CUPE 3902 Health Benefits

Graduate students employed as TAs are automatically members of the Canadian Union of Public Employees (CUPE) local 3902, Unit 1, and thus are entitled to health benefits under the current Collective Agreement. There are two plans in which CUPE members may be enrolled: members who have worked or have a contract worth a minimum of 30 hours (as will be the case for most graduate students) are enrolled in Plan A, while all others are enrolled in Plan B. Note that you must not opt out of your UTGSU coverage in order to be eligible for Plan A.

Plan A consists of a comprehensive “top-up” plan to supplement your UTGSU coverage, typically increasing both the percentage/amount covered per visit and the annual limit for each service (a table showing the top-up amounts can be found here), as well as a $300 Health Care Spending Account (HCSA) that can be applied to expenses above existing coverage or to some expenses not covered under either plan. Plan B consists only of the HCSA. In both cases, coverage runs from September 1st to August 31st.

For more information about the plan, see the CUPE 3902 Unit 1 Benefits page or their Plan FAQ document, or contact our Department’s CUPE Stewards.

Submitting Claims

Note: both CUPE 3902 plans will be unavailable during a “blackout period” of September 1st to November 15th, during which time the University confirms the eligibility of members and sends the list to Green
Shield; claims submitted to your CUPE plan during this period will be denied. For expenses incurred during this period, hold on to receipts (as well as any applicable claim statements from your UTGSU coverage) and submit the claims in late November.

As with your UTGSU coverage, the CUPE 3902 plan is managed through Green Shield Canada; you can submit and review claims through their online portal. To register your account, you will need your member ID (UOT followed by your employee/personnel number, obtainable by contacting the Department Administrator or TAship Coordinator or by checking your paystub) as well as your date of birth.

Claims are submitted in precisely the same manner as for your UTGSU plan, except with some added complications to coordinate benefits between the two plans, as explained below.

Submitting a Claim to Multiple Plans

Students covered under both the UTGSU plan and the CUPE 3902 plan may submit claims to both plans for the same service or item. These claims can either be automatically coordinated or manually submitted; instructions for both options are available below. In all cases, you must submit your claim through the UTGSU plan first.

Automatic Coordination
Note: automatic claim coordination will not work during the “blackout period” described above.

  1. Log in to the Green Shield Canada portal with your UTGSU account.
  2. Click “Submit a Claim” and select the service, provider, and recipient.
  3. Under “Questions We Have to Ask,” for “Is this person covered another benefits plan?”, select “Yes.”
  4. For “Is the plan with GSC?”, select “Yes.”
  5. For “Has this claim already been submitted to the other plan?”, select “No.”
  6. For “Would you like to submit any unpaid amount to the other plan?”, select “Yes.”
  7. Enter the member ID for your CUPE 3902 plan (UOT + personnel number).
  8. Fill out the rest of your claim as normal and submit.

Your claim will be automatically processed through both plans, UTGSU first; note that one or both claims may be denied if you have reached the annual limit(s) for that benefit. Eligible claims will usually be approved and funds deposited (in a separate amount for each plan) within 1-3 business days.

Manual Submission

  1. Follow steps 1 and 2 as above.
  2. Under “Questions We Have to Ask,” for “Is this person covered another benefits plan?”, select “No.”
  3. Fill out the rest of your claim as normal and submit.
  4. Write down the amount approved for payment under your UTGSU plan.
  5. Log out.
  6. Log back in with your CUPE 3902 account.
  7. Click “Submit a Claim” and select the same service, provider, and recipient.
  8. Under “Questions We Have to Ask,” for “Is this person covered another benefits plan?”, select “Yes.”
  9. For “Is the plan with GSC?”, select “Yes.”
  10. For “Has this claim already been submitted to the other plan?”, select “Yes.”
  11. Fill out the date, amount, etc. for your claim.
  12. Under “Amount paid by alternate carrier,” enter the amount from step 4.
  13. Submit.

You can also wait between steps 5 and 6, particularly during the aforementioned “blackout periods.” In these periods, you may choose to submit claims to your UTGSU plan and then simply wait to resubmit the same claims to your CUPE 3902 plan once the blackout period has finished.

Health Care Spending Account (HCSA)

Per Green Shield, the Health Care Spending Account is “like a bank account that you can use to pay for eligible health and dental expenses not fully covered by your group benefits plan or your provincial health plan.” You can also apply it to a range of expenses that fall outside of the plans; a list of such expenses (some of which require a prescription to be eligible) can be found here. The HCSA totals $300 ($600 for members with dependents; see below) and can be used across multiple expenses over the course of the year.

When submitting claims online with your CUPE 3902 account, you will have the option to submit any unpaid balance through your HCSA. You can also submit a claim directly to the HCSA from the portal dashboard by clicking “Your Health Benefits” and then “Spending Account(s)” at the top of the screen, and then clicking “Health Care Spending Account” and “Submit a Claim.” This is also where you can see your HCSA amount used to date and amount remaining, as well as set your account to automatically submit unpaid claim balances through the HCSA (saving you from having to check the box every time).

As with the overall plan, the HCSA runs from September 1st to August 31st of any given year. Any unused amounts from the HCSA will be lost at the end of the coverage period, so be sure to use it!

Dependents/Family Coverage

As with the UTGSU plan, students may choose to enroll their spouse (including common-law partners) and/or children as dependents, entitling them to the same coverage. Members covered under Plan A (the “top-up” plan) should simply enroll their dependents under their UTGSU plan as described here; those dependents will then automatically be enrolled in the top-up plan, if eligible, at no additional cost. Members covered under Plan B (just the HCSA) are advised to contact Green Shield directly at 1-888-711-1119 to enrolled their dependent(s).

The HCSA amount for members with enrolled dependents (no matter how many) is increased from $300 to $600; this amount is shared between the member and all enrolled dependents.