Thank you for visiting the UTGSU Health and Dental Insurance Frequently Asked Questions (FAQ’s). The UTGSU Health and Dental Insurance Office encourages you to visit www.studentcare.ca for your go-to Health and Dental information.
Click here for more information and a list of FAQs: https://utgsu.ca/health-and-dental/frequently-asked-questions/
If you need assistance regarding your coverage, opt-outs, and enrolments, please call Studentcare at 1-866-358-4436 (Monday to Friday 9-5 PM) or visit www.studentcare.ca.
Welcome to the 2023-2024 Academic year!
Q. Who is covered?
All Full-time and Part-time graduate students who are members of the University of Toronto Graduate Students’ Union (UTGSU) are automatically covered by the UTGSU Health and Dental Plan.
Q. What is my green shield policy number and id number?
Your Green Shield Policy Number is UTG. Your ID Number is your student number preceded by UTG. Your identification number ends in -00 If you have enrolled any dependents, each dependent has your identification number followed by -01, -02, etc.
Q. What is the benefit period?
For students who start their Program in September, their coverage begins September 1st and for students who start their Program in January, their coverage begins on January 1st. Coverage terminates on August 31st except for students who graduate after the first semester or leave their program after the first semester. In this case, you will not be charged the winter fees, therefore your coverage is terminated December 31st. For students who finish their program in April, you will have paid the winter fees, therefore your coverage will expire on August 31st.
Q. Why do i have to pay incidental fees?
All tuition-paying students, including those engaged in academic work away from the campuses of the University, are charged compulsory non-academic incidental fees. These fees include designated amounts for the student health and dental plans.
Q. Why is utgsu allowed to charge a health plan fee?
The health and dental plan fees were established through a referendum in which students were asked to support collection of the compulsory fee. The UTGSU Health and Dental plans are the result of the University-wide graduate student referendum. In this referendum graduate students voted in favor of a mandatory health and dental plan; therefore, it was a democratic decision by the entire graduate student body. Increases to the fee and the establishment of the health and dental plan fee were approved by student referenda in subsequent years.
Q. Why do previous students have the power to set my incidental fees?
As in any democracy, a current voting population makes decisions that affect the future. Current students will likely be asked to make similar decisions for future students.
Q. I have another insurance plan. How do i opt out of the utgsu insurance plan?
You can opt-out during the Change of Coverage period September 1-October 3, 2023. Opting out can only be done online. The links to opt out are: www.studentcare.ca, http://www.utgsu.ca/health, or, ROSI/ACORN. To opt out, you must provide proof of alternative comparable health insurance. This is not UHIP, OHIP or another provincial health plan, but a benefits plan through an employer plan, etc.
Opt-out cheques/direct deposits/e-transfers are issued in two installments. The first cheque/direct deposit is issued in the Fall session (November) and the second deposit is issued in the Winter session (March). The opt out cheques/direct deposits are processed once the Broker has received the final list of all registered and active students from the University. This follows the University of Toronto’s protocols regarding how fees are issued based on sessions. You do not have to opt out again in January until the following year in Fall.
PS: Your opt out will not carry over to the next academic year; therefore, you must opt out every year to cancel your UTGSU benefits.
Q. Why can’t my refund be credited back to my student account?
Student society fees are collected in trust by the University and paid directly to the student society. The student societies, therefore, receive your fees in trust and must issue the refund directly. In addition, ROSI currently cannot handle this transaction on behalf of student societies.
Q. My program starts in the summer – when does my coverage begin?
You are charged tuition and incidental fees in the summer, which is applied to the upcoming academic year. Your insurance is effective from September 1st 2023 to August 31st 2024. If you already have alternative coverage, you can opt-out during the Change of Coverage period September 1-October 3, 2023. Please visit www.studentcare.ca or http://www.utgsu.ca/health for more information.
Q. I am returning in the summer from my leave of absence, when does my coverage reactivate?
You are charged tuition and incidental fees in the summer, which is applied to the upcoming academic year. Your insurance will be effective from September 1st 2023.
Q. What is a blackout period – when can i make claims?
A blackout period is duration of time when access to your benefits plan is temporarily unavailable. Why does this exist? The University sends a file to the Broker/Insurance Provider of all registered students in the Fall after the Fall add/drop period has ended. The add/drop period date is usually the third week of October. You are covered effective September 1st, however, Greenshield will not recognize you until the file is sent to them by the University. If you require a prescription or need to see a dentist between September 1st and November 1st, you can use the services, make the payment for the prescription or dentist fees, and submit a claim form to Green Shield after the end of October blackout period to be reimbursed. For students starting in January, please wait until March 15th.
