FAQs Regarding Benefits
During your New Employee Orientation you will be provided with information regarding the benefits you are eligible for, together with appropriate application forms. These should be returned to your Pension & Benefits Professional in the HR Department.
Applications for all plans should be submitted within one month of the date you are hired or you may be asked to provide evidence of good health. Evidence of good health is required on all applications for Optional Life Insurance.
Coverage is effective on the date of eligibility, except when: (a) the employee is not actively at work on the day that coverage would otherwise become effective, or (b) the application is made after the 31 day period.
If you are not actively at work when you normally have become eligible, your coverage will commence when you return to work on a full-time basis.
Evidence Of Health
Proof of good health is not required if application is made within 31 days of first becoming eligible. If coverage is not applied for within this 31-day period, evidence may be requested for the employee and his/her dependents, if any, before benefits commence.
Coverage for your eligible spouse and dependent children is available under both the Group Health and Optional Life Insurance Plans.
Spouse and dependents defined below shall exclude any person for whom evidence of health, if required, was not approved by Medavie Blue Cross.
1) Spouse means a spouse legally married to the employee in an ecclesiastical or civil ceremony or a partner who cohabits on a continuous basis with the employee in a spousal relationship that is not a legal marriage, including a partner of the same gender, provided that the cohabitation existed for a period of 12 months prior to the partner being admitted to the plan. The subscriber requesting coverage for such a partner must give written notice to Medavie Blue Cross. Unless such written request is made, the period legally married to the subscriber shall be considered to be the covered spouse. Discontinuance of cohabitation with the subscriber shall terminate coverage of the partner.
2) Children shall mean the subscriber's natural, adopted or stepchildren who are dependent upon the subscriber for financial care and support. Such children must be unmarried, and less than 21 years of age; or, to age 25 if attending an accredited educational institution, college or university on a full-time basis. The children of the subscriber's common-law spouse shall be covered provided the children are living with the subscriber.
Unmarried children 21 years of age or older shall qualify, if they are dependent upon the subscriber by reason of a mental or physical disability and became totally disabled prior to attaining age 21, and who have been continuously disabled since that time. Unmarried, unemployed children who became totally disabled while attending an accredited educational institution, college or university on a full-time basis prior to their attaining age 25 and have been continuously so disabled since that time shall also qualify as a dependent.
Dependent coverage begins for your eligible dependents on the same date as your coverage, or as soon as they become eligible dependents if added later, provided that dependent benefits were applied for within 31 days of their becoming eligible. If coverage is not applied for within this 31 day period, evidence of health on the dependents may have to be submitted and approved before coverage begins.
Coverage for health benefits is effective from the first day you are actively employed. If, at any time, you or a dependent for whom you have applied for membership is hospitalized, coverage for that individual will begin upon his or her discharge from the hospital.
The cost of your employee benefits program is shared by you and the University as follows:
Long Term Disability Insurance is paid for in full by the University;
Basic Group Life and Accidental Death & Dismemberment is paid by you through payroll deduction;
Group Health Insurance premiums are split 50/50 between you and the University;
Optional Life Insurance is paid by you;
Dental premiums are split, with 20% paid by you and 80% by the University (available to Faculty only).
There is a Group Insurance adjustment that is applied in such a way that the combined premium of Long Term Disability, Basic Group Life and Accidental Death and Dismemberment are shared evenly by you and the University.
If you already have equivalent health coverage through your spouse's employer, you will be permitted to waive your membership in the University's Group Health Insurance Plan. However, if you choose not to waive your membership, it may be possible for you to claim reimbursement under both plans.
When claiming under two plans, expenses should be filed first with the plan under which the person being treated is insured as an employee. Any balance remaining after payment of claims under the primary plan may then be submitted to the secondary plan, the total refund from both plans may not exceed your actual out-of-pocket expense or your payment will be adjusted accordingly.
Claims for dependent children should be submitted first by the parent whose birthday falls earlier in the calendar year.
If you need help determining the order in which your claims should be submitted, call Medavie Blue Cross toll free at 1-800-667-4511.
Please note that all claims must be submitted directly to Medavie Blue Cross.
How to submit a claim with Medavie Blue Cross:
- Direct from your provider
Many providers offierdirect billing to Medavie Blue Cross. Ask your health professional if they offer ePay – they’ll submit the claim electronically for you, so you pay only what’s not covered by your plan.
- From your smartphone
Use our Medavie Mobile app to submit your claim right from your smartphone. Take a picture of your receipt(s) and submit – you can do it in under a minute.
- Online via eClaims
Use a scan or photo of your receipt(s) and submit through the secure Member Services site. Click the eClaims tab once you're logged in.
- By mail
Mail them to your nearest Blue Cross office. Forms are available from your health professional or by downloading them here.
- In person at a Quick Pay location
Find a location near you
If you become disabled, your membership in the benefits program continues much as before. During any period in which you are receiving Short Term Sick Leave, there will be no change in your coverage or payroll deductions. If you are covered for sick benefits under Employment Insurance, the University will carry your benefits until you return to work, at which time premiums paid by the University must be refunded.
If the disability is prolonged and you become eligible for Long Term Disability (LTD) benefits, your premium may be waived for your LTD, Basic Life Insurance and Optional Life Insurance and Accidental Death & Dismemberment coverage. Your Group Health Insurance may be maintained at your own expense.
If you take a sabbatical, or other paid leave, your coverage will remain in effect throughout the duration of your leave.* You will continue to pay your share of group insurance premiums as usual and your benefits will be based on the salary you would have earned had you not taken such a leave.
Your coverage may also be maintained during periods of approved unpaid leave*, such as maternity leave.
Sessional employees who accept a further term of employment prior to the completion of the current term, are given the option to prepay their benefits in between recurring sessional contracts i.e. during the summer months.
Note: Group Health Coverage is dependent upon the subscriber being eligible under a Provincial Government Health Program.
*See Accidental Death & Dismemberment for information of entitlement due to death or injury caused by accident.
All coverages end on your last day of work. However, you may convert your Group Health, Basic Group Life and Optional Life Insurance Plans to individual programs anytime within 31 days of the termination date.
Please see our retirement page for more information.
Should you die before retirement, death benefits under the Basic Life Insurance and Optional Life Insurance plans will be paid to the beneficiary(ies) names on your most recent enrolment materials or to your estate if you have not names a beneficiary. Additional death benefits may be payable under certain government-sponsored plans.
Reference is made at various points throughout our website to government departments with which you may be required to make contact. Addresses and telephone numbers of the local offices of these departments are listed below for your convenience.