The CUPE Top-Up Health and Dental Plan works in conjunction with your existing Green Shield Student Health and Dental Plan 
(e.g. GSU/UTSU/SCSU/APUS or PDF [post-doctoral fellow] Plan). It is meant to “top up” the amount of the health and dental benefit included in your Student or Postdoctoral Plan.

• You are eligible if you are employed as a teaching assistant, teaching fellow, demonstrator, tutor, marker, teaching instructor, laboratory assistant, Chief Presiding Officer, invigilator, or part-time lecturer and are registered as a Post Doctoral Fellow, Undergraduate Student in the University of Toronto, and Graduate Student in the School of Graduate Studies of the University of Toronto.

• You have worked 15 hours during the current academic year (Sept 1 to August 31) and have been paid through the ESS.

• You are enrolled in a Student Health and Dental Plan (e.g. GSU/UTSU/SCSU/APUS) or the PDF (post-doctoral fellow) Plan

In order for your dependent/s to be included in the Top-Up Plan, they must first be enrolled in your Student Health and Dental Plan (base plan). They will then be automatically enrolled in your Top-Up Plan (Plan A) if you are eligible.

If you only have the HCSA (Plan B) you should contact Green Shield directly at 1-888-711-1119 to add your dependent/s.

If you are a graduate student, please contact the UTGSU for more information on your base plan at 416-978-8465. Couple and family coverage can also be done online at studentcare.ca.

Your eligibility for the two different plans are as follows:

1. Plan A (Health & Dental + HCSA)

• Members who have coverage under the base plan (e.g. GSU/UTSU/SCSU/APUS or PDF Plan (post-doctoral fellow)) for both health and dental coverage. 

• Members who are ineligible for any of the base plans because of an approved academic leave but continue to do TA work during the academic year. (NOTE: This does not apply to members who opt out of their base plan; also if graduating by the end of the Fall term, you must purchase an extension to your base-plan by January 1 to maintain Plan A coverage through to August 31).

2. Plan B (HCSA-only) 

• Members who have fully opted out of their health and dental coverage in the base plan.

• Members who have opted out of either the health or the dental coverage in their base plan.

Should you voluntarily choose not to enroll in a base plan (GSU/UTSU/SCSU/APUS/PDF), you will lose entitlement to Plan A and will only have access to Plan B ($500 single HCSA or $800 family HCSA).

Members who have worked 15 hours or more can expect to be enrolled approximately 4 weeks following their first pay cycle. For example, if you worked 15 hours in September, you should be enrolled by early November. Members working in an hourly position (i.e. invigilators) will be enrolled 4 weeks following the pay cycle in which they achieve at least 15 hours of paid work. 

For example, if you achieve 15 hours of work on your October pay cycle, you can expect to be enrolled by late November.

If you are not sure whether you have reached 15 hours, you can check your monthly pay stub for the hours you have worked. Hours are calculated on an average between months: e.g. a 100 hour TA contract spanning Fall and Winter terms works out to 12.5 hours in the first month (100/8), such that it would take two months to accrue enough hours to become eligible.

A blackout period is the duration of time when access to Plan A and Plan B is temporarily unavailable. This is the period when the University confirms the eligibility of members and sends the list to Green Shield.

The blackout period for the Fall semester is from September 1 to October 31; the Winter semester is from January 1 to March 15.

If you require access to medical and dental services or need a prescription during the blackout period, you can make the payment and submit the claim with receipts to Green Shield after the blackout period.

Once you have been enrolled into one of the CUPE Top-Up plans, you will be able to sign up for online services with Green Shield. Online services allow you to view your benefits coverage, submit claims online, submit “mock claims” to view what your benefits plan will cover in an actual scenario, and sign up for direct deposit, allowing you to receive reimbursements quickly.

To access the online registration page, please visit the Green Shield login page.

Should you require any assistance setting up your account, you may call Green Shield directly at 1-888-711-1119.

