Health & Dental Plans - FAQ's
Who is covered by the plans?
Full-time undergraduate students enrolled at the St. George and UTM campuses (including B. Ed., Medical, Dental, Pharmacy, and Law) and full-time Toronto School of Theology students are automatically covered under the Health and Dental Plans. The plans are underwritten by Green Shield Canada (1-888-711-1119).
Who is NOT covered by the plans?
Part-time undergraduate students are covered under a plan offered by the Association of Part-time Undergraduate Students.
Full-time undergraduate students enrolled at the Scarborough campus are covered under a plan offered by the Scarborough Campus Students' Union.
Graduate students are covered under a plan offered by the Graduate Students' Union.
For what periods am I covered by the plans?
Students charged full-time incidental fees in both the fall and winter sessions are covered under the plan from September 1st to August 31st. Students charged full-time incidental fees in one session only are either covered from September 1st to December 31st, or January 1st to August 31st, depending on the term the student is enrolled in courses.
How much do the plans cost?
The annual fee paid for the Health Plan is $109.68 (2009-2010). The annual fee paid for the Dental Plan is $93.42 (2009-2010). Students can confirm all fees paid by reviewing their detailed account statement on the ROSI Student Web Service.
How do I confirm what I paid?
Students can review all fees paid by reviewing their detailed account statements on the ROSI Student Web Service. Alternately, students may contact the Fees Department at 416-978-2142.
What if I am already covered by another plan?
Students already covered under another health plan offering similar coverage may request a refund of the Health Plan fee. Any student may request a refund of the Dental Plan fee. The process is referred to as opting out. The opt-out periods are held between September to mid-October, and January to early February. Students should refer to the current Benefit Booklet or the U.T.S.U. website for specific dates. Late opt-out requests are not accepted. To request a refund, students should go to www.studentplans.ca (select the University of Toronto, then select University of Toronto Students' Union) or complete an opt-out form and submit to the U.T.S.U. or UTMSU office.
Note: Students are required to provide proof of alternative coverage by providing the name of the insurer and policy number. OHIP and UHIP are not eligible alternatives. Once a student has left the plans they may not rejoin until the following September. Some exceptions may apply. Contact U.T.S.U. for details.
Can I add family members to the plan?
Students may add a spouse (common law and same sex couples included) and dependent children to either plan. The enrollment period coincide with the opt-out periods described above. Students should refer to the current Benefit Booklet or the U.T.S.U. website for specific dates and additional costs.
What coverage do the plans offer?
Students should refer to the current Benefit Booklet for a detailed description of the coverage offered. Students can also find information on the U.T.S.U. and Green Shield websites.
Are vaccines covered?
Vaccines are not covered by the plan.
What types of drugs are covered?
Curative prescription drugs are 100% covered up to a maximum of $5000 per year. Students are limited to purchases of no more than 3 months worth at a time. Reimbursement is based on the cost of available generic drugs.
Oral contraceptives, Ortho Evra and Depo-Provera are covered up to $150 per year. Students are limited to purchases of no more than 3 months worth at a time. Reimbursement is based on the cost of available generic drugs. Health Services sells a variety of contraceptive drugst at cost.
Are orthodics covered?
Orthodics are covered to a maximum of $350 per year provided they are medically necessary.
Are glasses/contact lenses covered?
No. Green Shield plan members are eligible for discounts at participating Bay Optical, Sears Optical and Zellers Vision Centres.
Is Emergency Travel insurance included?
The Health Plan includes a 60-day Emergency Travel coverage. Details are available in the 2009-2010 Benefit Booklet and through the Greenshield Student Centre website.
What is the Discount Dental Network?
Green Shield has created a network of dentists willing to charge rates between 20% - 30% lower on covered treatments than the recommended fees used by most dentists, established by the Ontario Dental Association. Students are not required to use a Network dentist. Students should refer to the current Benefit Booklet or contact Green Shield for details.
Are there any limits/exclusions to my health and dental plan benefits?
There are a variety of limits and exclusions. Students should refer to the current Benefit Booklet for details.
How do I coordinate claims with another plan?
