O. Reg. 201/05: Salaries and Benefits of Justices of the Peace - Regions Designated under section 22 of the Act

 

ontario regulation 201/05

made under the

Justices of the peace act

Made: May 4, 2005
Filed: May 6, 2005
Printed in The Ontario Gazette: May 21, 2005

Amending O. Reg. 247/94

(Salaries and Benefits of Justices of the Peace — Regions Designated under section 22 of the Act)

1. Clause (b) of the definition of “child” in subsection 26 (2) of Ontario Regulation 247/94 is amended by striking out “25 years of age” and substituting “26 years of age”.

2. The Regulation is amended by adding the following sections:

Benefits for Retired Justices of the Peace

39. (1) The Crown may enter into agreements with insurance underwriters for the purpose of providing justices of the peace with the following group insurance coverages:

1. A Basic Life Insurance Plan.

2. A Supplementary Health and Hospital Insurance Plan.

3. A Dental Insurance Plan. 

(2) Except as provided in sections 41, 42 and 43, the benefits provided under the insurance plans referred to in subsection (1) shall be those set out in the agreements made with the insurance underwriters.

40. (1) In this section and section 43,

“dependent child” means, in respect of an eligible person,

(a) an unmarried child who has not attained the age of 21 years,

(b) an unmarried child who has not attained the age of 26 years and who is in full-time attendance at an educational institution or on vacation from it, or

(c) a child who is 21 or more years of age and is mentally or physically infirm and dependent on the eligible person.

(2) In this section and sections 42 and 43,

“eligible dependant” means, in respect of an eligible person,

(a) the spouse of the eligible person, if the spouse would have been entitled to receive a benefit if the eligible person had continued holding the office in respect of which the pension is paid to the eligible person,

(b) a dependent child of the eligible person, if the dependent child would have been entitled to receive a benefit if the eligible person had continued holding the office in respect of which the pension is paid to the eligible person,

(c) the surviving spouse of the eligible person, if the eligible person is deceased and the surviving spouse is entitled to receive a pension as a result of the death of the eligible person, or

(d) a child of the eligible person, if the eligible person is deceased and the child is entitled to receive a pension as a result of the death of the eligible person.

(3) In this section and sections 41 and 42,

“eligible person” means a person who is receiving a pension and whose last contribution to the fund from which the pension is paid, or the last contribution made on his or her behalf to that fund, was made while the person was holding the office of justice of the peace and,

(a) the person has a credit of at least 10 years in the pension plan under which the pension is paid,

(b) the person contributed or had contributions made on his or her behalf to the fund from which the pension is paid in respect of continuous service of at least 10 years and has credit in the pension plan under which the pension is paid for some part of each of those 10 years,

(c) the pension is a deferred pension that the person elected to receive on terminating membership in the pension plan in 1988 or 1989, or

(d) the pension is paid in respect of the person having held the office of justice of the peace or in respect of having held the office of justice of the peace and having been an employee and the person,

(i) first held the office or was first employed in the period commencing January 1, 1987 and ending November 3, 1989 (excluding any period for which credit was purchased for past service), and

(ii) had attained 55 years of age when he or she first held the office or was first employed.

(4) In sections 42 and 43,

“eligible recipient” means an eligible person or an eligible dependant of an eligible person.

(5) In this section,

“pension” means a pension paid from the Public Service Pension Fund or from a pension fund established by statute to continue that Fund;

“pension plan” means the plan governing a fund referred to in the definition of “pension”.

41. The Basic Life Insurance Plan shall provide life insurance of $2,000 on the life of each eligible person during his or her lifetime. 

42. (1) The Supplementary Health and Hospital Insurance Plan shall provide,

(a) the benefits described in subsection (4); and

(b) vision care and hearing aid benefits in accordance with subsection (7).

(2) The Crown shall pay,

(a) 100 per cent of the monthly premium for the coverages described in subsection (4);

(b) 80 per cent of the monthly premiums for vision care coverage; and

(c) 60 per cent of the monthly premiums for hearing aid coverage.

(3) Every person receiving a pension shall pay the balance of the monthly premiums for the vision care and hearing aid coverages referred to in clauses (2) (b) and (c), by deduction from pension payments.

(4) The Supplementary Health and Hospital Insurance Plan shall provide the following benefits by reimbursing an eligible recipient for the following in respect of goods and services provided to him or her:

1. 90 per cent of the cost of prescribed drugs and medicines that require the written prescription of a legally qualified medical practitioner.

2. 90 per cent of the cost of a generic equivalent of a drug or medicine described in paragraph 1, if a generic equivalent exists.

3. Subject to paragraph 4, 100 per cent of the cost of semi-private or private hospital accommodation of eligible recipients to a maximum of $120 each day over and above the cost of standard ward care.

4. Charges for semi-private or private accommodation in a licensed chronic care or convalescent hospital of eligible recipients who are at least 65 years of age, up to $25 each day for a maximum of 120 days each calendar year.

5. Charges imposed by a licensed hospital for out-patient treatment not paid for under a provincial health plan.

6. Charges for private-duty nursing in the home by a registered nurse or a registered nursing assistant who is not normally resident in the eligible recipient’s home and who is not related to the eligible person or any of his or her eligible dependants, if the nursing service is approved by a licensed physician or surgeon and is certified by the physician or surgeon to be necessary to the health care of the eligible recipient.

7. Charges in excess of amounts, if any, reimbursed by a provincial health plan for the services of a chiropractor, osteopath, naturopath, podiatrist, physiotherapist and masseur, if licensed and practising within the scope of their license, to a maximum of $25 for each visit and with an annual maximum of $1,200 per type of practitioner.

