Enter the name for this tabbed section: Job Security
About this Guide...

CUPE’s hospital workers have made very real gains in job security as a result of our commitment in collective bargaining to gain the greatest degree possible of employment security for our members. This Guide is intended to assist local unions to use the job security provisions of the central agreement in a consistent way. The Guide has been reviewed by the officers, staff, and specialists who assist with the negotiation, arbitration and administration of the collective agreements.

The job security provisions operate in an integrated way. It is important to have an understanding of the entire network of provisions to see how each of them operates. This guide deals with layoff; notice of layoff; alternatives to layoff and employee options; contracting out, and contracting in.

The purpose of the whole of the job security language is two-fold from our point of view. On the one hand, it offers protection to employees who are about to be subject to layoffs, protection which will depend upon the length of the layoff and an individual employee’s seniority. Second and just as important, it provides some protection to the integrity of the Local Union’s bargaining unit.

We do not expect that we will be able to answer every question that may arise. Instead, we are hoping to provide Local Union officers with an overview of these collective agreement provisions so that they can continue to provide effective and informed representation of their members. We look forward to any comments which you may have as to how we can improve the Guide.

(a) In the event of a proposed layoff at the Hospital of a permanent or long-term nature or the elimination of a position within the bargaining unit, the Hospital shall:

(i) provide the Union with no less than five (5) months' written notice of the proposed layoff or elimination of position; and

(ii) provide to the affected employee(s), if any, who will be laid off with no less than five (5) months' written notice of layoff, or pay in lieu thereof.

Note: Where a proposed layoff results in the subsequent displacement of any member(s) of the bargaining unit, the original notice to the Union provided in (i) above shall be considered notice to the Union of any subsequent layoff.


Article 9.08(a) requires the Hospital to give notice to the Union of a permanent or long-term layoff, or the elimination of a position. A ‘permanent or long-term’ layoff has been found to be one which is at least 13 weeks in length.1 A reduction in regular hours of work of a full-time or regular part-time employee is considered a layoff under the central collective agreement.2

There are three different types of notice requirements. The Union is entitled to notice of a layoff of an employee, or else notice of the elimination of a position. Individual employees are entitled to notice of their layoff.

The notice must be provided five (5) months before the event, and it must be specific. When a hospital has given general or ‘blanket’ notice, of the elimination of positions or layoff of employees, the notice has been found to be deficient and has been disallowed. For example, when a hospital gave the Union notice that it would eliminate housekeeping positions as they became vacant, without identifying any particular positions and without identifying any dates, the notice was found to not meet the obligations under the collective agreement. 3

A layoff generally is defined as the cessation of work, a reduction in the workforce, or the reduction in an employee’s working hours. Where a permanent or long-term reduction of working hours is applied unevenly across the bargaining unit, that is where some, but not all, employees have their hours reduced, employees will be able to access the job security protections of article 9. 4

It is important to note that there is more than one definition of a ‘laid off’ employee under our collective agreement.5 For example, an employee who has been laid off ‘to the street’ and who is not actively at work in the hospital, may be considered to be ‘laid off’. In other provisions, for example article 9.09, a ‘laid off’ employee may refer to an employee who has received notice of layoff but is still actively at work – either because they have displaced another employee or because they are serving their notice period. So the term ‘layoff’ under this collective agreement has more than one meaning.

Before a notice of layoff or the elimination of a position occurs, article 18.03(b) must be complied with. Employees in the same classification(s) as those who may be affected by any layoff, must first be offered the option of taking early retirement, including receiving an early retirement allowance. This requirement is dealt with later in the Guide, but for now it is important to appreciate that these offers of early retirement allowance must be made before any layoff notices are served within that classification.

The purpose of the notice period is to retain the status quo (i.e. the present circumstances) throughout the period of notice. In the case of an employee who has received notice of layoff, this means that the substantive position of the employee (i.e. their regular classification) is not to be altered during the notice period. For example, where a hospital requires an employee to begin working in another classification that they have bumped into during the notice period, the hospital will violate the collective agreement.6

Also, where a hospital fails to give notice to the Union of the elimination of a position and simply fails to post a position that has been vacated, the hospital will be found to have breached the collective agreement.7

Finally, payment in lieu of notice is required for any missed portion of the notice period. Payment for late notice does not relieve a hospital of the obligation to follow the other required steps (for example, canvassing for early retirement).


KEY CASES:
Footnotes
1. Whitby General Hospital and CUPE Local 3082, unreported, September 10, 1996 (Springate)
2. St. Vincent de Paul Hospital and CUPE Local 2491, unreported, May 12, 2006 (Devlin)
3. Hamilton Health Sciences Corp. and CUPE Local 839 (2001), 94 L.A.C. (4th) 156 (Adams)
4. Scarborough Hospital and CUPE Local 1487, unreported, January 17, 2006 (Burkett)
5. Hamilton Health Sciences Corp. and CUPE Local 4800, unreported, October 14, 2004 (Burkett)
6. Toronto Hospital (Toronto Western Division) and CUPE Local 1744, unreported, February 17, 1997 (Charney)
7. Kingston General Hospital and CUPE Local 1974, unreported, November 12, 2002 (Devlin)

(b) A layoff shall not include a reassignment of an employee from her or his classification or area of assignment who would otherwise be entitled to notice of layoff provided:

(I) the reassignment of the employee is to an appropriate permanent position with the employer having regard to the employees skills, abilities, qualifications and training or training requirements;

(II) the reassignment of the employee does not result in a reduction of the employees wage rate or hours of work;

(III) the job to which the employee is reassigned is located at the employee’s original work site or at a nearby site in terms of relative accessibility for the employee;

(IV) the job to which the employee is reassigned is on the same or substantially similar shift or shift rotation; and

(V) where more than one employee is to be reassigned in accordance with this provision, the reassigned employees shall be entitled to select from the available appropriate vacancies to which they are being reassigned in order of seniority provided no such selection causes or would cause a layoff or bumping.

The Hospital bears the onus of demonstrating that the foregoing conditions have been met in the event of a dispute. The Hospital shall also reasonably accommodate any reassigned employee who may experience a personal hardship arising from being reassigned in accordance with this provision.


In the event a hospital reassigns an employee in accordance with article 9.08(b), the hospital does not need to serve notice of layoff and a layoff will not have occurred for the purposes of the collective agreement. In other words, if a reassignment is properly conducted which meets all the requirements of article 9.08(b), an arbitrator will find that no notice of layoff is necessary, and no layoff has occurred.1

The purpose of article 9.08(b) is to give hospitals some relief from the obligations of the layoff language. It permits hospitals to avoid having to give notice of layoff, and thus avoid all of the consequences of serving notice of layoff, if the hospital is able to comply with the terms of 9.08(b). For example, if a hospital reassigns employees in a way which complies with this article it may contract out the work previously performed by those employees without a layoff being found to have occurred.

In order for a hospital’s actions to fall within article 9.08(b), the hospital must ensure that the employees are reassigned precisely within the requirements of the article. The new position to which the employee is assigned must:

1. be permanent,
2. be a position which accords with the employee’s skills and training,
3. not have a lower wage rate than the employee’s previous wage rate,
4. not reduce the employee’s hours of work,
5. be on the same or substantially similar shift or shift rotation as the employee’s previous shift, and
6. be at the same work site or a nearby work site.

The onus is on the hospital to demonstrate that it has met these conditions – not on the Union to prove that it hasn’t. Furthermore, in order to fit within this article, a hospital will need to strictly comply with its requirements. ‘Substantial’ or partial compliance is not good enough. 2 Where a Hospital ‘red-circles’ the wage rates of employees who are reassigned to a lesser-paid classification until the rate of the new position catches up to the rate of the employee’s previous position, arbitration boards have found that this satisfies the obligation at 9.08(b)ii.3

Although a hospital will not be required to post the positions into which employees are reassigned, the employees concerned will be allowed to choose among the available positions on the basis of their seniority.

Although a hospital is not required to post the vacancies into which employees are reassigned, this article must be read in conjunction with article 9.05. Article 9.05 now requires hospitals to post vacancies within thirty days of their occurrence or else declare the positions eliminated pursuant to article 9.08(a). It states in part:

The Hospital agrees that it shall post permanent vacant positions within 30 calendar days of the position becoming vacant, unless the Hospital provides the Union notice under Article 9.08 of its intention to eliminate the position.

We are of the view that after that thirty-day period, the vacancy cannot ‘reappear’ for the purposes of a reassignment. In other words, the vacancy must be used within the thirty-day ‘window’ for reassignment.

KEY CASES:
Footnotes
1. Hamilton Health Sciences Corp. and CUPE Local 4800, unreported, October 14, 2004 (Burkett)
2. Scarborough Hospital and CUPE Local 1487, unreported, January 17, 2006 (Burkett)
3. Sudbury Regional Hospital and CUPE 1623 (Bosse Grievance), unreported, December 1, 2008 (Stewart)

(c) Any vacancy to which an employee is reassigned pursuant to paragraph (b) need not be posted.

(d) At each Hospital a Redeployment Committee will be established not later than two (2) weeks after the notice referred to in 9.08 and will meet thereafter as frequently as is necessary.

(i) Committee Mandate
The mandate of the Redeployment Committee is to:

(1) Identify and propose possible alternatives to the proposed layoff(s) or elimination of position(s), including, but not limited to, identifying work which would otherwise be bargaining unit work and is currently work contracted-out by the Hospital which could be performed by bargaining-unit employees who are or would otherwise be laid off;

(2) Identify vacant positions in the Hospital or positions which are currently filled but which will become vacant within a twelve (12) month period and which are either:

(a) within the bargaining unit; or
(b) within another CUPE bargaining unit; or
(c) not covered by a collective agreement.

(3) Identify the retraining needs of workers and facilitate such training for workers who are, or would otherwise be, laid off.

(4) Subject to article 9.11, the Hospital will award vacant positions to employees who are, or would otherwise be laid off, in order of seniority if, with the benefit of up to six (6) months retraining, an employee has become able to meet the normal requirements of the job.

(5) Any dispute relating to the foregoing procedures may be filed as a grievance commencing at Step 3.

(ii) Committee Composition
The Redeployment Committee shall be comprised of equal numbers of representatives of the Hospital and of the Union. The number of representatives will be determined locally. Where for the purposes of HTAP (the Ontario Hospital Training and Adjustment Panel) there is another hospital-wide staffing and redeployment committee created or in existence, Union members of the Redeployment Committee shall serve on any such hospital wide staffing committee established with the same or similar terms of reference, and the number of Union members on such committee will be proportionate to the number of its bargaining unit members at the particular Hospital in relation to other staff groups.

Meetings of the Redeployment Committee shall be held during normal working hours. Time spent attending such meetings shall be deemed to be work time for which the representative(s) shall be paid by the Hospital at his or her regular or premium rate as may be applicable.

Each party shall appoint a co chair for the Redeployment Committee. Co chairs shall chair alternative meetings of the Committee and will be jointly responsible for establishing the agenda of the Committee meetings, preparing minutes and writing such correspondence as the Committee may direct.

(iii) Disclosure

The Hospital shall provide to the Redeployment Committee all pertinent staffing and financial information.