Your plan member ID number for the CUPE Top-Up Plans is as follows: UTA[Personnel Number]-00.

For example, if your personnel number is 1001234, your Green Shield ID number is UTA1001234-00

Please note your base plan will have a separate plan ID.

Your personnel/employee number can be found on your pay stub and starts with a 0.

If you don’t have access to a pay slip, you can contact ESS (https://people.utoronto.ca/hr-service-centre/) or the U of T Payroll Department at payroll.hr@utoronto.ca or 416-978-0452. Even if you are no longer an employee, they should still have this information on file.

NOTE: CUPE 3902 does not administer employment information such as Records of Employment or personnel numbers, that is solely the responsibility of the employer.

here are several ways to submit a claim.

1. Direct Payment 
   Several service providers are able to submit their bill directly to Green Shield. However, you will need to give the provider both your Student Plan and Top-Up Plan Member IDs.

2. Submitting your claim through the GSC member portal

   • You can coordinate your benefits from your Student Plan and the Top-Up Plan to receive up to 100% coverage. Login in to Green Shield using your Student Plan ID (e.g. UTG[Student Number]-00), submit the claim under the relevant services. There will be another section as shown. Under the GSC number, enter your Top-Up Plan Member ID UTA[Personnel Number]-00.

   • Log in using your CUPE Top-Up Plan Member ID and submit your claim. You should submit your claim first to your Student Plan. You can submit directly to your CUPE Top-Up Plan if you have reached the maximum amount you can claim from your student plan. 

3. You also have the option to complete the General Claim/Dental Claim Form and mail it directly to Green Shield. More information can be found on the Green Shield Canada website.

Once you are officially enrolled in the benefit plan, the effective date of coverage will date back to September 1 of the current academic year, as long as you become eligible by July 31 .

For example, if you begin a position as an invigilator in October 2020 and officially hit 15 hours in February 2021, your coverage will be retroactive to September 1, 2020.

Absolutely! Just be sure to hang on to a copy of the receipt or the “Explanation of Benefits” (EOB) from your base plan. Once your CUPE Top-Up Plan becomes active, you can then submit the unpaid portion which was not covered by your base plan.

This largely depends on the provider and the type of service being claimed. For example, your pharmacist should be able to submit your prescription to both plans without any issue (charging it to your base plan first and the balance to your CUPE Top-Up Plan).

Some other healthcare providers are also able to directly bill Green Shield. Regardless, you can always pay for the service and then submit any receipts to Green Shield Canada for reimbursement.

HCSA is an additional coverage that you can use to pay for additional medical and/or dental expenses not covered by your combined Student/PDF Plan and the CUPE Top-Up Plan.

As long as your leave is approved and falls under the Collective Agreement, you remain eligible for coverage for the entire plan year. If you are unsure if you are entitled to coverage while on leave, please contact the Union office at 416-593-7057.

All claims must be received by Green Shield no later than 60 days after the end of the benefit year (August 30 not August 31).

NOTE: August 30 is the last day you can submit claims through the Green Shield portal. After August 30, you must submit manual (paper) claim forms. Please contact Green Shield customer service at 1-888-711-1119 for assistance.

Please contact Green Shield customer service at 1-888-711-1119 to determine eligibility for a specific item or service and Green Shield Canada pre-authorization requirements

This is the “reasonable” reimbursement amount determined by Green Shield Canada (GSC) for a medical item or service. GSC establishes reasonable and customary pricing for all covered health services and major medical equipment. GSC determines reasonable and customary pricing based on reviewing rendered amounts, manufacturers’ pricing and provincial and association pricing. In all cases, GSC reimburses the lesser of either the submitted or the allowed unit cost per device or service, as determined by their reasonable and customary pricing policy (which is reviewed on an annual basis).

Examples of services are psychotherapy/counselling services, physiotherapy, etc. We suggest to consult GSC first or submit a mock claim if you are intending to use these services.