Health Care Plan FAQ

You will be enrolled by the University if you are a member of CUPE 3907 and are employed for at least one term in the current academic year (September 1st to August 31st).  Your level of coverage will depend upon your status in the student (GSU) health and dental plan as follows:

Top-up plan + HCSA

  • Only those enrolled under the student plan will be eligible for coverage under the Top-up plan + HCSA. You can access the most up-to-date Benefit Booklet online through your Green Shield Canada account.
  • If you have enrolled for single coverage under GSU plan, the individual HCSA is worth $300/year.
  • If you have enrolled for couple/family coverage under the GSU plan, the Family HCSA has a value of $600/year.

HCSA-only plan

  • If you have exempted coverage under the GSU plans, then you will be eligible for a $300 HCSA-only plan, regardless of whether you have eligible spouse/partner or dependent children

Once you have been enrolled into the appropriate plan by the University, you will be able to sign up for online services with Green Shield Canada. Online services allow you to view your benefits guide, submit claims online, and sign up for direct deposit allowing you to receive reimbursements quickly. You may use either the website or app to register – we recommend using the website, and then downloading the app!

  • Sign in or register to access Plan Member Online Service
  • To download the app, GSC mobile app
  • Should you require any assistance setting up your account, you may call Green Shield directly Toll-free: (1-888-711-1119)

Your ID number is UOT + employee number + -00 (the -00 identifies the plan member). This number is for your Top-up or HCSA plans, only. Your base plan with UTGSU will have a separate ID.

If you are unsure of your employee number, please contact the Business Officer for your department . You will still need your student plan number to submit claims so that the claim is appropriately adjudicated through your student plan first, and then through your top-up plan.

Your benefit plan does not use a plan number, only an individual ID. When signing up for an online account, or submitting a claim, you will need to include this ID number. The ID number will include: UOT + employee number + -00 (the -00 identifies the plan member).

Plan members should note that they will have a separate student number for their student plans and will need to enter both numbers when coordinating claims to both plans.

You can find the most up-to-date benefits booklet by logging to your Green Shield Canada account. Your benefit booklet provides you with important information about your benefits plan. The booklet includes:

  • a detailed benefit descriptions for each benefit in your benefit plan
  • a schedule of benefits that lists deductibles, co-pays and maximums that may impact the amount paid to you
  • a definitions section that explains common terms used in the booklet

It depends on the type of claim and whether all information submitted is complete. However, you should expect reimbursement of eligible expenses no later than 10 business days. In most cases, if you have signed up for direct deposit through GSC’s Plan Member Online Services, you will receive your reimbursement within 5 business days.

You status in the student plan needs to be finalized first. The opt-out period for each primary plan has to pass and the information has to be provided to GSC and reconciled before your enrollment can be established. During this first year of the plan this may take a little longer. It’s anticipated that for members of the GSU plan, the enrollment will be completed by the end of October. The University will communicate additional information as the finalized enrollment time is confirmed

Enrollment is based upon your Student Plan enrollment each year. We need to wait until the final student plan status is confirmed before loading your enrollment information. For GSU members, this will be late October/early November each year.

Members do not need to do anything to enroll for coverage under the CUPE 3907 top-up benefit plan.

Once you are employed for at least one term, you will be able to submit eligible claims once your enrollment is confirmed:

  • Coverage is retroactive to September 1st
  • Coverage continues until the end of the Plan Year – August 31st each year

Please note that claims cannot be reimbursed if you do not have a valid receipt indicating you have paid for the eligible service/product or prescription drug. You should retain all paper receipts or Explanation of Benefits (EOB) from your student plan even if you have already submitted an eligible receipt.

Yes, so long as the claim was incurred on or after September 1st of the current academic year, you can submit any unpaid balance once you become eligible under the CUPE plan.

It will depend on the provider and service being claimed. For example, your pharmacist should be able to submit your prescription first to your student plan using your student ID /GSC number, and then to your CUPE plan using your CUPE GSC number. If not, you can pay for the service and then submit any balance to GSC for reimbursement under both plans on the same claim form.

For both Plans, the individual HCSA is worth $300/year. If you have dependents, you will be enrolled in the Family HCSA, with a value of $600/year. If you have exempted coverage under the GSU plans, then you will be eligible for a $300 HCSA-only plan, regardless of whether you have eligible spouse/partner or dependent children

Then there is no access to the Top-up plan; however, you will be eligible for a $300 HCSA-only plan.

Yes, so long as your spouse/partner or dependent children are eligible, they can be enrolled for coverage by contacting GSC directly once you have received confirmation of your enrollment. If you have opted out coverage under the GSU plans, then you will be eligible for a $300 HCSA-only plan, regardless of whether you have eligible spouse/partner or dependent children

No. Your base plan’s 24-month window would not change and would be based on the claim you previously submitted to them. However, you may submit a claim at any point under the top-up plan, provided that the claim is incurred in the current plan year (September 1-August 31), and receive reimbursement for any unpaid amount (up to the maximum).

As long as your leave is approved and falls under the Collective Agreement, you remain eligible for coverage for the entire plan year. If you are unsure if you are entitled to coverage while on leave, please contact us at cupe3907@gmail.com.

You can use your HCSA to be reimbursed for your Student Health and Dental plan premium and or your UHIP premium, up to the balance available in your HCSA at the time you submit your claim

Here’s how:
1. Visit: https://www.rosi.utoronto.ca/ and log in
2. Go to “Financial Accounts”
3. Click “Show Invoice” and PRINT
4. Click “Show Detailed Report” and PRINT
5. Fill out the “Health Care Spending Account Claim Submission Form” (OR, submit online via Plan Member Online Services)
6. Send the form AND the two printouts to the address on the form to get your money!

If you have questions about your eligibility for coverage you can contact the University directly at benefits.help@utoronto.ca or by calling the benefits help line at 416.978.2598.

For questions regarding what’s eligible under the Top-up or HCSA plan, you can contact Green Shield Canada directly at 1.888.711.1119 once you have received confirmation of enrollment in the plan.

Please note: Green Shield will often ask for your Plan ID in order to ensure they are reviewing the appropriate plan, please have this in-hand when calling.

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