with a condition for which you have exhibited signs or
symptoms, received or should have received medical treatment,
consulted a physician, or been prescribed medication during the 24
months prior to the effective date of coverage, then during the first 24
months of coverage, no benefit is payable for a condition that is directly
or indirectly related to such a pre-existing condition.
Within the first 90 days of coverage no benefit will be paid for cancer or
benign brain tumour if the insured exhibits or receives any of the
following:
a. signs or symptoms that lead to a diagnosis of cancer or benign brain

tumour, regardless of the date when the diagnosis is made; or
b. medical consultations, tests or any form of clinical evaluation, that
lead to a diagnosis of cancer or benign brain tumour, regardless of
when the diagnosis is made; or
c. a diagnosis of cancer or benign brain tumour.
Individual plan options available to purchase if you are leaving the plan
When your group coverage ends, your relationship with Manulife doesn't have to stop there. You have the option to purchase your own
personal plans.
Conversion Option
Some core coverage benefits (Life, Optional Life, Critical Illness, Optional Critical Illness) give you the option to purchase
individual coverage when your group benefits terminate or reduce, without needing to provide medical evidence. Your
application for the individual policy along with the first monthly premium must be received by Manulife Financial within 31
days of the termination or reduction of your coverage. Other specific conditions for coverage may be noted in each
benefit information section of this document.
For more information on the conversion privilege, please see your Plan Administrator. Provincial differences may exist.
FollowMeTM Health
The FollowMe Health plan is specially designed for those whose group health coverage has recently or will soon come to
an end. FollowMe Health allows you to continue enjoying health and dental benefits without completion of a medical
questionnaire, so there's no need to worry about interruption of coverage for you or your loved ones.
If you apply within 60 days of your loss of group health and dental benefits, you will qualify without having to complete a
medical questionnaire.
With four different plans and levels of coverage to choose from, you're certain to find the FollowMe Health plan that
meets your needs.
To find out more, request a brochure, get a quote, apply online or print an application, go to www.coverme.com or call 1-877-
COVER ME® (1-877-268-3763)
Definitions
Explanation of some of the terms used in this document
Co-insurance
The way the cost of a service is shared between you and your plan. It exists in addition to any deductibles. So for example, an 80% co-insurance means
that after the deductible has been satisfied, your plan will cover up to 80% of the bill and you would pay the rest.
Co-payment
The fixed amount that you must pay towards the cost of a service each time you use your plan. Most often, co-payments exist in situations where a claim
is settled at point of sale. For instance, you might see a drug benefit with a $2.00 co-pay amount. Regardless of the cost of the prescription being filled,
you are required to pay $2.00.
Dependent
Your Spouse or Child who is insured under the Provincial Plan.
Spouse
your legal spouse, or a person continuously living with you in a role like that of a marriage partner
Child
your natural or adopted child, or stepchild, who is:
unmarried
under the age stated below:
for Dental coverage - under age 21, or under age 25 if a full-time student;
for Extended Health Care coverage - under age 21, or under age 25 if a full-time student
for other coverages (if applicable) - under age 21, or under age 25 if a full-time student;
not employed on a full-time basis
not eligible for insurance as an employee under this or any other Group Benefit Program
a child who is incapacitated on the date he or she reaches the age when insurance would normally terminate will continue to be an eligible dependent.
However, the child must have been insured under this Benefit Program immediately prior to that date
a child is considered incapacitated if he or she is incapable of engaging in any substantially gainful activity and is dependent on the employee for
support, maintenance and care, due to a mental or physical disability. Manulife Financial may require written proof of the child's condition as often as
may reasonably be necessary
a stepchild must be living with you to be eligible
a child must be at least 14 days old to be eligible (excluding Dental and Extended Health Care coverage)
Drugs
must be prescribed in writing by a physician, dentist or other health care professional whose scope of practice within their province permits them to
write a prescription;
must be dispensed by a licensed pharmacist;
must have been approved for use by Health Canada and have a drug identification number(DIN).
RAMQ - Drug Benefit and Pharmacy Services for persons who reside in Quebec
If you and your dependents reside in Quebec, the following provisions apply to your drug benefit coverage:
drugs that are on the List of Insured Drugs that is published by the Régie de l'assurance-maladie du Québec (RAMQ List), provided such drugs are on
the list at the time the expense is incurred; and
covered pharmacy services that are to be paid when the drug is on the RAMQ List; and
drugs that are listed as a covered expense under your drug plan but are not on the RAMQ List.
The following provisions apply to the coverage of drugs that are on the RAMQ List and pharmacy services for private plans, as legislated by An Act
Respecting Prescription Drug Insurance and the Health Insurance Act (R.S.Q. c., A-29-01). Coverage for all other drugs will be subject to the regular
provisions included in your benefit plan.
a) Benefit Percentage
Prior to the annual out-of-pocket maximum being reached, the percentage of covered drug expenses payable under this benefit will be as follows:
i) For any drug on the RAMQ List which is not otherwise covered under the terms of this benefit, the percentage payable is the percentage as set out by
legislation.
ii) For any Legislated pharmacy services which are not otherwise covered under the terms of the Policy, the percentage is as set out by the then
applicable Legislation.
iii) For any drug on the RAMQ List which is covered under the terms of this benefit, the percentage payable is the greater of:
the benefit percentage stated under the benefit; or

