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Benefits Information for Producers and Performers

  Supplementary Health Care Benefits

Coverage is provided for treatment of an injury which occurs as a direct result of a qualifying accident on set.

Coverage: 100% reimbursement of all covered expenses.

Annual Maximum: $25,000 per injured performer, except additional background performers and the parent/guardian of a minor child where the annual maximum is $10,000.

Expense

Limitations

Maximum Payable

Ground Ambulance Services

  • To the nearest hospital
  • Limited to the co-payment amount  established within your province of residence

 

 

Air Ambulance

  • For flights originating and terminating in Canada only
  • This is not repatriation to your province of residence as a result of an accident.  Ensure that out-of-province emergency coverage is in place.

 

  • Overall maximum reimbursement - $5,000

Hospitalization

When the initial expense is incurred for acute care in an accredited hospital.  Subsequent room costs for rehabilitation in an accredited hospital are covered when this immediately follows at least three days of acute care.

 

  • Room cost differential between ward and semi-private accommodation only
  • Payable within Canada only
  • Does not cover the cost of standard ward accommodation

 

 

Private Duty Nursing

(LNP, RN, RNA)

 

  • Must follow hospitalization
  • Recommendation by your doctor and pre-approval by AFBS required

 

  • Up to $5,000 following each hospitalization
  • Overall maximum reimbursement - $25,000

 

Home Care Assistance

The provider must be supervised by an organization recognized to provide such care

 

  • Must follow hospitalization and used within 90 days
  • Recommendation by your doctor and pre-approval by AFBS required

 

  • Up to $50 per day for a maximum of 21 days
  • Overall maximum reimbursement - $15,000

 

Accidental Dental

Excludes injuries to natural teeth caused by an object, wittingly or unwittingly, placed in the mouth, deterioration of teeth or by any other cause, except as indicated

  • Injury must be due to breakage of tooth/teeth by a direct accidental blow to the mouth, or as a result of the use of a dental prosthesis required by the Production
  • Reimbursement is based on the current fee guide in the province where the service is provided
  • Must be provided by a legally licensed dentist

 

 

Prescription Drugs

The usual and customary ingredient cost and dispensing fee charges are covered

  • Must be prescribed by a medical doctor, dentist or health care practitioner as may be specified under their provincially legislated scope of practice
  •  Certain drugs covered only after submission of a Special Authorization request form and approval by AFBS

 

 

Visioncare

  • Examination and replacement of one pair of prescription glasses or contact lenses (up to a one year supply) when necessitated as a result of the accident
  • Sunglasses and safety glasses are excluded
  • If laser surgery is chosen as an alternative, the same maximum will apply

 

  • Overall maximum reimbursement - $1,000

Professional Services

Part A

  • Chiropractor
  • Registered Psychologist
  • Naturopath
  • Homeopath
  • Chiropodist
  • Podiatrist
  • Osteopath

 

  • Are eligible for reimbursement once medical confirmation of the accident has been provided by your medical doctor and approved by AFBS
  • Prior to reimbursement, a treatment plan, directly related to the injuries sustained, may be required from the practitioner

 

Applicable to Parts A&B

  • Up to $3,500* annually during the first 5 years
  • Up to $1,500* annually during the next 5 years

 

*   benefits for additional background performers and the parent/guardian of a minor child are limited to $1,000 annually for 5 years

Professional Services

Part B

  • Registered Massage Therapist
  • Registered Acupuncturist
  • Occupational Therapist
  • Physiotherapist
  • Speech Therapist
  • Audiologist

 

  • Requires a recommendation from your medical doctor confirming both the necessity for treatment as a result of the accident and the duration and frequency of the expected treatment

Medical Supplies

When prescribed by your medical doctor and after submission to any available provincial program

 

  • Pre-approval by AFBS required for either rental or purchase
  • Limited to the specified amount or when unspecified, the usual and customary cost as defined by AFBS
  • Limited to only the items specified

 

  • Hospital Bed – overall maximum $5,000
  • Wheelchair – overall maximum $5,000
  • Oxygen Set
  • Hearing Aids – annual maximum $500 per ear and overall maximum $2,000
  • Artificial Limbs, including myoelectric prosthesis – overall maximum $20,000
  • Artificial Eyes – one of each of left and right
  • Tens machine – overall maximum $500
  • Devices and medical aids necessitated after surgery
  • Abdominal, knee and/or back brace
  • Catheter
  • Cast
  • Cervical Collar
  • Ostomy supplies where medical stoma exists
  • Splint
  • Tracheostoma tubes
  • Truss
  • Walking cane

 

Corrective custom made boots/shoes or adjustments to stock item footwear

Only for a medical condition resulting from the qualifying accident

 

  • Must be prescribed by one of: medical doctor (MD), podiatrist (DPM) or chiropodist (D CH or D Pod M)
  • Must be dispensed by a pedorthist (C Ped(c) or C Ped (MC)) and include the biomechanical assessment as well as an itemized invoice listing all items and modifications and detailing the method of orthotic casting and fabrication including which raw materials were used

 

  • Overall maximum $5,000

Orthotics

Only if a new medical condition results from a qualifying accident

 

  • Requires  a recommendation from your medical doctor confirming the necessity for orthotics  as a result of the accident
  • Must be prescribed by one of: medical doctor (MD), podiatrist (DPM) or chiropodist (D CH or D Pod M)
  • Must be dispensed by one of:
  • Orthotist (CO or CPO(c)), pedorthist  (C Ped(c) or C Ped (MC)),  podiatrist (DPM) or chiropodist (D CH or D Pod M)

 

  • Overall annual maximum $500