Students already covered under another plan can coordinate the benefits with those offered by the U.T.S.U. In such circumstances, the students are required to first submit the claim to the plan under which they are a primary member, and then submit a claim for the outstanding portion to the plan under which they are enrolled as a dependent. Simply send the letter (called Explanation of Benefits) received from the first company claimed from, showing what has not been paid, with a completed claim form to the secondary benefits provider.
I was in an accident and require dental work, am I covered?
Charges for dental treatments to natural teeth required as a result of an accident that occurs during the period of coverage are covered up to $3000 per accident. Treatment must commence within six (6) months and be completed within one (1) year of the date of the accident. If the cost of any proposed treatment is expected to exceed $300, students can submit a "Dental Pre-Treatment Form" before treatment begins. With this information Green Shield can tell the student what is covered and how much they will have to pay.
I was involved in an accident with a motor vehicle, am I covered?
Eligible services do NOT include (and reimbursement will NOT be made) for services or supplies which relate to treatment of injuries arising out of a motor vehicle accident.
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 include fees for student societies, e.g. the University of Toronto Students' Union (formerly SAC), the Association of Part-time Undergraduate Students (APUS), and the Graduate Students' Union (GSU) and for campus based services (e.g., Student Services, Student Life, Health Services, Hart House and the Athletics Centre). The SAC/U.T.S.U., APUS and GSU fees include designated amounts for student health plans.
Why is SAC/U.T.S.U. allowed to charge a health plan fee?
The health plan fees were established in the late '80s through a referendum in which students were asked to support collection of the compulsory fee. Increases to the fee and the establishment of the dental plan fee were approved by student referenda in subsequent years.
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.
Why do I have to pay for student services separately from paying for tuition?
While some universities fund the cost of providing student services out of the tuition fees collected from students, others, including the University of Toronto, choose to charge separate non-academic fees to cover these costs.
Can I get these fees back?
Compulsory non-academic incidental fees are automatically charged to all tuition-paying students. Fees charged for student services are not refundable. Some specific portions of student society fees are refundable through the student society in question. More information is available through the society involved.
How do I receive a refund of my health plan fees if I already have coverage?
Certain portions of some student society fees are refundable upon request. These refunds are issued by the society that levies the fee (unless noted otherwise) within limited time periods (normally at the beginning of each session). Questions should be directed to the appropriate student society.
Why can't I get my money back right away?
SAC/U.T.S.U. and the other student societies in question determine the schedule of issuing refunds. However, it is important to note that for most students, SAC/U.T.S.U. cannot be certain that a particular student's incidental fees will be paid to SAC/U.T.S.U. until early in the Winter session. This is because until that time students might become enrolled part-time and, as a consequence, become members of APUS and part of the APUS health plan.
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.
How do I know what student society fees I am charged?
Check your account on the ROSI Student Web Service if you are not certain which student society fees you have been assessed.
When was I told about the availability of a refund?
General information about refunds is available in a wide variety of print and online resources.
What is the Students' Union's relationship to the University?
SAC/U.T.S.U. is an independently incorporated student society within the University of Toronto community. The University has no direct control over the affairs of any student society. However, the University will investigate complaints that a society has acted illegally or in a manner that is inconsistent with its constitution or by-laws.
Why do I have to pay these fees even if I don't use them or if I'm located far away from campus?
The University takes the position that there must be equity with respect to assessing these fees. Even for those that spend a great deal of time on campus, making use of available services is based upon individual needs and desires. It may be the case that students who spend all year on campus actually make use of services less than some located far away. Many services are now being delivered through non-traditional means making proximity to campus less relevant. For example, many resources and services are now available via the Internet.
What if I want to be exempted from paying fees?
There is no provision in the University's Policy to provide individual student exemptions or refunds of compulsory non-academic incidental fees for any reason.
What legislation and policies govern incidental fees?
The provincial government's funding guidelines allows universities to charge
fees that are separate from tuition fees. Within the University of Toronto, non-tuition ancillary fees are governed by the Policy for Compulsory Non-Academic Incidental Fees.
How do I replace a lost/stale dated refund cheque?
To request a replacement cheque, please contact the Plan Administrator at health@utsu.ca or 416-978-4911. Cheques that are not redeemed after fifteen (15) months from the date of being frist issued will not be re-issued and shall be deemed forfeited by the payee.