the percentage as set out by the then applicable legislation.
After the annual out-of-pocket maximum has been reached, the percentage of covered drug expenses payable under this benefit will be 100%.
b) Annual Out-of-Pocket Maximum

The annual out-of-pocket maximum is a portion of covered drug expenses or covered pharmacy services which must be paid by you and your spouse in
a calendar year, before the percentage payable under this benefit will be 100%. Amounts that will be applied to the annual out-of-pocket maximum are:
i) deductible amounts, and
ii) the portion of covered drug expenses that is paid by an insured person, when the percentage of covered expenses payable under this benefit is less
than 100%; and
iii) covered pharmacy services that are performed by pharmacists for drugs on the RAMQ formulary.
The annual out-of-pocket maximum for you and your spouse is as stipulated in the legislation and includes those portions of covered drug expenses and
covered pharmacy services relating to a drug on the RAMQ formulary paid for your dependent children.
For the purposes of calculating the out-of-pocket maximum for you and your spouse, those portions of covered drug expenses and covered pharmacy
services paid for your dependent children will be applied to the person who is closest to reaching the annual out-of-pocket maximum.
c) Deductible
Deductible amounts (if any) for the drug benefit will apply, until the annual out-of-pocket maximum is reached. Thereafter, the deductible will not apply.
d) Lifetime Maximums
Lifetime maximums (if any) will not apply to drugs on the RAMQ List or covered pharmacy services. Drug and pharmacy service coverage provided after
the lifetime maximum stated under this plan is reached is subject to the following conditions:
i) only drugs that are on the RAMQ List are covered, and
ii) covered pharmacy services that are performed for drugs on the RAMQ List, and
iii) the percentage payable by Manulife Financial for covered expenses is the percentage as set out by legislation.
e) Eligible Dependent Children

Your eligible dependent children who are in full-time attendance at an accredited educational institution will be covered until the later of:
i) the age specified in this Benefit Booklet or
ii) age 26.
Drug coverage and covered pharmacy services provided for dependent children after the age stated in this Benefit Booklet is subject to the following
conditions:
only drugs that are on the RAMQ List are covered, and
covered pharmacy services performed for a drug on the RAMQ List, and
the percentage payable by Manulife Financial for covered expenses is the percentage as set out by legislation.
f) Termination Age for Covered Drug and Pharmacy Service Expenses

Provided you are otherwise eligible for the drug benefit, the termination age (if any) for the drug benefit will not apply. Drug coverage provided after the
termination age specified under The Benefit is subject to the following conditions:
i) only drugs that are on the RAMQ List are covered,
ii) only covered pharmacy services related to a drug on the RAMQ List,
iii) the percentage payable by Manulife Financial for covered expenses is the percentage as stipulated in the legislation
iv) the Annual Out-of-Pocket Maximum is as stipulated in the legislation
Coverage for drugs that are listed as a covered expense under this Benefit but not on the RAMQ List will be subject to all the standard provisions
included in this Benefit Booklet.
Due Diligence
A process employed by Manulife Financial to assess new drugs, existing drugs with new indications, services or supplies to determine eligibility under
the plan. This process may use pharmacoeconomics, cost effectiveness analysis reference information from existing Federal or Provincial formularies,
recognized clinical practice guidelines, or an advisory body.
Earnings
Earnings are your regular rate of pay from your employer (prior to deductions)
including regular bonuses
including regular overtime pay
Earnings may include other income as agreed to in writing by your employer and Manulife Financial.
If you are being paid on a commission basis, your earnings will be as reported on your T4/T4A form for the previous year. If you have less than one year
of service with your employer, your earnings will include an average of the total commissions paid over your actual period of employment.
For the purposes of determining the amount of your benefit at the time of claim, your earnings will be the lesser of:
the amount reported on your claim form, or
the amount reported by your employer to Manulife Financial and for which premiums have been paid.
Experimental or Investigational
Not approved as an effective, appropriate and essential treatment of an illness or injury.
Lower Cost Alternative