(iv) Alternatives

The Redeployment Committee, or where there is no consensus, the committee members shall propose alternatives to cutbacks in staffing to the Hospital's Chief Executive Officer and to the Board of Directors.

At the time of submitting any plan concerning rationalization of services and involving the elimination of any position(s) or any layoff(s) to the District Health Council or to the Ministry of Health, the Hospital shall provide a copy, together with accompanying documentation, to the Union.


This committee’s mandate is far greater than that of the Labour/Management Committee. It exists specifically to carry out its mandate provided under this article.

Upon receiving notice of a proposed layoff or elimination of position, the Union should immediately write to the Hospital requesting establishment of a Redeployment Committee with its proposal for the Committee’s size and Union members.

The Committee must be set up within two weeks of the notice of the proposed layoff or elimination of position being given to the Union.

The Committee is mandated to search not only for existing vacant positions in the Hospital, but to identify work that would fall within the bargaining unit but is currently being contracted out. In combination with 10.02 “Contracting In”, the intent here is clearly to make the Hospital responsible to provide work to employees who would otherwise be laid off and shifts the onus onto the Hospital to justify any refusal to do so, even when it means contracting-in work.

Bargaining unit employees capable of performing the work who are or who would otherwise be laid off have the right to be considered for this contracted-out work.

The Committee is to identify positions that are currently vacant or are to become vacant within six (6) months within the bargaining unit or in another CUPE bargaining unit or outside of any bargaining unit.

The Hospital is required to award vacant positions to workers who would otherwise be laid off if, with six months retraining, they become able to meet the normal requirements of the job.

This refers to the training needs of CUPE members to qualify them for the positions identified by the Redeployment Committee.


Training needs are to be addressed not only for those who are laid off but for those who ”would otherwise be” laid off.

Any dispute relating to the Committee’s procedures or mandate may and should be filed as a “step two” grievance to achieve quicker movement to arbitration.

The Union has the right to participate as a full partner in the operation of the Committee. Whatever the actually number agreed to locally, there must be the same number of representatives for the Union and Hospital.

The Union appoints a Co-Chair responsible for alternate meetings of the Committee. The Co-Chairs jointly determine Committee meeting agendas, prepare Committee minutes and conduct Committee correspondence.

The Committee functions during normal working hours and Committee time is deemed worked time to be paid at the appropriate (i.e. regular or premium) rate.

The Hospital is obliged to provide the Committee with “all pertinent staffing and financial information”. It is recommended that the Union members of the Redeployment Committee ensure that this information is provided by the Hospital before looking at which employees are to be affected by the lay-off so that rational and practical alternatives can be proposed. Motions may have to be raised within the Committee itself to obtain additional information from the Hospital.

The Committee is clearly empowered to propose alternatives to layoffs. Accessing complete information is crucial in building these alternatives. The powers given to the Committee shift the onus onto the Hospital to show why alternatives are impractical or not cost-effective, should it choose not to follow the Committee’s proposals. The documentation and supporting rationale therefore are extremely important should a future dispute arise over the Hospital’s right to ignore alternatives proposed by the Committee.

If the Committee cannot agree on alternatives, the individuals members (including Union members) of the Committee have the right to present their suggested alternatives to layoffs to the Chief Executive Officer and Hospital Board.

The Union has a right to a copy of any rationalization plan involving layoffs or the elimination of positions that the Hospital may submit to either the District Health Council (now defunct) or Ministry of Health. The Union also has a right to a copy of any documentation accompanying such a submission. These provisions would appear to provide even more notice to the Union should such plans be submitted in advance of the six month notice requirement set out in 9.08(a).

An employee in receipt of notice of layoff pursuant to 9.08(a)(ii) may:

(a) accept the layoff; or
(b) opt to receive a separation allowance as outlined in Article 9.12; or
(c) opt to retire, if eligible under the terms of the Hospitals of Ontario Pension Plan (HOOPP) as outlined in Article 18.03(b); or
(d) displace another employee who has lesser bargaining unit seniority in the same or a lower or an identical paying classification in the bargaining unit if the employee originally subject to layoff has the ability to meet the normal requirements of the job. An employee so displaced shall be deemed to have been laid off and shall be entitled to notice in accordance with Article 9.08.

An employee who chooses to exercise the right to displace another employee with lesser seniority shall advise the Hospital of his or her intention to do so and the position claimed within seven (7) days after receiving the notice of layoff.

Note: For purposes of the operation of clause (d), an identical paying classification shall include any classification where the straight time hourly wage rate at the level of service corresponding to that of the laid off employee is within 1% of the laid off employee's straight time hourly wage rate.

In the event that there are no employees with lesser seniority in the same or a lower or identical paying classification, as defined in this article, a laid off employee shall have the right to displace another employee with lesser seniority who is the least senior employee in the classification and where the straight time hourly rate at the level of service corresponding to that of the employee is within 15% of the laid off employee's straight time hourly rate.

An employee who is subject to layoff other than a layoff of a permanent or long term nature including a full time employee whose hours of work are, subject to Article 14.01, reduced, shall have the right to accept the layoff or displace another employee in accordance with (a) and (d) above.

The Hospital agrees to post vacancies during the recall period, as per the job posting procedure, allowing employees on recall to participate in the posting procedure. Should the position not be filled via the job posting procedure, an employee shall have the opportunity of recall from a layoff to an available opening, in order of seniority, provided he or she has the ability to perform the work.

In determining the ability of an employee to perform the work for the purposes of the paragraphs above, the Hospital shall not act in an arbitrary or unfair manner.

An employee recalled to work in a different classification from which he or she was laid off shall have the privilege of returning to the position held prior to the layoff should it become vacant within six (6) months of being recalled.

No new employees shall be hired until all those laid off have been given an opportunity to return to work and have failed to do so, in accordance with the loss of seniority provision, or have been found unable to perform the work available.

The Hospital shall notify the employee of recall opportunity by registered mail, addressed to the last address on record with the Hospital (which notification shall be deemed to be received on the second day following the date of mailing). The notification shall state the job to which the employee is eligible to be recalled and the date and time at which the employee shall report for work. The employee is solely responsible for his or her proper address being on record with the Hospital.

No full time employee within the bargaining unit shall be laid off by reason of his/her duties being assigned to one or more part time employees.

In the event of a layoff of an employee, the Hospital shall pay its share of insured benefits premiums for the duration of the five month notice period provided for in Article 9.08.


Should the affected employee accept the layoff, they should refer to 9.11 Retraining. 9.12 Separation Allowances is another option as is retirement should they be eligible (see18.01(e) and 18.03(b)). They may also opt to “bump” or displace another employee.


The “bumping’ provisions apply both to short-term and long-term layoffs. The worker who chooses to exercise their right to “bump” another worker in the case of a long-term or permanent layoff, must advise the Hospital within seven days after receiving the actual notice of layoff.

The employee can pick the position in the same or lower-paying classification in which they are interested and “bump” the person holding that position providing that person has less bargaining unit seniority.

An “identical paying classification” refers to one in which the straight time hourly rate for a corresponding level of service falls within one per cent (1%) of the laid off worker’s hourly rate.

The worker who chooses to “bump” is required to have the ability to meet the normal requirements of the job. This is the same test as a job posting.


Applies only where there are no employees with seniority in the same or lower classifications whom the laid-off worker could bump. The laid-off worker has the right to “bump” someone with less seniority who is the least senior in a classification where the straight time hourly rate with a corresponding level of service is within fifteen per cent (15%) of the laid-off worker’s hourly rate. Of course the laid off worker must meet the normal requirements of the position.

Any worker who has been “bumped” or displaced is entitled to the full rights to notice and redeployment from the beginning of the process. That is, the Hospital must give them six months notice and follow all the procedures outline in the collective agreement to try to avoid their layoff from taking place.

Where the layoff is not of a long-term or permanent nature, workers have the right to accept the layoff or displace another worker in accordance with 9.09(a) and (d). (See 9.08, page 4 for long-term/short-term definition).

When there is a layoff to the street, the Hospital is obliged to pay its share of insured benefit premiums during the six-month notice period – so is the employee. Employees are entitled to this even if the hospital chooses to pay them in lieu of the six- month notice period.

As previously, a laid-off employee is obliged to accept a recall within seven (7) calendar days of being notified by registered mail or forfeit their seniority and ability to be recalled to any future positions. It is crucial that laid-off workers keep an up-to-date address on file with the Hospital. When a laid-off worker is not going to be available for a seven day period, it may even be appropriate to have the Union designated as their agent so that the recall could be acknowledged within the time limits.

Positions are to be posted before recalls occur. Any position must first be posted before it can be filled by recall. This allows more senior employees not on layoff to bid on the position and frees later positions for recall.

Laid off employees keep their layoff status with seniority for 24 months (9.03); a refusal to accept a recall to their position results in termination; they have preference for temporary positions lasting more than 10 days but are not obliged to accept; full-time positions cannot be converted to part-time; and new employees cannot be hired until laid off workers have been given the chance to return.

(The following clause is applicable to full time employees only)

In the event of a lay off of an employee, the Hospital shall pay its share of insured benefits premiums up to the end of the month in which the lay off occurs.

The employee may, if possible under the terms and conditions of the insurance benefits programs, continue to pay the full premium cost of a benefit or benefits for up to three (3) months following the end of the month in which the lay off occurs. Such payment can be made through the payroll office of the Hospital provided that the employee informs the Hospital of his or her intent to do so at the time of the lay off, and arranges with the Hospital the appropriate payment schedule.

(a) Retraining for Positions within the Hospital
Where, with the benefit of retraining of up to six (6) months, an employee who has either accepted the layoff or who is unable to displace any other employee could be redeployed to a hospital position identified by the Redeployment Committee in accordance with Article 9.08(d)(i):

(i) Opportunities to fill vacant positions identified by the Hospital Redeployment Committee through retraining shall be offered to employees who apply and would qualify for the position with the available retraining in order of their seniority until the list of any such opportunities is exhausted. Opportunities to fill vacancies outside of CUPE bargaining units may be offered by the Hospital in its discretion.

(ii) The Hospital and the Union will cooperate so that employees who have received notice of permanent layoff and been approved for retraining in order to prevent a layoff will have their work schedules adjusted in order to enable them to participate in the retraining, and scheduling and seniority requirements may by mutual agreement be waived. The Redeployment Committee will seek the assistance of the Hospital Training and Adjustment Panel (HTAP) to cover the cost of tuition, books and any travel.

(iii) Apart from any on the job training offered by the Hospital, any employee subject to layoff who may require a leave of absence to undertake retraining in accordance with the foregoing shall be granted an unpaid leave of absence which shall not exceed six (6) months.

(iv) Laid off employees who are approved for retraining in order to qualify for a vacant position within the Hospital will continue to receive insured benefits.

(b) Placement
Upon successful completion of his or her training period, the Hospital and the Union undertake to waive any restrictions which might otherwise apply, and the employee will be placed in the job identified in 9.11(a)(i).

An employee subject to layoff who applies but later declines to accept a retraining offer or fails to complete the training will remain subject to layoff.