Full-time undergraduate students enrolled at the St. George and UTM campuses (including B. Ed., Medical, Dental, Pharmacy, and Law) and full-time Toronto School of Theology students are automatically covered under the Health and Dental Plans. The plans are underwritten by Green Shield Canada (1-888-711-1119).
Who is NOT covered by the plans?
Part-time undergraduate students are covered under a plan offered by the Association of Part-time Undergraduate Students.
Full-time undergraduate students enrolled at the Scarborough campus are covered under a plan offered by the Scarborough Campus Students' Union.
Graduate students are covered under a plan offered by the Graduate Students' Union.
For what periods am I covered by the plans?
Students charged full-time incidental fees in both the fall and winter sessions are covered under the plan from September 1st to August 31st. Students charged full-time incidental fees in one session only are either covered from September 1st to December 31st, or January 1st to August 31st, depending on the term the student is enrolled in courses.
How much do the plans cost?
The annual fee paid for the Health Plan is $109.68 (2009-2010). The annual fee paid for the Dental Plan is $93.42 (2009-2010). Students can confirm all fees paid by reviewing their detailed account statement on the ROSI Student Web Service.
How do I confirm what I paid?
Students can review all fees paid by reviewing their detailed account statements on the ROSI Student Web Service. Alternately, students may contact the Fees Department at 416-978-2142.
What if I am already covered by another plan?
Students already covered under another health plan offering similar coverage may request a refund of the Health Plan fee. Any student may request a refund of the Dental Plan fee. The process is referred to as opting out. The opt-out periods are held between September to mid-October, and January to early February. Students should refer to the current Benefit Booklet or the U.T.S.U. website for specific dates. Late opt-out requests are not accepted. To request a refund, students should go to www.studentplans.ca (select the University of Toronto, then select University of Toronto Students' Union) or complete an opt-out form and submit to the U.T.S.U. or UTMSU office.
Note: Students are required to provide proof of alternative coverage by providing the name of the insurer and policy number. OHIP and UHIP are not eligible alternatives. Once a student has left the plans they may not rejoin until the following September. Some exceptions may apply. Contact U.T.S.U. for details.
Can I add family members to the plan?
Students may add a spouse (common law and same sex couples included) and dependent children to either plan. The enrollment period coincide with the opt-out periods described above. Students should refer to the current Benefit Booklet or the U.T.S.U. website for specific dates and additional costs.
What coverage do the plans offer?
Students should refer to the current Benefit Booklet for a detailed description of the coverage offered. Students can also find information on the U.T.S.U. and Green Shield websites.
Are vaccines covered?
Vaccines are not covered by the plan.
What types of drugs are covered?
Curative prescription drugs are 100% covered up to a maximum of $5000 per year. Students are limited to purchases of no more than 3 months worth at a time. Reimbursement is based on the cost of available generic drugs.
Oral contraceptives, Ortho Evra and Depo-Provera are covered up to $150 per year. Students are limited to purchases of no more than 3 months worth at a time. Reimbursement is based on the cost of available generic drugs. Health Services sells a variety of contraceptive drugst at cost.
Are orthodics covered?
Orthodics are covered to a maximum of $350 per year provided they are medically necessary.
Are glasses/contact lenses covered?
No. Green Shield plan members are eligible for discounts at participating Bay Optical, Sears Optical and Zellers Vision Centres.
Is Emergency Travel insurance included?
The Health Plan includes a 60-day Emergency Travel coverage. Details are available in the 2009-2010 Benefit Booklet and through the Greenshield Student Centre website.
What is the Discount Dental Network?
Green Shield has created a network of dentists willing to charge rates between 20% - 30% lower on covered treatments than the recommended fees used by most dentists, established by the Ontario Dental Association. Students are not required to use a Network dentist. Students should refer to the current Benefit Booklet or contact Green Shield for details.
Are there any limits/exclusions to my health and dental plan benefits?
There are a variety of limits and exclusions. Students should refer to the current Benefit Booklet for details.
How do I coordinate claims with another plan?