If two or more drugs, supplies or services result in therapeutically similar results, or prescribing guidelines recommend alternate drugs, supplies or
services be tried first that are lower in cost, the lower cost alternative will be considered.
Medical and Non Medical Travel Emergencies

Sudden, unexpected injuries which occur or unforeseen illnesses which begin while travelling out-of-province or out-of-Canada for business or pleasure
and for accidents or illnesses that were not previously diagnosed or treated in Canada.
Medically Necessary
Accepted and recognized by the Canadian medical profession and Manulife Financial as effective, appropriate and essential treatment of a phase of an
illness or injury. Manulife Financial has the right after due diligence has been completed to determine whether the drug, service or supply is eligible
under the Plan.
Non-Evidence Limit
The amount of insurance benefits you can receive without needing to provide proof of good health. Anything over this figure means that Manulife must
review medical evidence before you are approved for the higher amount.
Out-Of-Pocket Maximum
This is the maximum amount of money you will have to pay on your own before your insurance benefits begin to take over and pay. It includes things like
deductibles, and co-insurance, but not things like co-payments or your monthly premium.
Prior Authorization
A claims management feature applied to a specific list of drugs, supplies or services to determine eligibility based on predefined clinical criteria and a
pharmacoeconomic or cost effectiveness evaluation.
Pyogenic Infection
A bacterial infection or inflammation that produces a generally viscous, yellowish-white fluid formed in infected tissue. The fluid consists of white blood
cells, dead tissue and cellular debris.
Reasonable and Customary Charges

The lowest of:
the prevailing amount charged for the same or comparable service or supply in the area in which the charge is incurred, as determined by Manulife
Financial; or
the amount shown in the applicable professional association fee guide; or
the maximum price established by law

2023 Benefit Summary

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3/1/23, 11:27 AM Benefit Summary

Unijet Industrial Pipe Ltd.

A message from your plan sponsor

Planning for Financial Security

Core Coverage and Services

Benefit Details Your Plan's Coverage

Waiting Period 3 months

Coverage ends At the earlier of age 75 or your retirement

Combined Maximum applies to:

Level I - Basic Services

Includes items such as:

Includes items such as:

Benefit Details Your Plan's Coverage

surgical procedures not included in Level I (excluding implant

Level III - Dentures

Includes items such as:

Level IV - Major Restorative Services

Includes items such as:

No Dental Care benefits will be payable for expenses resulting from:

Benefit Details Your Plan's Coverage

Extended Health Care Benefit

Benefit Details Your Plan's Coverage

Waiting Period 3 months

$25 Individual, $50 Family, per calendar year(s)

Not applicable to:

Covered expenses used to satisfy the deductible in the last 3 months of

Co-insurance 100% for Hospital Care, Medical Services & Supplies,

Coverage Ends At the earlier of age 75 or your retirement

(not applicable to Health Service Navigator®)

Benefit Details Your Plan's Coverage

Benefit Details Your Plan's Coverage

Includes the following drug classes:

drugs for the treatment of an illness or injury which by law or

EHC - Health Care Professionals (Professional Services)

Benefit Details Your Plan's Coverage

$500 per calendar year(s) for Chiropractor

$500 per calendar year(s) for Osteopath

$500 per calendar year(s) for Podiatrist/Chiropodist

$500 per calendar year(s) for Massage Therapist

$500 per calendar year(s) for Naturopath

$500 per calendar year(s) for Speech Therapist

Recommendation by a physician for Professional Services

EHC - Medical Supplies and Services

Benefit Details Your Plan's Coverage

Private Duty Nursing Services

Provided by a registered nurse or registered nursing

custodial care, homemaking duties or supervision

services performed by a nurse practitioner who is an immediate

services that could be performed by a person with lesser

$500 per 5 calendar year(s)

$150 per calendar year(s) for Stock-item Orthopaedic

Custom Made Shoes which are required because of a

$400 per 3 calendar year(s) for Custom Made Orthotic

Must be recommended by a physician or podiatrist.

ambulance (licensed including air ambulance, provided in province of

Benefit Details Your Plan's Coverage

Surgical Stockings $400 per calendar year

Benefit Details Your Plan's Coverage

Charges for any portion of the cost of ward