(c) Regional Redeployment Committee
A joint committee of the participating hospitals and local unions identified in Appendix "A" shall meet prior to June 30, 1993, and will establish Regional Redeployment Committees to identify employment opportunities and to facilitate and arrange for the redeployment of laid off employees.

Each Hospital will provide such Regional Redeployment Committee with the name, address, telephone number, and years of service and seniority of all employees who have been laid off.

In filling vacancies not filled by bargaining unit members, the Hospitals will be encouraged to give first consideration to laid off employees who are on the list and who are qualified to perform the work. For benefit entitlement purposes, it is recognized that Hospitals shall be free to grant to any employees hired through this process full credit for service earned with another hospital.


You are eligible for retraining if: there are no vacancies available for which you can qualify; no work can be found for contracting-in; you are unable to displace another worker.

The opportunities are identified by the Redeployment Committee, but employees still have to apply.

Retraining is to be offered in order of seniority.

The Hospital is to cooperate in changing schedules of retrainees so they can participate in retraining program. Scheduling and seniority requirements may be waived by mutual consent for the same reason.

An unpaid leave of absence of up to six (6) months is available for those needing it in order to retrain.

Employees approved for retraining within the Hospital have a right to continue to receive insured benefits during that training.

Unlike a refusal to accept recall, an employee may refuse a retraining offer without losing their rights under the layoff and recall provisions.


(a) Where an employee resigns within 30 days after receiving notice of layoff pursuant to article 9.08(a)(ii) that his or her position will be eliminated, he or she shall be entitled to a separation allowance of two (2) weeks' salary for each year of continuous service to a maximum of twelve (12) weeks' pay, and, on production of receipts from an approved educational program, within twelve (12) months of resignation, may be reimbursed for tuition fees up to a maximum of three thousand ($3,000) dollars.

(b) Where an employee resigns later than 30 days after receiving notice pursuant to Article 9.08(a)(ii) that his or her position will be eliminated, he or she shall be entitled to a separation allowance of four (4) weeks' salary, and, on production of receipts from an approved educational program, within twelve (12) months of resignation, may be reimbursed for tuition fees up to a maximum of one thousand two hundred and fifty ($1,250) dollars.


When an employee resigns after receiving Notice of Layoff, they are eligible for a Separation Allowance. The amount differs significantly depending on the time of resignation. If they resign within 30 days of receiving their Notice, they are to receive 2 weeks pay per year’s service to a maximum of 12 weeks. They may also be reimbursed for up to $3000 in tuition fees. If, however, they resign after the 30 days, they will receive only 4 weeks’ salary and be eligible for only $1250 in tuition reimbursement.

Article 9.12(a), which provides a payment based upon years of continuous service, has been found to offset any severance payment owed to the employee.1 On the other hand, Article 9.12(b) is not based upon years of continuous service and there would be no offset against a employee’s severance payment.


KEY CASES:
Footnotes
1. Northeast Mental Health Centre and OPSEU, unreported, May 21, 2004 (Kaplan)

The Hospital shall not contract out any work usually performed by members of the bargaining unit if, as a result of such contracting out, a layoff of any employees other than casual part time employees results from such contracting out.


Article 10 provides an extensive set of protections against contracting out. But first, in order for article 10 to apply, contracting out must occur.

A number of arbitration cases have distinguished between ‘contracting out’ and ‘contracting in’. Often hospitals will bring contractors, for example Aramark or Marriott, to operate entire departments. Housekeeping and dietary departments are frequent examples. Arbitrators will enquire as to who is the ‘true employer’ of the employees concerned for labour relations purposes. In other words, it is not enough that the contractor signs the employees’ pay cheques. An arbitrator will be interested in whether the employees fit into the hospital’s organization or the contractor’s, and whether it is the hospital or the contractor that controls the employees’ working conditions. In a circumstance where the employees are considered part of the hospital’s organization and not the contractor’s and/or the hospital and not the contractor controls the working conditions, then the hospital and not the contractor will be considered the ‘true employer’ of the employees concerned.1 In that case the employees concerned will be covered by the hospital’s own collective agreement rather than the terms established by the contractor.

At present (February 2006), there are at least two arbitration cases proceeding where the Union claims that the hospital, and not a contractor, is the true employer. Both cases involve housekeeping.

Where a true contracting out does occur, article 10.01 requires that no layoff occurs as a result. In the event employees are reassigned by the hospital in a way which complies with the requirements of article 9.08 (b), no layoff will be found to have occurred.

Where a hospital reassigns employees in a manner which does not comply with article 9.08(b) so that layoff notices should have been issued, then a contracting out will be considered invalid even if no employees have been laid off to the street.

In the event a hospital breaches article 10.01, the proper remedy is to cancel the contracting out. It is not enough for the hospital to try to ‘repair’ the layoff.2



KEY CASES:
Footnotes
1. IKO Industries and U.S.W.A. (2002), 118 L.A.C. (4th) 1 (P.Picher)
2. Scarborough Hospital and CUPE Local 1487, unreported, January 17, 2006 (Burkett); and see William Osler Health Centre and CUPE Local 145, unreported, March 20, 2006 (Springate), and William Osler Health Centre and CUPE Local 145, unreported, February 10, 2007 (Springate)


Notwithstanding the foregoing, the hospital may contract out work usually performed by members of the bargaining unit without such contracting-out constituting a breach of this provision if the hospital provides in its commercial arrangement contracting out the work that the contractor to whom the work is being contracted, and any subsequent such contractor, agrees:

(1) to employ the employees thus displaced from the hospital; and

(2) in doing so to stand, with respect to that work, in the place of the hospital for the purposes of the hospital’s collective agreement with the Union, and to execute into an agreement with the Union to that effect.

In order to ensure compliance with this provision, the hospital agrees that it will withdraw the work from any contractor who has failed to meet the aforesaid terms of the contracting-out arrangement.


Article 10.02 governs the content of the commercial agreement between the hospital and contractor, and the agreement between the contractor and the union. It requires that a hospital and the contractor have as part of their commercial agreement, an obligation on the contractor to enter to recognize the CUPE Local at the hospital as bargaining agent for its employees, to employ all the employees displaced from the hospital, and to enter into a collective agreement that is identical to the collective agreement between the hospital and the union.1 Moreover, the contractor is bound to continue to provide the identical collective agreement as the hospital’s, as is any subsequent contractor. If a contractor does not fulfill this requirement, the hospital is obligated to return the work in-house.



KEY CASES:
Footnotes
1. St. John’s Rehabilitation Hospital and CUPE Local 790 and Brookfield LePage Johnson Controls, unreported, January 15, 2002 (Abramsky)

Further to Article 9.08(d)(i)(1) the parties agree that the Redeployment Committee will immediately undertake a review of any existing sub contract work which would otherwise be bargaining unit work and which may be subject to expiry and open for renegotiation within six (6) months with a view to assessing the practicality and cost effectiveness of having such work performed within the Hospital by members of the bargaining unit.


This provision applies whether a notice of layoff has been sent to an employee or not. Refer also to 9.08(d).



Employees not covered by the terms of this Agreement will not perform duties normally assigned to those employees who are covered by this Agreement, except for the purposes of instruction, experimentation, or in emergencies when regular employees are not readily available.


The purpose of article 11.01 is to prevent duties normally assigned to bargaining unit members from being assigned to employees of the hospital who are not members of the bargaining unit.

A violation of this article is not dependent upon whether a layoff has occurred. Also, the exceptions to the article’s protection are limited – instruction, experimentation, or when regular employees are not readily available.

Often disputes will arise when the duties normally assigned to bargaining unit members are also often assigned to members of other bargaining units, or to supervisory personnel. In these cases, an ‘overlap’ is said to exist in that the duties are assigned to bargaining unit members and non-bargaining unit members on a regular basis. In those circumstances, the earlier arbitration awards appeared to give the hospitals an unfettered right to change the amount of work assigned to bargaining unit members when an ‘overlap’ existed. However, the more recent cases hold that the purpose of 11.01 is to protect not only the ‘type’ of duties that members of the bargaining unit perform from being assigned to other employees, but also the ‘volume’.1 In other words, more recent cases have found that even when there is an overlap between bargaining units, a hospital must maintain the amount of work performed within the bargaining unit rather than assign it to other employees.

KEY CASES:
Footnotes
1. Northumberland Health Care Corp. and CUPE Local 2628, unreported, November 27, 2003 (Verrity)



The use of volunteers to perform bargaining unit work, as covered by this agreement, shall not be expanded beyond the extent of existing practice as of June 1, 1986.

Effective October 1, 1990, the Hospital shall submit to the Union figures indicating the number of volunteers as of September 20, 1990. Thereafter, the Hospital shall submit to the Union, at three (3) month intervals, the number of volunteers for the current month, and the number of hours worked and the duties performed.


Article 11.02 is intended to restrict the hospital in assigning bargaining unit work to volunteers. The restriction is based upon the extent of existing practice at June 1, 1986.
In other words, the hospital may not expand the use of volunteers performing bargaining unit duties, beyond the June 1, 1986 threshold.

Arbitral authority holds that there are both qualitative and quantitative protections provided by article 11.02. The ‘qualitative’ protection addresses the ‘type’ of bargaining unit work involved.1 The ‘quantitative’ protection addresses the ‘amount’ of bargaining unit work involved. Thus a hospital can breach article 11.02 either when it assigns bargaining unit work not previously performed by volunteers to them, A hospital may also breach article 11.02 when it increases the share of bargaining unit work which volunteers perform if they were already performing that type of duty.

KEY CASES:
Footnotes
1. Oshawa General Hospital and CUPE Local 45, unreported, August 26, 1997 (Swan)

(b) Prior to issuing notice of layoff pursuant to article 9.08(a)(ii) in any classification(s), the Hospital will offer early retirement allowance to a sufficient number of employees eligible for early retirement under HOOPP within the classification(s) in order of seniority, to the extent that the maximum number of employees within a classification who elect early retirement is equivalent to the number of employees within the classification(s) who would otherwise receive notice of layoff under article 9.08(a)(ii).

An employee who elects an early retirement option shall receive, following completion of the last day of work, a retirement allowance of two weeks' salary for each year of service, plus a prorated amount for any additional partial year of service, to a maximum ceiling of 26 weeks' salary, and, in addition, full time employees shall receive a single lump sum payment equivalent to $1,000 for each year less than age 65 to a maximum of $5,000 upon retirement.


It is significant that this article specifically requires the employer to offer early retirement “prior to issuing notice to layoff”.

The Hospital must repeat this same early retirement offer to employees in classifications where subsequent layoffs are proposed before those notices of layoff are sent.

It does not matter whether an employee occupies a position into which a laid off employee could be redeployed. If the employee is within the classification in which early retirement allowances are to be offered, then the employee is entitled to be offered the allowance.1 If a hospital declines to offer the allowance because it does not intend to fill that employees job, or because the employee to whom the layoff notice is to be given does not meet the requirements of the job, then the hospital breaches article 18.03(b).

Finally, in a number of cases hospitals have offered enhanced exit packages to entice employees to leave. Union agreement in these circumstances is required, and it is important that Local Unions make sure they are not enabling the hospital to contract out the work once the positions are vacated.