Students already covered under another plan can coordinate the benefits with those offered by the U.T.S.U. In such circumstances, the students are required to first submit the claim to the plan under which they are a primary member, and then submit a claim for the outstanding portion to the plan under which they are enrolled as a dependent. Simply send the letter (called Explanation of Benefits) received from the first company claimed from, showing what has not been paid, with a completed claim form to the secondary benefits provider.
I was in an accident and require dental work, am I covered?
Charges for dental treatments to natural teeth required as a result of an accident that occurs during the period of coverage are covered up to $3000 per accident. Treatment must commence within six (6) months and be completed within one (1) year of the date of the accident. If the cost of any proposed treatment is expected to exceed $300, students can submit a "Dental Pre-Treatment Form" before treatment begins. With this information Green Shield can tell the student what is covered and how much they will have to pay.
I was involved in an accident with a motor vehicle, am I covered?
Eligible services do NOT include (and reimbursement will NOT be made) for services or supplies which relate to treatment of injuries arising out of a motor vehicle accident.
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 include fees for student societies, e.g. the University of Toronto Students' Union (formerly SAC), the Association of Part-time Undergraduate Students (APUS), and the Graduate Students' Union (GSU) and for campus based services (e.g., Student Services, Student Life, Health Services, Hart House and the Athletics Centre). The SAC/U.T.S.U., APUS and GSU fees include designated amounts for student health plans.
Why is SAC/U.T.S.U. allowed to charge a health plan fee?
The health plan fees were established in the late '80s through a referendum in which students were asked to support collection of the compulsory fee. Increases to the fee and the establishment of the dental plan fee were approved by student referenda in subsequent years.
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.
Why do I have to pay for student services separately from paying for tuition?
While some universities fund the cost of providing student services out of the tuition fees collected from students, others, including the University of Toronto, choose to charge separate non-academic fees to cover these costs.
Can I get these fees back?
Compulsory non-academic incidental fees are automatically charged to all tuition-paying students. Fees charged for student services are not refundable. Some specific portions of student society fees are refundable through the student society in question. More information is available through the society involved.
How do I receive a refund of my health plan fees if I already have coverage?
Certain portions of some student society fees are refundable upon request. These refunds are issued by the society that levies the fee (unless noted otherwise) within limited time periods (normally at the beginning of each session). Questions should be directed to the appropriate student society.
Why can't I get my money back right away?
SAC/U.T.S.U. and the other student societies in question determine the schedule of issuing refunds. However, it is important to note that for most students, SAC/U.T.S.U. cannot be certain that a particular student's incidental fees will be paid to SAC/U.T.S.U. until early in the Winter session. This is because until that time students might become enrolled part-time and, as a consequence, become members of APUS and part of the APUS health plan.
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.
How do I know what student society fees I am charged?
Check your account on the ROSI Student Web Service if you are not certain which student society fees you have been assessed.
When was I told about the availability of a refund?
General information about refunds is available in a wide variety of print and online resources.
What is the Students' Union's relationship to the University?
SAC/U.T.S.U. is an independently incorporated student society within the University of Toronto community. The University has no direct control over the affairs of any student society. However, the University will investigate complaints that a society has acted illegally or in a manner that is inconsistent with its constitution or by-laws.
Why do I have to pay these fees even if I don't use them or if I'm located far away from campus?
The University takes the position that there must be equity with respect to assessing these fees. Even for those that spend a great deal of time on campus, making use of available services is based upon individual needs and desires. It may be the case that students who spend all year on campus actually make use of services less than some located far away. Many services are now being delivered through non-traditional means making proximity to campus less relevant. For example, many resources and services are now available via the Internet.
What if I want to be exempted from paying fees?
There is no provision in the University's Policy to provide individual student exemptions or refunds of compulsory non-academic incidental fees for any reason.
What legislation and policies govern incidental fees?
The provincial government's funding guidelines allows universities to charge
fees that are separate from tuition fees. Within the University of Toronto, non-tuition ancillary fees are governed by the Policy for Compulsory Non-Academic Incidental Fees.
How do I replace a lost/stale dated refund cheque?
To request a replacement cheque, please contact the Plan Administrator at health@utsu.ca or 416-978-4911. Cheques that are not redeemed after fifteen (15) months from the date of being frist issued will not be re-issued and shall be deemed forfeited by the payee.