CUPE Local 3261, Full-time and Part-time: Eligibility

Unless specifically stated otherwise, definitions for these terms are available in the Definitions of Benefit Terms section.

There are several Green Shield Benefit Plans available to University of Toronto employees. Each of these Plans is prepaid by one month, with coverage normally effective the first of the month following the month of your appointment.

For You

To be eligible for coverage, you must be:

  • a) a plan member who is a resident of Canada;
  • b) covered under your provincial health insurance plan or UHIP; and
  • c) appointed on a continuing or term basis and with a total percentage of appointment equal to 25% or more.

For Your Dependents

To be eligible for coverage you must be:

  • a) covered under this plan; and;
  • b) each dependent must be covered under a provincial health insurance plan.

Coverage Effective Date

Your coverage begins on the date the University certifies that you are eligible for coverage, and have satisfied the eligibility requirements and are enrolled under the plan.

Your dependent coverage will begin on the same date as your coverage.

If you have waived eligibility due to having coverage through your spouse’s benefit plan, you must request coverage from the University within 31 days after termination of the coverage under your spouse’s plan.

Your plan sponsor is solely responsible for submitting all required forms to Green Shield as of the Effective Date of this plan or as of the first date that you become eligible.

Termination

Your coverage will end on the earliest of the following dates:

  • a) the date your employment ends;
  • b) the date you are no longer actively working, or your approved leave expires;
  • c) the end of the period for which rates have been paid to Green Shield for your coverage;
  • d) the date the group contract terminates.

Dependent coverage will end on the earliest of the following dates:

  • a) the date your coverage terminates;
  • b) the date your dependent is no longer an eligible dependent;
  • c) the end of the month in which your dependent child attains the specified age limit;
  • d) the end of the period for which rates have been paid for dependent coverage;
  • e) the date the group contract terminates.

Dependent Children Continuation of Coverage

Any child whose coverage would end because they have reached the specified age limit may qualify for continued coverage, subject to the following conditions:

  • a) your child became dependent upon you by reason of a mental or physical disability prior to reaching this age; and
  • b) your child has been continuously so disabled since that time.

Survivor Continuation of Coverage

In the event of your death, while you covered under this plan (regardless if you were a pensioner or actively at work) single coverage for your surviving spouse may continue if he/she:

  • is the same person who was your spouse on the date you retired;
  • is in receipt of a survivor pension; and

continues to pay the required rates for coverage.

Coverage for your surviving spouse who was your spouse on the date you retired will terminate upon the earlier of:

  • the date your surviving spouse becomes covered under any other group plan; or
  • the date the group contract terminates.

Losing your Group Benefits?

If your coverage terminates under your Plan Sponsor’s benefit plan, you may apply for one of GSC’s individual Health and Dental plans.  Acceptance for these plans is guaranteed as long as GSC receives your application within 90 days of your employee benefits termination date, provided GSC receives the initial payment.  There are no health questions and no medical when you apply.  These plans offer coverage for medications that treat pre-existing conditions.  Best of all, they provide life-time coverage

SureHealth™ LINK PlansBuying directly from GSC

Visit SureHealth.ca where you’ll find details about the SureHealth™ LINK plan options available.  You can request an information package, you can get quotes online, and you can buy completely online.  It is quick and easy.  You can give us a call at 1.844.753.SURE (7873) –we can answer any questions you have or we can take your application over the phone

PRISM CONTINUUM® – Buying from an Advisor  

Special Benefits Insurance Services (SBIS) can help. Call 416.601.0429 or 1.800.667.0429 to speak with a specialist about the Prism Continuum program.  They can review the options available to you and advise you on the coverage that best suits your needs.