KEY CASES:
Footnotes
1. Temiskaming Hospital and CUPE Local 904, unreported, November 28, 1995 (Charney)

(a) The Union's representative(s) will be included in the consultation and planning process from the early phases of, including representation on the Fiscal Advisory Committee or equivalent committee, to its final stages of completion, to assist the Hospital in minimizing layoffs or job loss, and in developing labour adjustment strategies where necessary.

(b) Where the Hospital experiences unforeseen circumstances such that will necessitate changes to an operating plan which has been approved by the Ministry of Health, the Hospital agrees that revisions to the operating plan will be carried out in consultation with the Union.

(c) In furtherance of the foregoing, the Hospital agrees to provide to the Union in a timely way any financial and staffing information pertinent its budget, or to any other re-structuring plan that would affect the Union's members.

(d) It is understood that employee time spent at meetings with the employer in pursuance of the above shall be deemed to be work time for which the employee shall be paid by the Hospital at his or her regular or premium rate as may be applicable.


Article 21 obligates the hospital to involve the union in both the financial decisions that impact on staffing, and also any revisions to the budget that may impact on staffing. The Union is to be involved from the outset of the budgetary process and is also to be involved in any subsequent revisions to staffing levels arising from budgetary revision. This obligation is before the Redeployment Committee, in that it precedes any decision of the hospital to issue notices of layoff or the elimination of positions.

Where employees are to be reassigned in accordance with article 9.08 and their positions eliminated, the union should have been first consulted in accordance with article 21 in order to allow it to participate in the development of the labour adjustment strategy.

In addition to allowing the union participation in the development and amendment of hospital operating plans, article 21 imposes an onerous obligation on the hospital to provide financial and staffing information which is pertinent to the operating plan, or to any other re-structuring plan which impacts upon the members of the bargaining unit.



APPENDIX A
EMPLOYMENT INSURANCE BENEFITS

General:
If you have worked long enough during the year leading up to your layoff, you are entitled to 55% of your average weekly insurable earnings in Employment Insurance (“EI”) benefits to a maximum of $447 per week. A Family Supplement is available to low-income families who receive the Canada Child Tax Benefit. You must serve a 2-week unpaid waiting period before your EI benefits begin to be paid.

To qualify for EI benefits, you must have worked a minimum number of insurable hours in the last 52-week period (the “qualifying period”). The number hours required varies from region to region depending on the unemployment rate. Most people will need between 420 and 700 insurable hours of working their qualifying period to qualify. Your local Service Canada Centre can give you the qualifying requirements for your region.

In Ottawa, for example, with an unemployment rate of 4.7% (February, 2006), the amount of insurable hours required in the previous 52 weeks would have been 700 hours, while in Sudbury with a 7.7% unemployment rate (February, 2006), you would have only had to have accumulated 630 insurable hours in order to qualify. There is an exception to this rule, which tends to discriminate against women, youth and new immigrants. New entrants (individuals entering the workforce for the first time) and re-entrants (individuals re-entering the workforce after an absence of two or more years) are required to accumulate 910 hours of insurable employment during the previous 52 weeks to qualify for EI benefits

The length of time you can receive benefits also varies be region and can extend from 14 to a maximum of 45 weeks. The number of weeks depends upon the unemployment rate in your region and the amount of insurable hours you have accumulated in the qualifying period.

On Separation
Upon separation, you must request your Record of Employment (“ROE”) from your employer. Any earnings made or allocated during the two-week waiting period, including vacation pay, pay in lieu of notice and severance pay can delay the start of an EI claim. All earnings that an employer has paid by reason of layoff or separation, delay the required 2-week waiting period, because they are allocated from the week of the layoff or separation, based on the normal weekly earnings for that employment, no matter the period for which the earnings are supposed to be paid or payable.

An example from the Human Resources and Skills Development Canada (“HRSDC”) government website (www.hrsdc.gc.ca) illustrates how this might work:
Your employment ended on August 26, 2004 due to a plant closure and you are not expected to return. In the week of August 30, 2004, you apply for regular benefits. Your normal salary was $500.00 per week. Following your lay-off, your employer paid you the following:
• Your salary for the week of 23 to 26 August 2004: $400.00
Vacation pay: $600.00
Severance pay: $1,500.00
The wages, vacation pay and severance pay are earnings and are consequently deductible from your benefits. The vacation pay and severance pay are earnings allocated as follows, based on the normal weekly earnings for that employment.
• August 22 to 28, 2004 — Salary of $400 + Vacation pay of $100
• August 29 to September 4, 2004 — Vacation pay of $500
• September 5 to 11, 2004 — Severance pay of $500
• September 12 to 18, 2004 — Severance pay of $500
• September 19 to 25, 2004 — Severance pay of $500
• September 26 to October 2, 2004 — 1st week of waiting period to serve
• October 3 to 9, 2004 — 2nd week of waiting period to serve
• October 10 to 16, 2004 — EI benefits paid
In this example, the allocations of these earnings have the following effects:
• Delays the required 2-week waiting period to serve
• Delays the date on which you begin receiving benefits
• Allows a 4-week extension of your benefit period

Pension income constitutes earnings for benefit purposes unless an individual requalifies for EI benefits after the date on which payment of the pension begins, i.e. if, after the date on which the pension became payable, and while receiving your pension, you worked and accumulated the necessary number of insurable hours to establish a claim, and that claim is calculated using the insurable hours accumulated after the start of the retirement pension.

Enter the name for this tabbed section: Insured Benefits
CUPE Research Branch
May 2010


TABLE OF CONTENTS

INTRODUCTION 3
Part-time and Casual Employees 4
Coverage Maintained for Early Retirees 5
Coverage Maintained During Certain Leaves of Absence 5

1. SEMI-PRIVATE ACCOMMODATION 6

2. EXTENDED HEALTH CARE PLAN 7
2.1 Eligibility 7
2.2 Family Coverage 8
2.3 Definition of Spouse 8
2.4 Pre-Existing Conditions are Covered 8
2.5 Deductibles 8
2.6 Out of Province Coverage 8
2.7 Drugs 8
2.8 Private Nursing 9
2.9 Physiotherapy 9
2.10 Diagnostic Service 9
2.11 Private Room 9
2.12 Accidental Dental 10
2.13 Private Hospital 10
2.14 Prosthetic Appliances 10
2.15 Durable Medical Equipment 10
2.16 Medical Services and Supplies 11
2.17 Ambulance 11
2.18 Psychologists 11
2.19 Masseurs 11
2.20 Speech Therapy 11
2.21 Chiropractic 11
2.22 Extra Medical Fees 11

3. VISION BENEFIT 12
4. HEARING AID BENEFIT 12

5. HOSPITALS OF ONTARIO GROUP LIFE INSURANCE PLAN (“HOOGLIP”)12

5.1 Eligibility 13
5.2 Portability 13
5.3 Amount of Insurance Benefit 13
5.4 Appointing a Beneficiary 14
5.5 Payment of Benefit 14
5.6 Leaves of Absence 14
5.7 Disability Benefit 14
5.8 Early Payment Option 14
5.9 Post-Retirement Coverage 15
5.10 HOOVLIP and AD&D 15

6. DENTAL PLAN 16

6.1 Examinations 17
6.2 Consultations 17
6.3 X-Rays 17
6.4 Diagnostic Services 17
6.5 Preventive Services 18
6.6 Endodontic Services 18
6.7 Periodontal and Adjunctive Services 18
6.8 Denture Repairs and Relines 19
6.9 Complete and Partial Dentures (50/50 Co-Insurance to $1,000 annual maximum) 19
6.10 Minor Restorative Services 19
6.11 Crowns and Bridgework (50/50 Co-Insurance to $1,000 annual maximum) 19
6.12 Surgical Services 20
6.13 Other Services 20
INTRODUCTION


This CUPE Members’ Guide describes the insured benefits to which you are entitled under article 18.01 of the central collective agreement (“central agreement”) between participating hospitals and CUPE locals who participate in central bargaining. It is divided into six parts as follows:

• Semi-Private Accommodation
• Extended Health Care Benefits
• Vision Benefit
• Hearing Aide Benefit
• Hospitals of Ontario Life Insurance Plan (HOOGLIP) Benefits
• Dental Plan

If you want more detailed information than is provided in this Guide, ask your Human Resources staff to provide you with a copy of the “master policies” of your benefit plans. If there is any problem, contact your local union, since under the central agreement, the union has a right to access this information.


Not every hospital uses the same insurer for its benefit plans. After the Ontario Hospital Association sold Ontario Blue Cross to Liberty Health, CUPE negotiated provisions into the central agreement, which are intended to ensure that individual hospitals cannot provide inferior benefits to those provided by other hospitals. By referencing the standardized Blue Cross plans, which existed in 1993, and any “riders” to those plans, hospitals are required to meet the standards contained in those plans. It is important to note that this provision does not preclude hospitals from providing enhancements to those plans.



NB: The information in this Guide itemizes the minimum level of benefits a hospital is obliged to provide. Some hospitals may be currently providing superior provisions to those, which existed under the Blue Cross plans referenced in the collective agreement.




Part-time and Casual Employees

Under the terms of the central agreement, regular part-time and casual employees receive a dollar amount instead (“in lieu”) of benefits. This amount is equivalent to 14% of the part-time employee’s straight-time hourly rate for all straight time hours paid.














If you are a CUPE part-time employee, it is important to know that your “percentage in lieu of benefits” is not supposed to cover the employer’s share of pension contributions. If you receive the percentage in lieu of benefits, you are entitled to participate in the pension plan without a reduction in the percentage in lieu of benefits, and the employer must still contribute its share of contributions towards your pension benefits.

The central agreement between Participating Hospitals and CUPE includes a Letter of Understanding that allows the parties at the local level to provide part-time employees with the option of participating voluntarily in the group benefit plans provided for in Article 18.01.














Coverage Maintained for Early Retirees

Under the terms of the collective agreement, employees who retire early and have not yet reached age 65, and who are in receipt of the hospital’s pension plan, maintain coverage.














Coverage Maintained During Certain Leaves of Absence

In addition, your central agreement (Article 9.04) ensures that if you are off work due to sick leave or a disability resulting in receipt of LTD or WSIB benefits (including any time you spend on EI sickness benefits), your employer must continue to pay its share of the premiums for up to thirty months.

Likewise, if you are a full-time employee away from work on pregnancy leave (Article 12.06), the employer has to continue paying its share of the pension and benefit premiums for up to 17 weeks. If you take parental leave in addition to the pregnancy leave, the employer must continue paying its share of premiums for an additional 35 weeks. If you take parental leave and you are not the parent who took pregnancy leave your employer must continuing paying its share of the pension and benefit premiums for 37 weeks (thereby covering off the EI waiting period). If you are a part-time employee, your employer must continue to pay the percentage in lieu of benefits and its share of pension contributions for the duration of the pregnancy leave (Article12.06) or for ten (10) weeks if your are on parental leave (Article 12.07).

In the event of a layoff of a full-time employee, the employer is required to pay its share of insured benefits premium up to three months from the end of the month in which the layoff occurs or until the laid off employee is employed elsewhere, whichever occurs first. (Article 9.10 of the central agreement).



