About the Account
The University will provide a Health Care Spending Account (HCSA) for each eligible employee in CUPE 3902 Unit 3 not covered under any other University of Toronto (U of T) group health or dental plan, and are enrolled in the Health Care Spending Account (HCSA).
Enrolment: In order to begin using your HCSA, members of CUPE 3902 (Unit 3) must enroll by completing the Green Shield Enrolment/Change form, which can be downloaded from the Forms web page.
For further details:
Once enrolled, call Green Shield Canada:
Monday to Friday
8:00 a.m. to 9:00 p.m. (EST)
Health Care Spending Account (HCSA) summary
HCSA Plan Rules
|Enrolment for Sessional Lecturers and employees paid on an Hourly basis||
|Enrolment of dependant(s)||
HCSA Annual Credits (Plan Year)
|Employees paid on an Hourly Basis
HCSA Annual Credits (Plan Year)
|Reimbursement from the HCSA||
|What if you leave the University?||
Guidelines to completing HCSA form
CUPE 3902 – Unit 3 – HCSA
For Sessional Lecturers I and II
The Green Shield Enrollment/Change form is a standard benefit enrollment form, with some fields pre-filled with the relevant information. This simple guide will help you fill out the relevant parts of the form quickly and easily. This form is availableonline as a “fillable pdf” document. You can fill in the form online but you must still print it and sign it. We can only accept original signed Enrollment forms. You can also print a copy of the blank form and enter all the required information in the appropriate fields. Please print all information neatly in ink.
A) For New Subscribers to the CUPE 3902 – Unit 3 HCSA
Please complete all of the following sections. Incomplete enrollment forms could delay your enrollment in the HCSA.
- Employer Section
- The Employer name, client code and billing division information are pre-printed.
- In the Employee ID # box, please enter your University of Toronto Personnel #. If you don’t know your Personnel #, please contact your Department Business Officer.
- Transaction Type
- All new CUPE 3092 HCSA subscribers should check off the New Subscriber box
- Enter your date of appointment to your Sessional Lecturer position in the current academic year (September 1 to August 31).
- Comments Section – leave this area blank
- Subscriber Information
- Surname – Enter your last name exactly as you have provided to your Department Business Officer
- Legal First Name – Enter your legal first name. If you have a common first name that may be used in submitting claims, please include this name as well, separated by a comma after your legal first name (example – if your legal name is Robert, and you often use Bob, you should enter Robert, Bob).
- Birthdate – Enter your complete birthdate in the form year, month, day (yyyy-mm-dd)
- Gender – check off male or female
- Employee ID # – you have already entered this in #1, but please re-enter the number here
- Employment Date – enter start date of employment as a Sessional Lecturer (yyyy-mm-dd)
- Coverage – if you have dependants who will be included, please check off family.
- Employment Province – enter Ontario
- Employment Status – check off Active
- Language – please choose one
- Mailing Address – please complete this section carefully and completely. Green Shield will mail your subscriber card to this address and any subsequent reimbursement cheques or correspondence from Green Shield will be sent to this same address.
- Dependant Information
- If you are adding a spouse/partner for claims from your HCSA, check off the “Add” box, and enter the complete information on the first line. Complete information is needed to ensure claims can be processed properly when submitted. If your dependant is not registered, claims for eligible expenses will be rejected.
- If you are adding dependent children, please use lines 2 through 5.
- Co-ordination of benefits – you can leave this section blank.
- Signature and Date section
- Green Shield requires this section to be dated and signed by the employee before there can be any coverage under this plan. This section authorizes the University and Green Shield Canada to share eligibility information only, such as the amount to be allocated in your HCSA. Green Shield Canada is governed by privacy legislation and cannot share or provide any information to the University or a third party regarding your medical condition, treatment or detailed claims information without your prior authorization.
Once you have completed the enrollment form, please send it (or drop it off) to:
HCSA – Benefits Administration
Human Resources Department
University of Toronto
215 Huron Street – 8th Floor
Toronto, Ontario M5S 1A2
Do not send your enrollment form directly to Green Shield Canada or fax the signed form.