Q. How do i claim my benefits and/or submit claims online?
You can download a Pay-Direct Card at: www.studentcare.ca. Present your card to most pharmacists/dentists in Canada to have your claims automatically processed. You will only be required to pay the “co-pay”. You can also submit claims online. Visit greenshield.ca with your student ID card. Register for online services. Sign up for Direct Deposit so claim payments can be deposited directly into your bank account. To receive reimbursement for a dental claim, obtain a completed “Standard Dental Claim Form” from your dentist’s office and submit it to Green Shield. All claims submitted to Green Shield require a UTGSU Claim Form.
Q. How long do i have to submit a health or dental claim?
Green Shield must receive all claims within 12 months from the date of service. Claims should be made online or mailed to Green Shield with original receipts at the following address: Green Shield Canada, P. O. Box 1699, Windsor, Ontario, N9A 7G6.
Q. I have two benefit plans. How do i coordinate them?
Where you or your dependents have coverage with more than one carrier, you can co-ordinate your benefits, which means you can use both plans to receive up to 100% coverage. Submit first to the UTGSU plan. Green Shield will send you a statement called “Explanation of Benefits” (EOB) with your reimbursement. You than submit the EOB statement to the other insurance company to be reimbursed for the balance of the claim.
Q. I am also a ta – what are my benefits?
Please contact the CUPE 3902 office for guidance and assistance for your TA Top-Up plan. Their office number is 416-593-7057. Their email address is: firstname.lastname@example.org.
Q. What is my uhip number?
If you have questions about your UHIP coverage, you can direct your questions to the UHIP office. Their phone number is: 416-978-0290. And their email address is: email@example.com. Their website is: www.uhip.ca.
Q. I am in my final year of my PhD – how long am i covered?
You will be charged a one-term incidental fee in the Fall semester, which includes the health and dental premiums. You will be insured from September 1st to December 31st. If you don’t complete your studies by January 15th, you will be charged the incidental fee for the winter semester, therefore, your coverage will end on August 31st.
Q. Does the utgsu have an option for extended coverage after graduation?
Yes. At the end of the term for which you were charged fees, you have an option to purchase the 12 Month Extended Coverage after graduation, provided you have OHIP/UHIP coverage. You have a 30-Day grace period after your insurance expires to apply for the extended coverage. This is a 12-month Extension only. There is no short-term coverage i.e., 6-month coverage. If you are graduating in the summer, you can opt-in during the Change of Coverage period September 1st-October 3rd. Your coverage will begin on September 1st and end on August 31st. If you are graduating in the Fall, you can opt-in during the Change of Coverage period January 1st-January 31st. Your coverage will begin on January 1st and end on December 31st. Forms are available online at www.studentcare.ca
Q. Is dependent coverage available?
The UTGSU Plan gives you an option to enrol your family (spouse and/or dependent children) by completing an enrolment process and by paying an additional fee directly to the Broker. Visit www.studentcare.ca, select “Enrol Your Family Now” from the menu on the left under “Couple and Family Enrollments”. All enrollments must be completed during the Change of Coverage period from September 1-October 3, 2023. You must enroll your dependent at the start of each academic year that you are a registered student. Students that start in May or September cannot add dependents in January unless:
1. A child is born outside the opt-in periods (must be opted in by 30 days of date of birth)
2. Marital status changes (must be opted in by 30 days of date of change in status)
3. Spouse/partner moves to Canada (must be opted in by 30 days of move)
Note that there are reasonable limits on adding dependents toward the end of the benefit year.
Q. I will be graduating in the fall semester; can i enrol my dependents on this plan?
No. This Plan is an academic year Plan. Students are only able to enroll dependents on the Plan if they will be a registered and are an active student for the full academic year. Dependent coverage is only active if you remain an active student.
Q. What if my treatment is going to exceed $300.00?
If the cost of any proposed dental treatment is expected to exceed $300.00, please ask your dentist to submit to Green Shield a “pre-determination” before the treatment begins. If a description of the procedures to be performed and an estimate of the charges are not submitted in advance, Green Shield reserves the right to make a determination of benefits payable based on accepted standards of dental practice. For further information call the Green Shield Customer Service Centre at 1-888-711-1119.
Q. I am travelling for a research/academic trip for more than a 120 days? Can i get more coverage? And how can i get a “visa” travel letter” for the embassy?
Click on the following link: https://studentcare.ca/plan/en-CA/IHaveAPlan_UniversityofTorontoGraduateStudentsUnionUTGSU/assistance-centre and complete the Support Form. In the “Reason for Request” Question, you can select Travel Coverage and complete the Form by providing the details. There is a 10-day turnaround time to process this request. You will have to provide a letter from your department stating the purpose of your Research/Academic trip, the length of your trip, that you will remain a member of the UTGSU, pay university fees, including the plan fee, and keep your provincial coverage You can follow the same steps for the visa letter. In the “Reason for Request” Question, you can select Visa Letter and complete the Form by providing the details. There is a 10-day turnaround time to process this request. If your fees are not paid, you will not be covered and the UTGSU does not take responsibility of your travel insurance.
Please note: The UTGSU Travel Insurance does not cover you if you are going to your home country.