Health & Dental Plans

***Opt-in/Opt-out for 2014-2015 closes September 30 2014***

Our Health and Dental Insurance Office

UTGSU Building
16 Bancroft Ave, Toronto, M5S 1C1
Phone: (416) 978-8465
Email: health@utgsu.ca

Regular Hours
Monday – Friday: 10am – 4pm

 

Teaching Assistants Receipts

The Health and Dental Office will no longer be issuing family receipts starting 2013-2014 academic year. The family opt-in is now done on line through Ihaveaplan. Once your application to add dependents was processed, you would have received a confirmation email which includes your dependent names, what coverage you purchased and the amount you paid. This is your receipt to make your claims from the Health Care Spending Account.

 

General Information

The University of Toronto Graduate Students (UTGSU) Health Plan provides students with unique health benefits. The Plan was designed to provide many important services and cover expenses not covered by a basic health-care plan (i.e. OHIP), or the equivalent (such as UHIP for international students) such as prescription drugs, health practitioners, medical equipment, travel health coverage, and more.

In most provinces, only approximately 30%-40% of normal annual health-care expenses are covered by provincial health care for individuals aged 18-35. The balance is paid directly by individuals (out-of-pocket expenses) or through private insurance plans, usually through an employer. These costs can be extremely high and may pose a very real barrier to obtaining necessary health care. Unfortunately, a large number of students do not have access to affordable extended insurance through employers. Student health plans are designed to provide this access and eliminate barriers to affordable health care.

Most Plan benefits are effective across Canada and anywhere in the world for the duration of the coverage. Reimbursements are in Canadian funds and are calculated at the exchange rate of the day the claim is processed. Reimbursement is limited to what the service would have cost if done in Canada.

 

Who is covered

All full-time and part-time graduate students are automatically covered by the UTGSU Dental Plan except The Toronto School of Theology (see “Who is not covered” below). The Health Plan automatically covers only full-time graduate students. Please visit www.ihaveaplan.ca or call 1866-358-4436 for important benefit plan information and to view the detailed Benefit Booklet.

Coverage for students that begin in the fall semester will start September 1. However, Green shield is unable to process your claims or confirm your eligibility until they receive your enrolment information in early November from the University. Please keep your receipts for any claims that you incur until your coverage is activated (approximately November 15th), and then submit them to Green Shield Canada for processing. The UTGSU Fee covers the cost of the plan for an individual student.

Students starting in the summer session (May to August) – are charged tuition and incidental fees in the summer, which is applied to the upcoming academic year. Your insurance is effective from September 1st to August 31st.

 

Who is not covered

1) Students who are not Graduate Students (such as post-degree students, students on leave of absence, incoming exchange students from another university).

2) Toronto School of Theology graduate students are covered by UTSU’s insurance plan. If you are one of these students, go to UTSU’s website here or call 416-978-4911 X 227 for more information.

 

Opting-Out

NOTE: OHIP does not provide coverage equivalent to the UTGSU Health and Dental Plan; therefore, you cannot opt-out if you are only covered by OHIP. Travel health coverage obtained by international students in their home country may not provide an equivalent level of benefits to this Plan.

If you are a student with equivalent insurance elsewhere, you may opt-out of these plans. You must opt-out annually, at the beginning of the term you are first registered in. Students who missed the deadline in the fall cannot opt out again until the following year. You cannot rejoin the plan after you have opted-out, so check the expiry date on your insurance.
Change of Coverage period:

• for students starting in the Summer/Fall term – September 1 – September 30, 2014
• for new students only starting in the Winter term – January 3 – January 23, 2015

The opt-out link will be posted here during the above application periods only. SORRY. NO EXCEPTIONS WILL BE MADE IF YOU MISS THESE DEADLINES.

 

How much does the Plan cost?

The Health Plan costs $243.84 and the Dental Plan costs $168.54 for full-year coverage (September 1, 2014 – August 31, 2015) Students beginning in January 2015 will be assessed $121.92 for the Health Plan and $84.27 for the Dental Plan coverage from January 1, 2015 to August 31, 2015.

 

How do I claim my benefits?

You can download a Pay-Direct Card here or pick up a card at the Health & Dental Office, 16 Bancroft Avenue, 2nd Floor. Present your card to most pharmacists or dentists in Canada to have your claims automatically processed. Once processed, you will only be required to pay the “co-pay” and you will not have to pay the full amount of your bill.

Complete a claim form here and mail it to the address indicated on the form with original receipts. Photocopied receipts are not acceptable. Be sure to keep copies of receipts for your records. Claims for physiotherapy, psychology, massage therapy and chiropractic treatment must have a physician’s referral for reimbursement.
Claim cheques are mailed to the address provided on the form. Be sure to include your apartment number. Canada Post will not deliver mail without it. Please allow two weeks for your claim to be processed. You can also sign up for on line services after this period, and provide your banking information for your claim to be deposited directly into your account.

 

What is the Blackout Period?

Please note that due to the time it takes to update the Green Shield files following student registration and the opt-out period, your information will not be in the Green Shield system right away. The list of students is sent by the University and used by the insurance company to verify eligibility. If you require a prescription or need to see a dentist between September 1st and November 15th, you can make the payment for the prescription or dentist fees and submit a claim form to Green Shield after November 15th to be reimbursed. For students starting in January, please wait until March 15th. Claims will be processed and reimbursement cheques will only be mailed once the Blackout Period ends. You can also sign up for on line services after this period, and provide your banking information for your claim to be deposited directly into your account.

 

More Information

Please see the FAQs for answers to additional Health and Dental Insurance related questions before contacting our offices.

If you have any questions regarding the UTGSU Health & Dental Insurance Plan, please contact:

studentcare.net/works
phone: 1-866-358-4436
email: service@studentcare.net
website: www.ihaveaplan.ca

If you have any questions regarding your claims or have any claims eligibility questions please contact:

Green Shield Canada: 1-888-711-1119; or the UTGSU Insurance Office: 16 Bancroft Ave.; health@utgsu.ca