The Benefits Administration office must review each enrollment form and initial the form before sending to Green Shield Canada.
You are done! After you send your completed and signed form to the Benefits Administration Office, you should receive your subscriber card from Green Shield in the mail in about 6 weeks. Once you have received your card, you can start submitting claims to your HCSA.
B) Adding a dependant after initial enrollment
Once you have received your subscriber card, you can add a dependant at any time during the academic year by completing another enrollment form as above, except that you should check the “Add Dependant” box in the Transaction Type section.
Any questions regarding completion of this form? Email firstname.lastname@example.org
Health Care Spending Account FAQ
- Greenshield Canada
- How do I know how much credit I have available in my HCSA?
- My first teaching contract for the academic year is for a half credit course in January. Can I submit claims incurred in November of the previous year?
- I only teach a half-credit course in the fall. Will I lose my remaining balance in December?
- If I don’t have any expenses to claim against my HCSA, what happens to my allocation at the end of the academic year?
- Can I have my pharmacist make a direct claim for reimbursement to the HCSA so I don’t have to pay her for my prescription?
- Is the new Ontario Health (tax) Premium eligible for reimbursement under my HCSA?
- How do I make a claim for reimbursement from my HCSA?
- Are weight loss and exercise programs such as Bernstein clinic eligible?
How do I know how much credit I have available in my HCSA?
You will receive $325 for each half credit course taught and $650 for each full credit course taught, up to a maximum of $1,625 per academic year. Each time you make a claim for reimbursement, Green Shield will update your remaining account balance and this amount will show on the statement you receive with your reimbursement. Once you have received your subscriber card, you can also view your HCSA information through plan member online services on Green Shield Canada’s website or call Customer Service at 1-888-711-1119.
My first teaching contract for the academic year is for a half credit course in January. Can I submit claims incurred in November?
Eligible expenses must be incurred on or after the date of employee’s HCSA allocation, and on or before the end of the plan year for which the allocation is made.
I only teach a half-credit course in the fall. Will I lose my remaining balance in December?
No, once you have received an allocation to your HCSA, it remains available to you until the end of the academic year, even if you do not teach for the remainder of the academic year. Eligible claims incurred on or before August 31st must be submitted not later than sixty days beyond the end of the plan year
If I don’t have any expenses to claim against my HCSA, what happens to my allocation at the end of the academic year?
Any remaining balance in your HCSA at the end of the academic year reverts to 0. If you teach in the subsequent year, then a new allocation for that year will be set up based on your teaching load in that year.
Can I have my pharmacist make a direct claim for reimbursement to the HCSA so I don’t have to pay her for my prescription?
No, your HCSA is a reimbursement plan, which means that you must pay for the medical service or prescription first and then submit the claim for reimbursement together with the original receipt showing details of the medical/dental service, prescription or device.
Is the new Ontario Health (tax) Premium eligible for reimbursement under my HCSA?
No, The OHP is an additional tax collected in Ontario through your income tax, rather than a premium under a private health plan. The payment of the OHP through your taxes is not a qualifying medical expense.
How do I make a claim for reimbursement from my HCSA?
Once you have received your subscriber card with the correct information for you and your dependants, you can begin submitting claims directly to Green Shield Canada. The fastest and easiest way is to register for Plan Member Online Services … Plan Member Online Services provides you with instant access to important benefit … Health Care Spending Account Status. To register click here alternatively you could complete and sign the HCSA claim form and include the original receipt, and send to Green Shield Canada. The mailing address is on the HCSA claim form that you will receive with your subscriber card.
Are weight loss and exercise programs eligible?
To be eligible, the program must be part of a patient’s medical treatment that is required because of a serious health deterioration problem and that is both prescribed and monitored by a medical practitioner. Original receipts and supporting medical information from your medical practitioner will be required for consideration.