8. Charges for the services of a speech therapist, up to a maximum of $25 for each half-hour of service, to an annual maximum of $1,400.

9. Charges for the services of a psychologist, including a person holding a Master of Social Work degree, to a maximum of $25 for each half-hour and with an annual maximum of $1,400.

10. Charges for artificial limbs and eyes, crutches, splints, casts, trusses and braces.

11. 75 per cent of the cost of custom-made orthopaedic shoes or specially modified orthopaedic shoes that were factory custom-made off-the-shelf, to a maximum of $500, with a limit of one pair per calendar year, if the shoes are medically necessary and are prescribed by a licensed physician.

12. Charges for the cost of medically prescribed orthotics, to a maximum of $500, with a limit of one pair per calendar year. 

13. Rental charges for wheel chairs, hospital beds and iron lungs required for temporary therapeutic use.

14. The cost of a wheel chair recommended by the attending physician, if the rental charge would exceed the purchase cost.

15. 50 per cent of the cost of repairs, including batteries and modifications, to a purchased wheel chair, to a maximum of $500 for any one repair, battery or modification.

16. Charges for ambulance services to and from a local hospital that is qualified to provide treatment, excluding benefits allowed under a provincial health plan.

17. Charges for oxygen and its administration.

18. Charges for blood transfusions outside a hospital.

19. The cost of dental services and supplies provided by a dental surgeon within a period of 24 months following an accident for the treatment of accidental injury to natural teeth, including replacing teeth injured in the accident and setting a jaw that is fractured or dislocated in the accident, but excluding any benefits payable under a provincial health plan.

20. The cost of hearing aids and eye glasses required as a result of accidental injury.

21. The amount by which the lesser of the amount charged for services provided in Canada but outside Ontario by physicians, surgeons and specialists licensed to practise medicine in their particular jurisdictions and the amount provided for the same services in the current Ontario Medical Association Fee Schedule exceeds the amount in the O.H.I.P fee schedule for the same services.

22. Charges for surgery performed by a podiatrist in his or her office, to a maximum of $100.

(5) Despite paragraph 1 of subsection (4), if an equivalent generic product exists and a brand name product is dispensed, the benefit payable under the Plan shall be limited to 90 per cent of the cost of the equivalent generic product.

(6) Effective June 1, 2004, the reimbursement in respect of prescription drugs shall be reduced by a deductible amount of $3 for each prescription in respect of which a benefit is paid.

(7) Benefits payable under the Supplementary Health and Hospital Insurance for vision care and hearing aids shall,

(a) be reduced by a $10 deductible amount for single coverage and a $20 deductible amount for family coverage, for each calendar year;

(b) reimburse the eligible recipient for vision care up to a maximum of $300 per person every 24 months; and

(c) reimburse the eligible recipient for the cost of hearing aids up to a maximum of $1,200 per person every 48 months.

(8) If a benefit is payable under paragraph 20 of subsection (4), no benefit referred to in clause (7) (b) or (c) is payable in respect of the same expense.

(9) It is not necessary for an eligible recipient to be confined to a hospital to be eligible for benefits under the Supplementary Health and Hospital Insurance Plan.

(10) The Crown shall make available to eligible recipients,

(a) an information booklet relating to the Supplementary Health and Hospital Insurance Plan; and

(b) periodic updates when necessary, within a reasonable period of time after changes are made.

43. (1) The Dental Insurance Plan shall provide the following coverages for eligible recipients:

(a) examinations, consultations, specific diagnostic procedures and X-rays;

(b) fillings, extractions and anaesthesia services;

(c) preventive services such as scaling, polishing and fluoride treatments;

(d) periodontal services, endodontic services, surgical services;

(e) prosthodontic services necessary for relining, rebasing or repairing of an existing fixed bridgework, removable partial or complete dentures;

(f) services relating to dentures;

(g) services relating to orthodontics for unmarried eligible dependants who have attained the age of six years but are under 19 years of age;

(h) services for major dental restoration.

(2) The dental care insurance plan shall include a $100 single or family deductible amount for each calendar year.

(3) Dental recall coverage is six months for dependent children 12 years of age and under and nine months for all other eligible recipients.

(4) Dental coverage shall not include fluoride treatment for adults.

(5) Payments under the dental care insurance plan shall be in accordance with the current Ontario Dental Association Schedule of Fees.

(6) Despite subsection (5), effective January 1, 2004, reimbursements will be based on a dental fee guide lag of one year.

(7) The Crown shall pay the full premiums of the dental care insurance plan and the coverages, payments and reimbursements under the plan shall be paid by the plan as follows:

1. For services described in clause (1) (a), (b), (c), (d) or (e), coverage is on the basis of 85 per cent to 15 per cent co-insurance, and the eligible recipient shall pay the cost of the dental care directly and be reimbursed 85 per cent of the costs.

2. For services described in clause (1) (f), coverage is on the basis of 50 per cent to 50 per cent co-insurance, and the eligible recipient shall pay the cost of the services directly and be reimbursed 50 per cent of the costs, to a lifetime maximum benefit of $3,000 for each eligible recipient.

3. For services described in clause (1) (g), coverage is on the basis of 50 per cent to 50 per cent co-insurance, and the eligible recipient shall pay the cost of the services directly and be reimbursed 50 per cent of the costs, to a lifetime maximum benefit of $3,000 per unmarried eligible dependant who has attained the age of six years but is under 19 years of age.

4. For services described in clause (1) (h), coverage is on the basis of 50 per cent to 50 per cent co-insurance and the eligible recipient shall pay the cost of the services directly and be reimbursed 50 per cent of the costs, to a maximum benefit of $1,200 each year for each eligible recipient.