1. SEMI-PRIVATE ACCOMMODATION










The Hospital is responsible for paying 100% of the cost of semi-private accommodation in an acute treatment or convalescent hospital. If you occupy private room accommodation in hospital, the plan will pay up to the semi-private level. This sentence may seem strange to you when you read the next section of this Guide which will tell you that the Extended Health Care Plan (“EHC”) covers the difference in cost between semi-private accommodation and a private room in a public general hospital.

If you have private room coverage under EHC, why do you still need semi-private coverage?

The answer is that very often no private rooms are available, and if not, the extended health care plan may not cover the cost of semi-private accommodation. Therefore you need both plans to ensure that you can receive the best accommodation arrangements available to you.

At a minimum, your semi-private plan must provide up to $3.00 per day for up to 120 days per year for accommodation in chronic care hospitals and chronic care units of public general hospitals, but does not cover accommodation in psychiatric hospitals or nursing homes.

The plan will provide semi-private coverage outside Ontario up to the cost of comparable semi-private accommodation in Ontario when standard ward charges are paid by OHIP.


2. EXTENDED HEALTH CARE PLAN































Your hospital is responsible for paying 75% of the cost of the benefit premium for the extended health care plan (although this is subject to any superior contribution split). Benefits, which will be itemized in more detail below, include drugs, private nursing, physiotherapy, private accommodation, accidental dental work, private hospitals, prosthetic appliances, durable medical equipment, medical services and supplies, ambulance, psychologists, masseurs, speech therapy, chiropractic services and extra medical fees.

2.1 Eligibility

All full-time employees are eligible for coverage under the hospital’s extended health care plan. There are no waiting periods for benefits to start.

2.2 Family Coverage

For full-time employees, the family rate for all insured benefits covers you, your spouse, and all your unmarried children up to the age of 21, including newborns. It also includes children over the age of 21, if your child is mentally or physically infirm and dependent on you.


2.3 Definition of Spouse

The definition of spouse includes a person who is married to an employee, or if not married, cohabits with such employee in a continuing conjugal or homosexual relationship and resides in the same country.


2.4 Pre-Existing Conditions are Covered

No medical examination is required for you and your dependents. Pre-existing conditions are covered, except for dental care as a result of an accident.


2.5 Deductibles

Your coverage is subject to an annual $22.50 (single) or $35.00 (family) deductible before the plan kicks in, but once those levels have reached, the extended health care plan does not require any co-insurance. Unlike your plan, plans with co-insurance require an employee to pay some portion of the cost of a particular treatment or drug in addition to having to split the premium cost with the employer.


2.6 Out of Province Coverage

Benefits apply anywhere in the world, except that where charges are incurred for the services of a licensed physician while a person is outside his or her province of residence, payment will be made for the “reasonable and customary” charges which are in excess of the amounted listed in the Ontario Medical Association Fee Schedule.

Reimbursement for charges incurred outside of Ontario will be in Canadian funds, based on the rate of exchange in effect on the date the services were rendered.


2.7 Drugs

Drug coverage under your plan is very comprehensive incorporating all drugs, serums, injectibles and insulin (needles, syringes and testape for use by diabetics) purchased on the prescription of a medical doctor, but not including vitamins or vitamin preparations (unless injected), patent or proprietary medicines and drugs not approved for legal sale the general public in Canada.

Reimbursement for prescribed drugs is based on the cost of the lowest priced therapeutically equivalent generic drug [unless you have a documented adverse reaction to it] so it is important to inform your physician of this requirement before he or she writes out a prescription.


2.8 Private Nursing

The plan includes unlimited private duty nursing by a Registered Nurse who is registered in the jurisdiction in which the services are provided (cannot be a relative), either in the hospital or at home, providing the private duty nursing is ordered by the attending physician. This benefit does not include agency fees, commissions or overtime charges, or any amount in excess of the fee level set by the largest nursing registry in the province of Ontario.


2.9 Physiotherapy

Up until the 2006 – 2009 round of central bargaining, a large number of hospitals did not provide reimbursement for physiotherapy treatments. This is because reimbursement used to be based on the amount that would have been allowed by OHIP, but since 2004, these services are no longer covered by OHIP if used by Ontarians between the ages of 20 to 64 – unless they require these services following overnight hospitalization, as part of an approved home care program, or if they live in a long-term care home.

The central collective agreement now requires physiotherapy coverage up to $300 annually ($350 effective September 29, 2011), unless of course, the Hospital has been providing superior coverage.

2.10 Diagnostic Service

Diagnostic services performed at a hospital are included in the plan.


2.11 Private Room

The difference in cost between semi-private accommodation and a private room (not a suite) in a public general hospital is covered.


2.12 Accidental Dental

Dental care is covered when necessitated by a direct accidental blow to the mouth and not by an object wittingly or unwittingly placed in the mouth. The accident and treatment must occur while coverage is in force, and treatment must begin within 90 days of the accident, and must be completed within one year. Payment will be made up to the fees set out in the Ontario Dental Association suggested Fee Guide for General Practitioners in effect on the date of treatment.


2.13 Private Hospital

The plan covers charges up to $10 a day to a maximum of 120 days per person while your coverage is in force for care in a licensed private hospital.


2.14 Prosthetic Appliances

Payment will be made for the purchase of the following items when authorized in writing by your attending physician:

• Standard type artificial limb or eye
• Splints
• Trusses
• Casts
• Cervical collars
• Braces
• Catheters
• Urinary kits
• External breast prostheses (following mastectomies)
• Ostomy supplies (where a surgical stoma exists)
• Corrective prosthetic lenses and frames (once only for persons who lack an organic lens or after cataract surgery)
• Custom-made boots or shoes or adjustments to stock item footwear

2.15 Durable Medical Equipment

When authorized in writing by your attending physician, the plan will pay for the purchase or rental of a hospital bed, crutches, cane, walker, oxygen set, respirator, or standard-type wheelchair.


2.16 Medical Services and Supplies

The plan will cover the cost of bandages or surgical dressings, blood transfusions, plasma, radium and radioactive isotope treatments when authorized in writing by your physician.


2.17 Ambulance

The difference between the government agency allowance and the customary charge for licensed ground and air ambulance services are covered.


2.18 Psychologists

Payment for the services of a registered clinical psychologist will be made up to $35 for the first visit and $20 per hour for subsequent treatment to maximum of $200 per person per year.


2.19 Masseurs

Provided they are authorized by your physician, the services of registered masseurs are covered up to $7 per treatment for not more than 12 treatments per person per year, to a maximum of $200 per person during a benefit period.


2.20 Speech Therapy

Payment for the services of qualified speech therapists up to $200 per person per year will be made where your physician or dentist authorizes in writing that such treatment is necessary.


2.21 Chiropractic

In the 2006-2009 round of central bargaining, chiropractic coverage (which had not existed in the original Blue Cross plan) was added to article 18.01. Coverage is to $300 annually ($350 effective September 29, 2011), unless of course, the Hospital is already reimbursing for higher amounts already.


2.22 Extra Medical Fees

The plan will pay for the professional services of a physician where permissible by law and incurred while the person is traveling or temporarily residing outside his or her province of domicile when the physician’s fees are over the medical association fee guide and are not greater than what would be paid in the province of domicile, if it were legal to provide such benefits.


3. VISION BENEFIT

A vision benefit in the amount of $200 ($250 effective September 29, 2010 and $300 effective September 29, 2011) every 24 months is provided to you and each eligible dependent for eyeglasses (frames and/or lenses including contact lenses), and/or replacement glasses prescribed as a result of an eye examination by a licensed medical doctor, ophthalmologist or optometrist. Vision care coverage can be used for laser eye surgery.

In addition to the $200 ($250/$300) benefit every 24 months, the central agreement provides coverage for an eye examination every two years. As of November 2004, OHIP no longer covers routine eye examinations for patients between the ages of 20 and 24, unless they have medical conditions or diseases affecting the eye. It is important to note that the central agreement language does not put a limitation on the amount that can be reimbursed.


4. HEARING AID BENEFIT

Your plan provides payment for hearing aids obtained on the written prescription of a medical doctor every 36 months. There is no limit on the amount you can spend provided the hearing aids are purchased for your use or the use of a recognized dependent.

Medical examinations, audiometric examinations, and hearing aid evaluation tests are not covered.


5. HOSPITALS OF ONTARIO GROUP LIFE INSURANCE PLAN (“HOOGLIP”)













Your collective agreement requires your employer to provide group life insurance coverage for all full-time employees, and for it to pay 100% of the premium cost towards that coverage. In 1962, the Ontario Hospital Association established HOOGLIP to provide uniform group life insurance benefits for hospital employees. Many CUPE members will be covered by HOOGLIP, but you will note that the collective agreement language does not require all hospitals to provide HOOGLIP if another group life insurance plan is in effect.

The following section highlights the main features of HOOGLIP:

5.1 Eligibility

All new employees are required to join the plan after completing the waiting period.
The waiting period is the period of time it takes you from your first full shift of active work to the day you complete three months of service.

If your status changes to part-time (at which time you will start receiving the percentage in lieu of benefits) or you leave the employ of the hospital, you will no longer be insured, except if you go to work full-time for another employer who participates in HOOGLIP.


5.2 Portability

If you go to work full-time for another employer who participates in HOOGLIP within six months, you will be immediately eligible for coverage under the new employer’s plan. However, you must ask your new employer to arrange this transfer of coverage within one (1) month of your first day of employment, and inform your new employer of all service counted toward coverage with your previous employer.

If you fail to notify your new employer within the one-month timeframe, you may have to provide medical evidence of your insurability at your own expense.


5.3 Amount of Insurance Benefit

When you enroll in the plan, you are asked whether you want coverage for $5,000 or twice your annual rate of earnings, rounded to the nearest $500. Since $5,000 is a very small amount, and especially since HOOGLIP is provided at no cost to you, coverage at twice your annual rate of earnings is the option you should choose.


5.4 Appointing a Beneficiary

At the time you enroll, you should name a beneficiary. You may change your beneficiary at any time upon completion of a form. If you fail to name a beneficiary, or if your beneficiary predeceases you, payment will be made for your estate. If your beneficiary is a minor, you must also complete a form to appoint a trustee. All forms are available from your Human Resources department.


5.5 Payment of Benefit

Upon your death, provided at the time you are insured by the plan, the benefit will be paid to your beneficiary. You may choose the method of payment, or if you do not make the choice yourself, your beneficiary may make the choice. The three methods for payment of the benefit are as follows:

• Paid in cash
• Used to provide an income in the form of an annuity
• Left on deposit with interest

5.6 Leaves of Absence

If you take an approved leave of absence, your coverage may be continued for a period of up to twelve (12) months. Your collective agreement requires coverage to be continued during such paid leaves of absence such as sick leave, pregnancy and parental leave.


5.7 Disability Benefit

HOOGLIP coverage is continued if you become disabled before you reach age 65 at no cost to you. You must submit a disability claim to the insurance company within twelve (12) months of your date of disability. If you remain disabled until age 65, at that time retirement coverage will apply. The period during which you were disabled will count as service for purposes of calculating the amount of your retirement coverage.

5.8 Early Payment Option

In the event that it is medically proven that you are competent and certain to die within twelve (12) months, you may opt to receive a cash payment of 90% of the sum for which you are insured in lieu of all other benefits under HOOGLIP.

