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Health and Dental Insurance

The basic plans A, B, C, D, the supplementary plans, and the insurance plans for retirees R1, R2, R3 all offer health insurance; some provide dental coverage. Insurance plan Z covers only the purchase of medications.

Insurance coverage varies from one plan to another. The Bulletin MÉDIC Construction for each plan gives a short description of the coverage offered and the reimbursable amounts. Specific conditions, limitations, and exclusions may apply; only the Règlement sur les régimes complémentaires d'avantages sociaux dans l'industrie de la construction has legal value.

Application for reimbursement

The sections of the Commission de la construction du Québec (CCQ) site dealing with different insurance coverage explain how medical expenditures incurred may be paid. Applications for reimbursement must be sent to MÉDIC Construction within one year after the date on which the medical expenditure was made. If the expenditure is high, it is suggested that you ask MÉDIC Construction for an estimate of reimbursement before making the purchase. This enables you to know the amount that you will have to pay as an insured.

A worker who feels that he or she has the right to a reimbursement different from that granted by MÉDIC Construction may make a complaint about this decision. To do this, he or she must contact Customer Services, which will send him or her the appropriate form. If the employee has taken this step and is still dissatisfied with the CCQ’s decision, the Act Respecting Labour Relations, Vocational Training and Workforce Management in the Construction Industry allows him or her to ask for a review. The CCQ’s Customer Services can guide the employee with this process and supply the appropriate form.

Coordinated insurance

When the spouse of a worker or retiree insured under MÉDIC Construction is covered by another group insurance plan, it is possible for the other insurer concerned and MÉDIC Construction to share the reimbursement of claims. This is called coordinated insurance. It is legal and advantageous to make a claim to the spouse’s insurer and from MÉDIC Construction for a single expenditure; the amount reimbursed, however, may not surpass the total of the costs incurred.

For coordinated insurance, MÉDIC Construction requires that all of its insureds produce a Declaration by the Spouse form.

Following a work-related accident or an occupational disease

The reimbursement of medical care and medications related to a work-related accident or occupational disease must be claimed from the Commission des normes, de l'équité, de la santé et de la sécurité du travail (CNESST).

Following an automobile accident

The reimbursement of medical care and medications related to an automobile accident must be claimed from the Société de l'assurance automobile du Québec (SAAQ).

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