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.
If you need assistance with your claims or have inquiries, please contact Green Shield at 1-888-711-1119.
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 student voted in favour 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. What is the benefit period?
For students that start in September, their coverage begins September 1, 2022 and for students that start in January, it begins January 1, 2023. Coverage terminates August 31, 2023, except for students that graduate after the first semester or leave their program after the first semester. In this case, you are not charged winter fees, and therefore your coverage is terminated December 31, 2022. For students finishing their programs in April, you have paid winter fees, and therefore your coverage expires August 31, 2023.
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 while each dependent has a different number, e.g. -01, -02.
Q. I am in my Final Year of my PhD, how long am I covered?
You will be charged a one-term incidental fee, which includes the health and dental insurance. You will be insured from September 1st to December 31st. If you don’t complete your studies by January, you will be charged the incidental fee for the winter term and your coverage will end on August 31st. At the end of the term for which you were charged fees, you may purchase the “12 Month Extension”. Forms are available online at www.studentcare.ca.
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 to August 31st. If you already have alternative coverage, you can opt-out during the Change of Coverage period September 1-October 3, 2022. 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 is effective from September 1st to August 31st.
Q. I have another insurance plan, how do I opt out of the UTGSU insurance plan?
You can opt-out provided you do so within the required time frame. Opting out can only be done online at a link from www.studentcare.ca, http://www.utgsu.ca/health, or, ROSI/ACORN. A cheque will be mailed to you in 2 installments, one in November and the other in March. Or you can choose a “Direct Deposit” option. In order to opt out, you must provide proof of alternative health insurance. This is not UHIP, OHIP or another provincial health plan, but a benefits plan through an employer plan, etc.
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. 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. Is dependent coverage available?
Yes. However, you must pay an additional fee. Couple and Family coverage can be done online at www.studentcare.ca or at www.utgsu.ca/health. 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 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 then 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 refer all questions regarding TA benefits directly to CUPE 3902 Unit 1: 416-593-7057, www.cupe3902.org/unit-1/
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 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; your information will not be in the Green Shield system right away. 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.
Q. How do I claim my benefits and/or submit claims online?
You can download a Pay-Direct Card at: www.studentcare.ca 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. You can also submit claims online. Visit greenshield.ca with your student ID card. Register for online services. Click the LOGIN button (found in the top right corner) and click GO to register as a plan member. Sign up for Direct Deposit so claim payments can be deposited directly into your bank account.
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. How do I make a dental claim?
To receive reimbursement for out-of-pocket expenses 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. Your dentist can send your claim electronically to Green Shield using “UTG” as the Group/Policy Number and your student number as your ID.
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 research/academic trip for more than the 120 days, can I get more coverage?
Yes you can. You can send an email to firstname.lastname@example.org. Or call our Broker Student care at 1-866-358-4436 and request for a top-up beyond the 120 days at no cost to you at all. Please make sure you provide them with a letter from your Department stating that you are a “registered student”, the purpose of your Research/Academic trip, the length of your trip and also indicate that all your fees are paid. 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.
Q. I require a “visa” travel letter for the embassy, how do I get it?
If you require a “Travel Letter” (proof of coverage) when applying for Visa, please send an email to email@example.com. It should include: Your name, Your Student Number, Purpose of your Travel and Travel Dates. We require 4 business days to process this request. Your fees must be paid for the duration of your travel. Otherwise 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.
Q. Compared to other health and dental insurance plans offered by other graduate student unions, what competitive features does the UTGSU offer its Members?
The UTGSU Health and Dental Plan offers its Members competitive rates for vision coverage and the paramedical annual maximums. These features provide Members with one of the top coverage features in Ontario.