However, to receive this benefit you must contact your Human Resources department, and designate your estate irrevocably as your beneficiary.


5.9 Post-Retirement Coverage

Regular coverage ends when you retire or reach age 65, whichever is earlier.
At that time retirement coverage at no cost to you will begin for life.

Retirement coverage is $300 for each completed year of service as a full-time employee, to a maximum of $4,500. (Completed years of service include any qualifying period and any period during which premiums are waived due to disability.)


5.10 HOOVLIP and AD&D

While not required by the central collective agreement, some hospitals provide optional supplementary life insurance (typically through the Hospitals of Ontario Voluntary Life Insurance Plan or “HOOVLIP”) and accidental death and dismemberment benefits (“AD&D”).

The Ontario Hospital Association established HOOVLIP in 1978 to enable hospital employees to choose additional group life insurance on a voluntary basis to meet individual needs. Ask your Human Resources department if this or a similar plan is available in your workplace, as not all employers actively promote it.

Essentially HOOVLIP enables you to purchase supplementary life insurance coverage over and above HOOGLIP benefits. You may choose one, two or three times your annual earnings, rounded to the nearest $500 – although the plan restricts the maximum benefit for members aged 55 to 59 to twice your annual earnings, and for members aged 60 to 64, to one time your annual earnings.

You may also elect HOOVLIP insurance for your spouse in the amount of 25% or 50% of your HOOVLIP amount, rounded to the nearest $500. However, to exercise this option you must submit medical evidence of insurability for your spouse to the insurer.

Premiums, for which you are entirely responsible, vary according to your age and gender.

Where AD&D exists, it is usually part of HOOGLIP and provides benefits in addition to HOOGLIP benefits. Upon your death, a death benefit equivalent to your HOOGLIP benefit is payable to your beneficiary.

The amount of benefit if you are dismembered is payable to you and will depend upon the amount of loss suffered by you. For example, loss of a thumb and index finger of one hand entitles you to 33% of your HOOGLIP amount, while loss of use of one arm or one leg entitles you to 75% of your HOOGLIP amount.

Again, should this plan exist at your place of work, you will be fully responsible for the premium. Ask your Human Resources department if your employer has an accidental death and dismemberment program and if so, for a brochure outlining the details of the program.


6. DENTAL PLAN























The central collective agreement requires that your employer provide dental coverage equivalent to the Blue Cross #9 Dental Plan which was
in effect as of September 28, 1993 or comparable coverage. The Blue Cross #9 dental plan includes preventive, minor restorative, endodontic (root canal) and periodontal (gum tissue) services, denture repairs and relines and surgical services.

In addition, your employer is now required to provide you with coverage for dentures, crowns and bridges (equivalent to Blue Cross riders #2 and #4).

Reimbursement for services will be based on the most recent Ontario Dental Association fee schedule.

The employer is required to pay 75% of the cost of the benefit premium. There is a “co-insurance” feature attached to coverage for dentures, crowns and bridges, which will be described in more detail below. Unless otherwise specified, the insurance company is responsible for reimbursing you the full amount unless the fee charged by your dentist exceeds the most recent Ontario Dental Association fee schedule, in which case you are responsible for the balance. Services that are covered are itemized in more detail below:

6.1 Examinations

Coverage includes a complete oral examination once every three (3) years, with recall oral examinations (including preventive services) once every nine (9) months. Emergency examinations are covered as well as specific area oral examinations.

6.2 Consultations

The Plan includes treatment planning, with patients, and with another dentist.


6.3 X-Rays

A wide variety of x-ray services are covered, including complete series intra oral films once every three (3) years. Other x-ray examinations included in the plan are as follows:

Periapical films Occlusal films
Posterior bitewing films (every 6 months) Extra oral films
Sinus examination Sialography
Use of radiopaque dyes to demonstrate lesions
Temporomandibular joint films

Panoramic film (once every 3 years) Cephalometric films
Tracing of radiograph Tomography
Interpretation of radiographs from another source

Hand and wrist (as diagnostic aid for dental treatment)





6.4 Diagnostic Services

Other diagnostic services covered are bacteriological cultures for determination of pathologic agents, dental caries susceptibility tests, soft-hard tissue biopsies, cytological examinations and pulp vitality tests.


6.5 Preventive Services

Scaling and/or polishing once every six (6) months are included, as well as fluoride treatment, oral hygiene instruction (once every 6 months), caries/pain control and inter proximal discing of teeth.


6.6 Endodontic Services

Endodontic services (root canal treatment) are covered as itemized below:

Pulp capping Pulpotomy
Root canal therapy Apexification
Periapical services Root amputation
Gingival curettage Alveolectomy
Banding of tooth to maintain sterile operating field
Hemisection Chemical bleaching
Intentional removal, apical filling and reimplantation Emergency procedures



6.7 Periodontal and Adjunctive Services

Periodontal and adjunctive services involve the diagnosis and treatment of gum tissue. Services covered include:

Application of displacement dressing
Management of acute infections and other oral lesions
Desensitization of tooth surfaces
Gingival curettage Gingivoplasty
Gingivectomy Osseous surgery
Osseous grafts Soft tissue grafts
Vestibuloplasty Post surgical treatment
Provisional splinting-intra coronal, extra coronal per unit of
time
Occlusal equilibration (8 units of time every 12 months)

Periodontal scaling and root planning – per unit of time

Special periodontal appliances (including occlusal guards)

6.8 Denture Repairs and Relines

Other services, which are covered, include denture adjustments (complete or partial removable dentures), minor adjustments (after three months from insertion), denture repairs and denture rebasing and/or relining.


6.9 Complete and Partial Dentures (50/50 Co-Insurance to $1,000 annual maximum)

Complete and partial dentures (also referred to as “removable prosthodontic services”) are covered at 50/50 co-insurance to $1,000 annual maximum.
“Co-insurance” means that you are responsible for paying 50% of your dentist’s bill provided his or her fee doesn’t exceed the current Ontario Dental Association fee schedule. If your dentist charges more than the amount recommended by the ODA, you will be required to pay the difference.


6.10 Minor Restorative Services

Coverage includes amalgam restorations (silver fillings), pin reinforcements, stainless steel crowns and acrylic or composite restorations.


6.11 Crowns and Bridgework (50/50 Co-Insurance to $1,000 annual maximum)

Coverage for major restorative services includes the following:

Gold foil restorations
Metal inlay restorations
Retentive pins
Porcelaine inlay
Porcelain repair
Crowns
Post and core
Metal transfer coping
Other restorative services

Bridgework (or as it is referred to in dental terms, “fixed prosthodontic” services) includes the following services:

Evaluation of extensive restorative dentistry
Porcelain repair
Pontics
Retainers – inlay, onlay
Repairs
Retainers – crowns
Splinting
Retentive pins in abutments
Provisional coverage in extensive restorative dentistry

Again, you (and your dependents, if you have family coverage) are covered at 50/50 co-insurance to $1,000 annual maximum. “Co-insurance” means that you are responsible for paying 50% of your dentist’s bill provided his or her fee doesn’t exceed the current Ontario Dental Association fee schedule. If your dentist charges more than the amount recommended by the ODA, you will be required to pay the difference.


6.12 Surgical Services

The plans cover surgical services such as the removal of erupted and impacted teeth and removal of residual roots. Other services covered include:

Fibrotomy Surgical exposure of tooth
Tooth transplantation Surgical repositioning of tooth
Enucleation of an unerupted tooth and follicle Alveoplasty
Gingivoplasty and /or stomatoplasty Ostoplasty
Surgical excision (cysts and neoplasms) Surgical incision
Fractures Frenectomy
Miscellaneous surgical services


6.13 Other Services

Other services covered by the plan are anaesthesia, professional visits, drugs (injections) and in-office laboratory charges when applicable to covered procedure.


:nc/cope 491
May 3, 2010
S:\Research\WPTEXT\MARGARET\Guide to Insured Benefit Plans April 2010\Guide new\INSBENS 2010 guide May Final.doc
Enter the name for this tabbed section: HOOPP
Enter the name for this tabbed section: HOODIP

May 2010
CUPE Research Branch


T A B L E O F C O N T E N T S


1. INTRODUCTION 1

2. PART A: "SICK PAY BENEFIT" 3

2.1. Eligibility 3
2.2 Definition of Disability 4
2.3 Proof of Disability 4
2.4 Amount of Sick Pay and Length of Sick Leave 4
2.5 Employer Cost 5
2.6 Workplace Safety & Insurance Board (“WSIB”) 6
2.7 Seniority and Service 6
2.8 Modified Work 7
2.9 Effect of Sick Leave on Other Employee Benefits 7
2.10 Disputes 8

3. THE GAP - EMPLOYMENT INSURANCE SICKNESS BENEFITS 8
3.1 Eligibility 9
3.2 Amount and Duration of EI Sickness Benefits 9
3.3 Seniority and Employer Contributions to Benefits during EI Period 10

4. PART "B": LONG-TERM DISABILITY 10
4.1 Eligibility 10
4.2 Definition of Disability 11
4.3 Proof of Disability 11
4.4 Amount of LTD Income 12
4.5 Length of LTD Benefits 13
4.6 Recurrence of Disability 13
4.7 Employer Cost 13
4.8 Rehabilitation 14
4.9 Seniority, Service, and Employer Contributions to Benefits during LTD Period 14
4.10 Disputes 15

5. OTHER SOURCES OF DISABILITY INCOME 15
5.1 CPP Definition of Disability 15
5.2 HOOPP Definition of Disability 15
5.3 Appeals Process 16

6. REPLACING AN EXISTING ACCUMULATING SICK LEAVE PLAN WITH HOOD 16

Article 13.01 - HOODIP 18



1. INTRODUCTION



Under the full-time CUPE/OCHU central agreement, full-time CUPE hospital workers are entitled to paid leave for illness and disability. Article13 of the central agreement deals with sick leave, injury and disability.
This members' guide has been produced to provide you with an overview of the sick pay and long-term disability plans that make up HOODIP ("Hospitals of Ontario Disability Income Plan"). The information in the text boxes in this guide are relevant excerpts from the CUPE/OCHU central agreement.

The preamble to Article 13.01 in the collective agreement specifies that the Hospital must provide full-time employees with HOODIP (1992 booklets) or equivalent, or have some other sick leave/LTD arrangements.


Note :

Under the central collective agreement, part-time workers receive a fourteen (14%) percentage in lieu of sick leave and other benefits (Article 18.04 or Article 18.01 in part-time only collective agreements).


Some hospitals do not participate in HOODIP, and instead have an accumulating sick leave plan, where typically eighteen days a year of sick leave are earned at a rate of 1.5 days per month. This guide is not intended to cover the various accumulating sick leave plans which can be found in some CUPE hospital agreements, but focuses on those agreements with HOODIP or equivalent plan.

Where the Hospital and the local union mutually agree to replace the existing accumulating sick leave plan with HOODIP or equivalent, the plan becomes effective on the first of the month agreed to by the local parties.

The first thing to note about HOODIP is that it actually consists of two distinct plans - Part A "Sick Pay Benefit" and Part B "Long Term Disability Benefit". The two plans are quite independent of each other and have different eligibility requirements and benefit levels.




