Health benefits UHIPOHIP Base plan Unit 1 TopUp

Health benefits UHIP/OHIP, Base plan, Unit 1 Top-Up Plan and HCSA

OHIP / UHIP UTGSU: BASE PLAN Overview of Health insurance plans • OHIP: for domestic students • UHIP: for all international student • For all graduate students who don’t opt-out. (UTGSU) CUPE 3902 UNIT 1 - Plan A: TOP-UP PLAN + HCSA CUPE 3902 UNIT 1 - Plan B: HCSA only • For CIs, TAs, CPOs, invigilators or peer assistants who have the base plan (undergraduate or graduate students). • For graduate students who TA, CI or invigilate (contract with the university), who opted out of the base plan.

OHIP (Ontario Health Insurance Plan) • • • For residents of Ontario and domestic students Provided by the government of Ontario Covers: doctors, emergency room, medical test or surgery. If you are not from Ontario, you need to apply in person at a Service Ontario office. Application documents: (1) a Registration for Ontario Health Insurance Coverage form and (2) 3 separate, original, identification documents (a proof of Canadian citizenship, a proof that you live in Ontario, and a proof of identity) Useful links: OHIP application details and eligibility: https: //www. ontario. ca/page/apply-ohip-and-get-health-card OHIP coverage: https: //www. ontario. ca/page/what-ohip-covers

• UHIP (University Health Insurance Plan) • • • Mandatory for all international students (equivalent to OHIP) Provided by Sun. Life (managed by Uof. T) Printed card to access services Renewed every year: sent to you by email or go to the UHIP office Covers up to $1, 000. 00 per year (September 1 to August 31) for eligible medically necessary health services and medical treatments. You must purchase UHIP for your spouse, partner or dependents. Check details here: https: //uhip. ca/Enrollment/Coverage Useful links: UHIP Plan details: https: //uhip. ca/Enrollment/Plan. Details UHIP office location: https: //www. studentlife. utoronto. ca/cie/contact-us Uof. T UHIP details: https: //www. studentlife. utoronto. ca/cie/uhip

UTGSU Base plan: General features Plan number: UTG + student number + 00 • Coverage for all graduate students. • Managed by Greenshield • Supplementary to UHIP: covers additional services such as prescription medication, vision care, dental services, etc. • If you aren’t a student, then you aren’t eligible for a base plan. • You can apply for an extension of 12 months once you finish your degree.

• If you don’t have a comparable plan, you cannot opt out. UTGSU Base plan: Opting-out Useful links UTGSU page: https: //utgsu. ca/health-anddental/opting-out-opting-in/ Student Care page: http: //studentcare. ca/rte/en/IHave. APlan_Universityof. To ronto. Graduate. Students. Union. UTGSU_Changeof. Cover age_Opt. Outs

Base plan: Opting-in family (partner, spouse, and children) • Manual opt-in through Student Care • Enrolment dates: • Fall 2019: September 1 – October 1, 2019 • Winter 2020 (for incoming students): January 1 – January 30, 2020 • Pay additional fee

Are you a member of CUPE 3902? Benefits for CUPE 3902 members buying UHIP for family members and Opting-in family to Base Plan • You have access to the following health care insurance fees funds: • Uof. T Family Plan Assistance Fund (UFPAF): reimburse members in part for out-of-pocket payments made to add their immediate families to the base plan. Click link to apply: https: //www. cupe 3902. org/unit 1/benefits/ufpaf/ • International Health Plan Assistance Fund (IHPAF): reimburse members in full for out-ofpocket payments made to purchase UHIP for themselves or their immediate families. Click link to apply: https: //www. cupe 3902. org/unit 1/benefits/ihpaf/

Base plan: Useful links Benefits booklet: http: //www. studentcare. ca/RTEContent/Docum ent/EN/Miscellaneous/UTGSU_benefit_booklet. pdf Student care: http: //studentcare. ca/rte/en/IHave. APlan_Unive rsityof. Toronto. Graduate. Students. Union. UTGSU _Home

• CUPE 3902 UNIT 1 Plan A: Top-up plan + HCSA Plan number: UOT + Personnel number + 00 • • • Coverage for CIs, TAs, CPOs, invigilators or peer assistants Also managed by Greenshield Supplementary to UTGSU base plan: extends coverage of base plan Minimum of 30 hours of work per year Reasonable and customary fees apply: Coverage is subjected to reasonable customary fees calculated by Greenshield. If you opt-out of the base plan, you cannot get the Top up plan (Plan A). However, you can have access to HCSA (Plan B). If you opt-In your family members to the base plan, they automatically get access to the top-up plan.

