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Group Insurance for Small Business

BENEFIT COVERAGE & PREMIUM SUMMARY - ONTARIO

BENEFIT PLAN 1 PLAN 2 PLAN 3 PLAN 4
COVERAGE: (P2) (O5) (O6) (O8)
(80% co-insurance)  
         
DRUG MAXIMUM $15,000 per $15,000 per $15,000 per $15,000 per
(Generic & Brand) participant, per participant, per participant, per participant, per
  calendar year calendar year calendar year calendar year
         
EHS INCLUDED INCLUDED INCLUDED INCLUDED
         
VISION Not a benefit Not a benefit Not a benefit $300/24 months
         
SEMI-PRIVATE Not a benefit Not a benefit Not a benefit INCLUDED
         
DENTAL $800 per benefit $1,000 per benefit Not a benefit $1,000 per benefit
MAXIMUM year year   year
         
TRAVEL INCLUDED INCLUDED INCLUDED INCLUDED
         
NOTE: PST IS APPLICABLE - 8%   
         
MONTHLY PREMIUM PLAN 1 PLAN 2 PLAN 3 PLAN 4
SUMMARY:        
         
SINGLE  $              102.12  $              108.39  $                64.15  $              122.08
         
COUPLE  $              204.23  $              216.97  $              128.30  $              244.15
         
FAMILY  $              269.60  $              286.22  $              175.64  $              322.63
         
  5+* No Medical 5+* Deluxe Plan 5+* No Medical 5+* No Medical
  Underwriting or   Underwriting or Underwriting or
  1-4 With Medical   1-4 with Medical 1-4 with Medical
  Underwriting   Underwriting Underwriting
         
APPLICATION(S) Employee Application  
TO COMPLETE: Group Benefits Application  
         
*Life, AD&D and LTD Coverage can also be added to 5+ person plans
RATES ARE EFFECTIVE FROM JULY 1ST 2011 to JUNE 30TH 2012
NOTE: Remember Membership Application and Fee(You can choose $2.50 a month or pay annually $28.25)
 
Tel (519)936-7257 Fax (519)435-7999 1-888-676-4689
email:matt@pointway.ca
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