The Sick Pay Benefit is designed to last 15 weeks, after which time an employee must resort to Employment Insurance for the next 15 weeks before the Long Term Disability Benefit kicks in at 30 weeks. This gap in coverage is the weakest feature of HOODIP, especially given that not everyone automatically qualifies for Employment Insurance benefits.














Two other important aspects of both the sick pay and long-term disability parts of HOODIP are that any dispute around entitlement is grievable, and hospitals are required by your central CUPE/OCHU collective agreement to provide a copy of the HOODIP plan text, or equivalent, to the Union.



The collective agreement also provides that the Hospital shall pay the full cost of any medical certificate required of an employee.

2. PART A: "SICK PAY BENEFIT"
The first paragraph of Article 13.01(a) of the central collective states that the Hospital has total responsibility for providing short-term sick leave, and that the short-term sick leave plan must be equivalent to the one described in the August, 1992 HOODIP booklet.
There is one exception, however. CUPE has negotiated an improvement to the 1992 HOODIP plan. This improvement eliminates a penalty clause contained in the 1992 HOODIP plan.


The HOODIP penalty clause requires a waiting period of two days on the fourth and subsequent periods of illness before the sick benefit is payable. Article 13.01(e) of the central agreement removes this penalty clause for CUPE members covered by the central agreement.


2.1. Eligibility
You are eligible for sick pay benefits if you are a regular full-time employee and you have completed three months of service with the same employer following your first day of active work.

Unlike the long-term disability portion of HOODIP, the sick pay plan is not portable between employers.

2.2 Definition of Disability

Sick pay benefits are payable to employees who are "totally disabled". The definition in the plan text for totally disabled is as follows:

“Unable, due to injury or illness, to perform the regular duties pertaining to the occupation in which you participated immediately before becoming disabled.”


In other words, you are considered to be disabled if you are unable to perform the regular duties of your own job.

It is also important to know that the Supreme Court of Canada has ruled (Brooks v. Canada Safeway Ltd.) that it is illegal to exclude pregnant women from eligibility for short-term sick pay. If you are unable to do your job because you are pregnant you are entitled to HOODIP benefits.


2.3 Proof of Disability
Proof of disability is required if you are absent for three days or more. This proof is usually a doctor's certificate. The plan text states that evidence "satisfactory to the employer" must be provided. If your absence continues, the employer can require proof on a periodic basis.


2.4 Amount of Sick Pay and Length of Sick Leave
Clearly, the higher the level of income replaced, the better the sick leave plan. The length of time for which short-term sick pay is available is also of great significance. This includes whether the plan pays for each illness, or only for a stated length of time in each calendar year.

In HOODIP, the level of income replacement depends on the length of service prior to the first sick day as follows:

• after 3 months - 66.6% of regular earnings*
• after 1 year - 70% of regular earnings
• after 2 years - 80% of regular earnings
• after 3 years - 90% of regular earnings
• after 4 years - 100% of regular earnings

* means : straight time pay within the normal workweek, excluding bonuses, special payments, overtime, or premium payments.

Benefits are paid to you by the Hospital through salary continuance.

Sick pay benefits are paid for up to fifteen (15) weeks (seventy-five working days). It is important to note that although the short-term plan is expressed in ‘weeks’’ that is merely to equate employees with varying work schedules (e.g. extended shift employees). Coverage is provided in days and the 15-week bank for regular 5-day, 37.5-hour employees is to be calculated in days.

HOODIP pays on a per incident basis, for a maximum of 15 weeks each time. This means that you are entitled to a maximum of 15 weeks sick leave for each illness provided that when you return from an absence, you have worked for three continuous weeks.

If you become disabled again within three weeks from your return to work from the same or related illness, you are only entitled to the remainder of the 15-week period.

However, if you become disabled again within three weeks from your return to work from an unrelated cause of injury or illness, your benefit period will be reinstated in full. In other words, the short term plan is not a 15-week bank that becomes exhausted regardless of the disability.

Sick pay entitlement is based on pre-injury earnings, so if you are entitled to a negotiated wage increase while on sick leave, your sick pay benefit will not be adjusted to reflect the wage increase, unless of course the increase is made retroactive to a day when you were actively at work.

Short-term sick pay benefits are taxable and subject to all regular deductions, including union dues, EI and CPP and LTD contributions.

Article 13.01(d) of the central collective agreement ensures that you receive 100% of your regular pay if you have completed any portion of your shift before going on sick leave.




2.5 Employer Cost

The Hospital is totally responsible for paying for the full cost of the short-term sick pay benefit.
2.6 Workplace Safety & Insurance Board (“WSIB”)

You are not entitled to sick pay benefits under HOODIP if your absence from work is due to a compensable accident for which you are in receipt of WSIB benefits. However, Article 13.03 of the central agreement does provide for sick pay benefits to be paid pending approval of WSIB claims.



What this means is that although you are not entitled to receive both short-term sick pay from HOODIP and WISB benefits at the same time, you can borrow from your sick pay entitlement to tide you over until such time as your WISB claim is approved.

The amount you can receive is payment equivalent to the lesser of:

• the benefits you would receive from WISB if your claim were approved, or
• the benefit that you would be entitled to under the short-term sick portion of HOODIP or equivalent plan.

2.7 Seniority and Service

Because the Hospital has total responsibility for providing and funding sick pay benefits, paid sick leave is considered to be an approved absence paid by the Hospital, and both seniority and service continue to accrue.


This means that you continue to progress along the vacation and wage grids, so that following your return to work you will be placed higher on the wage grid if your anniversary date occurred during your absence, and you are entitled to any vacation improvement related to that anniversary date.


2.8 Modified Work


It is important to note that if you return to work on an approved modified work program within the fifteen-week period, you are not considered to be "actively at work". The time spent doing modified work continues to count towards the expiry of the 15-week short-term sick pay benefit period and does not cause it to be reinstated - an obvious weakness of the plan.

Some employers have taken the position that time spent on modified work by employees returning to work on a WSIB approved modified work program also counts towards the expiry of the 15-week short-term sick pay benefit period. A November, 2007 grievance arbitration award (re: Joseph Brant Memorial Hospital and CUPE) by arbitrator Kaplan now clarifies this is not the case, and that an employee on a WSIB approved modified work program who becomes sick, and the sickness is not related to their WSIB injury, is entitled to receive sick leave benefits.


2.9 Effect of Sick Leave on Other Employee Benefits

In addition to service and seniority continuing to accrue, it is important to know what happens to other employee benefits when you are in receipt of sick pay benefits.

The Hospital is required to continue making its share of contributions toward the extended health care plan, semi-private accommodation, life insurance, long-term disability and dental coverage while you are in receipt of sick pay benefits.

The Healthcare of Ontario Pension Plan ("HOOPP") requires you to continue contributing for fifteen (15) weeks while you are on a sick leave of absence, after which you must stop contributing to the Plan. If you receive less than your regular pay during this period, you will contribute less to HOOPP. To prevent any reduction in future pension benefits, you have the right to top-up your contributions to the pre-leave level.

During the 15-week period the employer is also compelled to continue making its contribution towards the pension plan.

If you can't return to work after the 15-week period, you can take a "health leave" from HOOPP for up to four years. For more information on HOOPP visit the HOOPP website at www.hoopp.com.



Article 17.03 of the central agreement calls for the Hospital to reinstate vacation credits if a serious illness interrupts your scheduled vacation.


2.10 Disputes

Don't forget that any dispute you have with the Hospital about your entitlement to sick pay benefits is grievable under article 13.01(f), although the parties to the central agreement have agreed that employees should be encouraged to utilize the medical appeals process first, should one exist under the plan.


3. THE GAP - EMPLOYMENT INSURANCE SICKNESS BENEFITS

Unlike other public sector short and long-term disability plans, HOODIP's sick pay and long-term disability plans are not joined together. A 15-week gap exists between the two. The only income protection for most members during this gap is federal Employment Insurance ("EI").


3.1 Eligibility

To qualify for EI Sickness Benefits, you must have:

• worked 600 hours in insurable employment (i.e. paid EI premiums) in the last 52 weeks or since your last claim, and

• have a medical certificate indicating how long your illness is expected to last (which you will have to supply at your own expense, and which you may have to provide on a periodic basis as continuing proof of your inability to return to work).

To prevent delays in having your claim approved it is important to apply at your nearest Service Canada Centre at least four (4) weeks before your HOODIP sick pay runs out.

If your application is denied, you can appeal the decision. Let the EI officer you have been dealing with know you wish the decision to be reviewed, and submit any additional medical information you may have in support of your claim. If the claim is still denied after the review has been completed, you may appeal to the Board of Referees within thirty (30) days after being notified of the final EI decision.


3.2 Amount and Duration of EI Sickness Benefits

Expect a substantial drop in income. EI Sickness Benefits are only fifty-five (55%) per cent of average weekly insurable earnings to a maximum of $457* per week (*except there is a supplement available for claimants with family net income under $25,921).

If your average insured earnings are $43,000 a year ($826.92/week) and if you have been working full-time, you can expect to get an EI Sickness Benefit of 55% of $826.92 or $454.81.

The benefit rate will be based on your average insured earnings in the 26-week period preceding the last paid working day. Since the calculation will include the 15-week HOODIP sick pay period, employees with less than four years' of service will be further penalized, since during that 15-week period they would have received less than 100% of their regular earnings. The maximum number of weeks during which you can claim EI Sickness Benefits is fifteen (15) weeks.

EI Sickness Benefits are taxable.

Because you must be totally disabled for thirty (30) weeks before LTD benefits are payable under HOODIP, it is important to consider very carefully whether you are well enough to return to work during the EI period. Going back to work only to find you can't handle the work may mean you are no longer considered totally disabled, and may also play havoc with your EI claim.


3.3 Seniority and Employer Contributions to Benefits during EI Period

Seniority (but not service) will continue to accrue during the employment insurance period of the sick leave. Likewise, during this same period the Hospital is required to continue paying its share of benefit premiums.


4. PART "B": LONG-TERM DISABILITY

The HOODIP long-term disability plan is an insured benefit.



4.1 Eligibility

Full-time employees who have completed six months of service are eligible for coverage regardless of a pre-existing condition. If you are not actively at work following your waiting period, due to injury or illness, then coverage becomes effective when you have completed seven consecutively scheduled days of active work following your return to work (known as the "7-day rule").

A good feature of HOODIP is that it is portable between hospitals that participate in HOODIP. If you terminate employment with one hospital and are subsequently re-employed within six months by another facility which participates in HOODIP, your coverage becomes effective on the first day of employment with your new employer.

HOODIP LTD benefits become payable after the 15-week short term sick pay period and the 15-week EI period have been exhausted. This 30-week period of time before LTD benefits are payable is referred to as the "qualifying period", and in order for LTD benefits to start on time, you should apply at least 4-6 weeks before the end of the qualifying period (i.e. after you have been off work for 24-26 weeks).

Your employer should have the appropriate application forms.

At the very latest, application for LTD benefits must be made within six months after the end of the qualifying period.