CUPE 3902 UNIT 1 Plan A: Top-up plan + HCSA • You cannot access the base plan? • You can use top-up plan as the first payer • Submit request to CUPE’s Benefits Office • You can apply for an extension of 12 months once you finish your degree. Useful links: Unit 1 benefits page: https: //www. cupe 3902. org/unit 1/benefits/

Coverage: UTGSU Base Plan + CUPE 3902 – Unit 1 Top-up Plan

CUPE 3902 UNIT 1 Plan B: HCSA (Health Care Spending Account) • Coverage regulated by Canada Revenue Agency, but claimed through Greenshield • Amount: • Single: $300/benefit year • Family: $600/benefit year • What is it for? • For claims when your benefits do not cover the entire cost. • In some cases, can be used to reimburse the cost of health care premiums. Useful links: HCSA eligible expenses: https: //www. cupe 3902. org/wpcontent/uploads/2018/04/HCSA-Allowed-Expenses. pdf

Important things to know: Blackout period • There is a “blackout” period at the beginning of each academic year: September 1 to November 15. • Students starting in January must wait until March 15 th. • During this time you won’t be able to access your insurance policy benefits. • Why does this exist? • The list of students is sent by the University following student registration and the opt-out period and is used by the insurance company to verify eligibility. • What happens if you need any services? • You can make the payment and submit a claim form to Green Shield after November 15 or January 15 to be reimbursed.

Important things to know: Travel insurance • Covered by the UTGSU Base Plan • Coverage is for 120 days of each trip and it covers hospital, physician, trip cancellations, and other services for emergency treatment of an injury or illness while travelling outside of Ontario or internationally. • Maximum coverage is $5, 000 CAD per incident • If you are travelling longer than 120 days, you can send an email to health@utgsu. ca or call Student care at 1 -866 -358 -4436 and request for a top-up beyond the 120 days at no cost. • Travel Insurance does not cover you if you are going to your home country. • Useful links: Student care Travel benefits page: http: //studentcare. ca/View. aspx? locale=en&uid=IHave. APlan_U niversityof. Toronto. Graduate. Students. Union. UTGSU_Travel_Trav el. Coverage&random=33&

Submitting a claim • First time? You need to register! 1. Get Registration key emailed by accessing Greenshield’s webpage 2. Register for each account: You need your plan numbers. • Need personnel number? : Get it through Employee Self-Service or talk to Departmental Business Officer 3. Create username and password for each account REMINDER – Plan numbers: Base plan: UTG + Student number + 00 Top-up plan: UOT+ personnel number + 00 Useful links: Greenshield webpage: https: //onlineservices. greenshield. ca/planmember/Access. Mgmt/Public/Sign. O n. aspx Uof. T Employee Self-Service webpage: (http: //ess. hrandequity. utoronto. ca/)

Online claims • You can do it online, once you set up your account(s). • If you have the base plan and top-up plan: Claim ALWAYS through base plan. Accounts will be linked.

PDF claim form • You can also make claims by using a PDF form. • Go to “My Claims: and get a personalized claim form. • Fill it out and upload it through the Greenshield webpage by logging into your account.

PDF claim form • Section 1 – Base plan information • Section 2 – Coordinate your benefits! Top-up plan info goes here! • Section 3 – Information relating to claims IMPORTANT: Always keep your receipts in case you get audited

Important things to know: Policy coverage and claims deadline • The policy coverage runs from September 1 st to August 30 th of each year. • You need to make claims annually. You can only make claims of services within 12 months of use. • You have until October 30, 2020 to make claims for the 2019 -2020 year.

SUBMITTING A HCSA CLAIM • Can be used to claim against benefit plan(s) (e. g. physiotherapy) • Claimed through your CUPE Greenshield account

SUBMITTIN G A HCSA CLAIM • You can also do claims online or through PDF form • Check HCSA eligible expenses: https: //www. cupe 3902. o rg/wpcontent/uploads/2018/0 4/HCSA-Allowed. Expenses. pdf

Reimbursement of HCSA • Claim can only be made if it is an out of pocket expense (if your tuition isn’t paid by the UTF). • You can try to claim it but Greenshield can refuse to give you the money or can ask for the money back. • Better to see what you can use the HCSA money for!

Reimbursement of HCSA • If you want to know how to claim it, please e-mail me! • You have until October 30, 2020 to claim the 2019 -2020 HCSA. • It renews every year.

Questions? We’re here to answer them Email your stewards: sociologycupe 3902@gmail. com Important CUPE Contacts: Vice-Chair, Unit 1 – vc 1@cupe 3902. org Benefits Coordinator – benefits@cupe 3902. org CUPE telephone number: 416 -593 -7057