Eligibility

Subject to the eligibility guidelines, NLTA members and employees residing in Canada are eligible to participate in this option providing they are a member of the NLTA Group Insurance Program. Note: In order for active teachers to be eligible to apply for Voluntary Critical Illness insurance benefits they must be enrolled in the $10,000 Basic Critical Illness Insurance Benefit.

Pre-existing Conditions Limitations Clause

It is important to note that this Critical Illness benefit has a 24-month pre-existing conditions Limitations clause. This limitation states that no benefit is payable for an illness or pre-existing condition for which the participant has received care, treatment or services, consulted a physician, or taken medication, in the 24 months prior to the effective date of coverage, unless the illness in question was diagnosed at least 24 months after the effective date of the insurance of the participant, subject to other applicable provisions of this policy.

Schedule of Benefits:

The Voluntary Critical Illness for NLTA members and staff provides the following benefits:

• Plan members – Units of $10,000 to a maximum of $300,000
• Spouse – Units of $10,000 to a maximum of $300,000
• Dependent child(ren) – $5,000 maximum
• A $50,000 non-evidence maximum. However, the Pre-existing Conditions Limitations Clause applies

Complete Policy Provision Exclusions and Limitations

Illnesses or conditions covered under option CV/CS

Illnesses covered under the extended coverage

Aortic surgery
Aplastic anemia
Bacterial meningitis
Benign brain tumour
Blindness (loss of sight of both eyes)
Coma
Coronary artery bypass surgery
Deafness (loss of hearing in both ears)
Dementia including Alzheimer’s disease
Dilated cardiomyopathy
Fulminant viral hepatitis
Heart attack (myocardial infarction)
Heart valve replacement or repair
HIV infection (occupationally-acquired infection)
Kidney failure
Life-threatening cancer
Liver failure of advanced stage
Loss of independent existence
Loss of limbs
Loss of speech
Major burns (severe)
Major organ failure (on waiting list)
Major organ transplant
Motor neuron disease
Multiple sclerosis
Muscular dystrophy
Paralysis
Parkinson’s disease
Primary pulmonary hypertension
Progressive Systemic Sclerosis
Stroke (cerebrovascular accident)

These “new” conditions are effective May 1, 2022 and are considered at a reduced coverage level:
Coronary angioplasty
Crohn’s disease requiring surgery
Ductal carcinoma in situ of the breast
Hip or knee replacement surgery
Severe rheumatoid arthritis
Stage 1A malignant melanoma
Stage A (T1a or T1b) prostate cancer
Systemic lupus erythematosus

Illnesses and conditions covered under Option CC – Dependent Child

To provide additional security for parents, dependent children are covered for 18 illnesses or conditions, some of which are often diagnosed early in life. The Dependent Child benefit is a flat $5,000 and covers all eligible dependent children.

Illnesses covered under the extended coverage

Benign brain tumour
Blindness (loss of sight of both eyes)
Cancer (life-threatening)
Cerebral palsy
Coma
Congenital heart disease requiring surgery
Cystic fibrosis
Deafness (loss of hearing in both ears)
Down’s syndrome
Kidney failure
Loss of speech
Major organ failure (on waiting list)
Major organ transplant
Muscular Dystrophy
Paralysis
Serious mental deficiency
Severe burns
Spina bifida cystica