4.2 Definition of Disability

HOODIP's long-term disability plan has the "two-year own occupation" definition of disability. What this means is that the plan provides for pay during the first two years of your absence if you are unable to do your own job:

“Unable, due to injury or illness, to perform the regular duties pertaining to the occupation in which you participated immediately before becoming disabled, for the first two years you are absent from work and not engaged in any gainful occupation.

Unable, after two years, due to injury or illness, to participate in any gainful occupation for which you are, or may become, fitted through training, education or experience.”


HOODIP starts counting the two years on the first day of the short-term sick pay portion, so in reality LTD benefits are only payable for 74 weeks and not the full two years (104 months - 30 weeks = 74 weeks).

After two years, the definition of disability changes such that the plan will only pay benefits if you are unable to engage in any gainful occupation for which you are (or may become) fitted by training, education or experience.

One very good feature of HOODIP is that coverage is compulsory for all full-time employees regardless of their previous health history. Other inferior plans have provisions which exclude persons who have had pre-existing medical conditions. HOODIP provides coverage regardless of any pre-existing medical condition.

HOODIP does not discriminate against mental, nervous, alcohol or drug-related disabilities and will cover these conditions.
HOODIP does discriminate against (and does not cover) disabilities which are wilfully self-inflicted, occur as a result of a criminal offence or illegal occupation, or as a result of war.

4.3 Proof of Disability

In order to qualify for HOODIP LTD benefits, you must be under the care of a physician and periodically provide proof of disability in the form of a doctor's note.

Your doctor, preferably a specialist (insurers prefers specialists to GPs), will have to provide sufficient medical documentation to prove to the insurance carrier that you cannot do you own job during the first 74 weeks, or do any job after 74 weeks.

Please note, as with the short-term plan, a disability due to pregnancy must be covered by the LTD plan (Supreme Court decision in Brooks v. Canada Safeway).


4.4 Amount of LTD Income

The amount of income you receive depends upon your length of service, and is paid monthly. HOODIP's LTD plan provides for an increasing level of income replacement related to years of service as follows:

• after 6 months 65% of regular earnings*
• after 20 years 70% of regular earnings
• after 30 years 75% of regular earnings

* means: straight time pay within the normal workweek, excluding bonuses, special payments, overtime, or premium payments.

LTD pay is offset by other sources of disability income, ("offset" means reduced.) Your monthly benefit will be reduced if you receive income from:

• your employer, in the form of earnings,
• the Canada Pension Plan ("CPP") disability or regular pension benefits (but any CPP income you receive for your dependents is not offset),
• Old Age Security,
• WISB benefits,
• Healthcare of Ontario Pension Plan ("HOOPP") disability or regular pension benefits.


No matter how much income you are receiving from other sources, HOODIP must pay you a monthly minimum benefit of $50.00. Because of this, it is important to note that if you are in receipt of benefits you should still apply for LTD after 30 weeks. In all likelihood the LTD will pay only $50.00 a month, but if at some point your WSIB pay decreases, the LTD may increase.

It is also very important to note that a disabled worker must apply for CPP. This is because HOODIP requires you to prove that you either are, or are not receiving CPP benefits. Otherwise HOODIP assumes you are collecting CPP, and the offset is calculated against your monthly LTD benefit.

LTD benefits are not indexed to the cost of living (meaning they are not protected against inflation). LTD benefits are also taxable.


4.5 Length of LTD Benefits

Benefits are payable for 74 weeks when you are disabled and unable to perform the duties of your own occupation.

Benefits are payable for longer than 74 weeks, but only if you can prove that you are unable to engage in any gainful occupation for which you are or may become fitted by training, education or experience.

After the initial 74 weeks, if you have at least 10 years of service and you can prove that you are unable to engage in any gainful occupation, your LTD benefits continue for life. In this case your benefit will be further reduced by any additional payments from government plans and your employer’s pension plan.

After the initial 74 weeks, if you have less than 10 years of service and you can prove that you are unable to engage in any gainful occupation, your LTD benefits continue to age 65.


4.6 Recurrence of Disability

If you have been collecting LTD and then return to full-time work, only to have to go off work again due to the same disability, LTD benefits will commence immediately without the need for a new qualifying period if the recurrence occurs within six months.

However, if you have to go off work due to a different disability, or if the recurrence occurs after you have been back on the job for six months or more, then the disability will be considered a new disability and you will complete the 15-week short-term sick pay period and the 15-week EI period before becoming eligible for LTD benefits after 30 weeks.
4.7 Employer Cost

The central agreement requires the Hospital to pay 75% of the premium cost, you pay 25%. The premium cost for LTD is high. The amount depends, in part, on the occupational groups included in the plan (some jobs are higher risk than others), age, sex, and how often the plan has been used (known as the "experience rating" of the plan).

Employees who are collecting LTD benefits are not required to pay an LTD premium. You should also note that premiums for the Hospitals of Ontario Group Life Insurance Plan ("HOOGLIP") are also waived while you are collecting LTD.


4.8 Rehabilitation

HOODIP's LTD plan does allow disabled workers to participate in a rehabilitation program approved by the insurer. This includes modified work programs at the Hospital. You will be assessed by one of the insurance company’s rehabilitation consultants who will help develop and coordinate a rehabilitation program.

Rehabilitation could involve vocational retraining, educational programs and trial or part-time work in a new or related field.

If you do participate in a rehabilitation program you will receive your monthly disability benefit less 50% of the earnings you receive from your rehabilitative employment.

If the total amount you get from the discounted disability benefit plus the earnings you get from your rehabilitative employment exceed your regular pre-disability earnings, HOODIP will discount your monthly disability benefit further, so that at no time will you be allowed to receive more than your regular pre-disability earnings.


4.9 Seniority, Service, and Employer Contributions to Benefits during LTD Period

The Hospital has to continue paying its share of premiums for insured benefits for up to 30 months while an employee is on sick leave, including the EI and LTD periods, to a maximum of 30 months from the time the absence commenced. The central agreement provides for the accrual of seniority while an employee is on paid or unpaid sick leave, including the EI and LTD periods, while service accrues for a period of 15 weeks if an employee’s absence is due to a disability resulting in LTD benefits.

If you can't perform your own job because of a disability, the Healthcare of Ontario Pension Plan allows you to take a "health leave of absence" for up to four years from the last day you worked.

As we saw in the earlier section on HOODIP sick pay benefits, during the first 15 weeks of health leave, you and your employer are required to make contributions to HOOPP. You are not allowed to contribute to HOOPP after the 15 week-period. After this 15-week period has expired, HOOPP allows you to receive "imputed" service for the remainder of your disability for up to four years. What this means is that you are credited with contributory service to HOOPP for this period even though you and your employer are not contributing to the pension plan during this time.

It is therefore a good idea to consider applying for a health leave of absence from HOOPP if you are off on LTD. Visit the HOOPP website at hoopp.com for more detailed information on HOOPP health leaves of absence.


4.10 Disputes

Again, don't forget that any dispute you have with the Hospital over your entitlement to LTD benefits is grievable.


5. OTHER SOURCES OF DISABILITY INCOME

In addition to WSIB and HOODIP LTD benefits, you may be entitled to a Canada Pension Plan ("CPP") disability pension and/or a HOOPP disability pension.

The definitions of disability under the CPP and HOOPP plans are more onerous to meet than under HOODIP.


5.1 CPP Definition of Disability

The disability must be a "physical or mental impairment that is both severe and prolonged", meaning that the disability is such that you are unable to work at any job and is likely to be of indefinite duration or is likely to result in death.

As has been mentioned earlier in this guide, you are expected by HOODIP to apply for a CPP disability pension. This is because you are required to demonstrate that you are NOT eligible for a CPP disability pension in order to avoid having your HOODIP benefit reduced by the amount you would be entitled to under the CPP disability program.


5.2 HOOPP Definition of Disability

HOOPP also offers a disability pension for contributing members who become "totally and permanently" disabled. This means that the disability must be severe enough to prevent an employee from engaging in any employment and is expected to last a lifetime.

To apply for a HOOPP disability pension also means that you would, if eligible, be retiring from your employment. Again, your HOODIP LTD benefit would be reduced by the amount of any benefit you would be entitled to under the HOOPP disability program.


5.3 Appeals Process

Both the CPP and HOOPP have an appeals process. Under the CPP program you have 90 days to appeal a denial in writing, and under HOOPP you have 60 days to notify in writing your attention to appeal. In both cases you will be expected to supply further medical evidence to support your argument.


6. REPLACING AN EXISTING ACCUMULATING SICK LEAVE PLAN WITH HOODIP

A significant number of CUPE hospital local unions do not belong to HOODIP - and instead have accumulating sick leave plans whereby employees typically earn sick leave credits at a rate of 1.5 days per month, for a total of 18 sick days per year.

Accumulating sick leave plans provide 100% income replacement from the first day of absence from work.

Unused sick leave credits accumulate from year to year. Some accumulating sick leave plans have an unlimited maximum accumulation feature, but most in the CUPE hospital sector have a maximum accumulation limit of anywhere between 60 and 180 days.

Most accumulating sick leave plans have "cash-out" provisions whereby an employee who is terminated or who retires is allowed to exchange any unused sick leave for a cash payment. Typically, an employee is entitled to some percentage of their accumulated sick leave credits (the range is usually 50 - 100%) upon termination or retirement.

A major shortcoming of accumulating sick leave plans is that employees who exhaust their accumulations have no income protection. This is especially the case for new employees or for employees who suffer a major illness. Most collective agreements with accumulating sick leave plans do not have additional long-term disability programs.

Where the parties have agreed to transfer from an accumulating sick leave plan to HOODIP, Article 13.01(a) of the central collective agreement deems all employees with three or more months of service to have only three months of service on the effective date of the transfer for purposes of determining the amount of sick pay entitlement in the short-term (sick pay) portion of HOODIP.


What this means is that on the date of transfer you are only entitled to 66.6% of regular earnings in sick pay benefits, after one year you are entitled to 70% of regular earnings, and so on until after four years from the date of transfer, you become entitled to 100% income replacement. In addition, 13.01 (a) states that for the purpose of transfer to the LTD portion of the disability program, employees with one year or more of service are deemed to have one year of service for determining how much income replacement you will get under the LTD program. This means that on the date of transfer you would only be entitled to 65% of regular earnings even if you had 20 years or more service with your employer.




































There is also language in the CUPE/OCHU central agreement outlining what happens to your existing sick leave credits when an accumulating sick leave plan is replaced by HOODIP.

Article 13.01(c) of the central agreement protects any sick leave credits that you have when a hospital converts to HOODIP.

The central agreement provides that your existing sick leave credits be converted into a sick leave bank which you can use to:

• top up to 100% any sick leave taken under the HOODIP Sick Pay Benefit program,
• top up Workplace Safety & Insurance Board benefits to 100% of net pay, if you so request,
• cash-out upon termination or retirement, provided your "old" accumulating sick leave plan had such provisions.









Note

If you need more information than is contained in this guide, or if you wish to consult with someone about your particular situation, you should contact your shop steward or your assigned CUPE National Representative.



















:nc/cope 491
(Revised May 3, 2010)
S:\Research\WPTEXT\MARGARET\Guide to Insured Benefit Plans April 2010\Hoodip\HOODIP-May 2010 Final.doc

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