Health & Dental Benefits for ACMG Members
Benefits effective January 1, 2025
As committed partners of ACMG from coast to coast, Acera Insurance is excited to offer an exclusive extended health and dental plan tailored specifically for members, through our partner, Simply Benefits. Our comprehensive coverage is designed to ensure that you and your family have access to quality care, so you can focus on what you love most.
Explore the features of the ACMG Benefits Plan.
Benefits Plan Features
With flexible options between Silver and Gold plan levels, you can choose the plan that works best for you. See the table below to compare the Silver and Gold plans and rates. Coverage is guaranteed acceptance, which means no medical requirement.
Extended Health Care
Silver
- Coinsurance: 80% (100% hospital/travel)
- Semi-private hospital room
- Travel Insurance OOC – $5,000,000 / Trip Duration: 60 days
- Termination: age 75
Gold
- Coinsurance: 100%
- Semi-private hospital room
- Travel Insurance OOC – $5,000,000 / Trip Duration: 60 days
- Termination: age 75
Prescription Drugs
Silver
- Coinsurance: 70%, 80% Costco or Pocketpills
- Maximum $50,000 per person per calendar year
- Includes mandatory generic
Gold
- Coinsurance: 80%, 90% Costco or Pocketpills
- Maximum $50,000 per person per calendar year
- Includes mandatory generic
Paramedical
Silver
- 80%, up to $500 per practitioner per calendar year
Gold
- 100%, up to $500 per practitioner per calendar year
Vision
Silver
- Exams – No coverage
- Eyewear – No coverage
Gold
- Exams – $75 once every 24 mo (adults), 12 mo (child)
- Eyewear – $300 every 24 mo (adults), 12 mo (child)
Dental Care
Silver
- Basic – 80% to a max of $1000 per cal yr
- Major – None
- Recall – 9 months
- Termination – age 75
Gold
- Basic – 80% to a max of $2000 per cal yr
- Major – 50% to a max of $2000 (combined with basic)
- Recall – 6 months
- Termination – age 75
Life Insurance and Accidental Death & Dismemberment
Silver and Gold:
- Benefit amount: $25,000 / $50,000 if accidental
- Benefit reduces by 50% at age 65
- Terminates at age 75
Monthly Rates
Silver
Single
$97.98
Duo
$203.25
Family
$249.40
Gold
Single
$124.97
Duo
$241.28
Family
$292.27
Enrolment & Eligibility Conditions
The criteria below are the terms of the group insurance contract. This provides for the cost sustainability of the plan and avoids anti-selection when members choose to sign on for the optional benefits offered through your association.
- Interested members must complete the “sign-up” page with personal information details.
- Members will receive an enrolment link from Simply Benefits. Members must complete enrolment within 30 days.
- Failure to complete the enrolment link will result in medical underwriting. You may be declined coverage if you have pre-existing conditions.
- Members can change from Silver to Gold (or vice versa) within 30 days of the plan anniversary (January 1st).
- You must enrol your eligible spouse and dependants if not already covered under another benefits plan.
- Premiums are billed directly to member via banking or credit card. Details are entered on the enrolment link.
- Members must remain on the plan for at least 12 months. Valid reasons for cancellation include:
- You become covered with an employer-sponsored benefits plan or through a spousal benefit plan.
- You are no longer a member of the association.
- Proof is required.
- Changes to family status can occur at any time.
- Proof of alternate coverage is required.
- Over-age dependents are automatically removed from the plan.
- Marriage break-up (separation or divorce) requires submission of proof from the member.
- Members leaving the plan must wait 24 months before becoming eligible for coverage.
Resources
- How to enrol in the ACMG Benefits Plan (video)
- How to use your benefits card (video)
- How to submit a claim (video)
- Benefit Plan Summary – GOLD (pdf)
- Benefit Plan Summary – SILVER (pdf)