Benefit Plans

    Benefit Claim Procedure


    All Health Benefits are on a reimbursement basis.

    • Claims must be submitted within 90 days of the end of the calendar year of receiving the service or supplies.
    • Claims incurred prior to employment terminating must be submitted within 90 days of the date of termination.

    If you have a medical expense that is either fully or partially covered by the plan, you can submit your claim in one of two ways:

    Online/Mobile App (e-claim)

    Sign up to mySunLife and enter your access ID and password.

    If you do not have an access ID, click on Register now and follow the steps. You will need your member ID (your university employee number) and contract number (150798). Once you have logged in sign up for direct deposit.

    You can submit claims online or from your phone and have your payment deposited directly into your bank account, usually within 24 to 48 hours from the time your claim has been processed. Please retain your original receipts for 12 months as they may be required to support your online claim. When your claim has been processed, Sun Life will send you an e-mail to notify you about the status of your claim.

    Mail

    All eligible expenses can be claimed by mailing your claim submissions. Complete Sun Life’s “Extended Health Care and Health Spending Account Claim Form”, enclose the original receipts and mail it to the address below. Be sure to keep a copy of the claim form and receipts for your records.
    When completing your claim, please note

    •  Policy Number - the University’s group policy number is 150798
    •  Member ID – Your university employee number

    ALL MAIL CLAIM FORMS ARE TO BE FORWARDED TO:
    Sun Life Assurance Company of Canada
    PO Box 2010 Stn Waterloo
    Waterloo, ON N2J 0A6
    Telephone: 1-800-361-6212 

    Admin/ASPA
    Exempt Staff

    This plan is available to Permanent and Limited Term Exempt Staff.

    Eligible employees are employees who work at least half time and are in a term appointment of at least six months.

    Eligibility to participate in the benefit plans is based on job status and/or the length of appointment.

    Term of 6 months                                                     Life Insurance, Dental, Health, Flexible Spending Program

    Term greater than 6 months but less than 2 years     Life Insurance, Dental, Health, Flexible Spending Program, Pension

    Term of 2 years or greater or permanent                  Life Insurance, Dental, Health, Flexible Spending Program, Pension, Disability

    Faculty (USFA)
    Faculty (Out of Scope)

    This plan is availabe to 'Out of Scope' Permanent and Limited Term Faculty.

    PAIRS

    This plan is available to employees who are residents (excluding Type B residents) in the College of Medicine and are members of the Professional Association of Internes and Residents.

    Sessionals (CUPE 3287)
    CUPE 1975
    Research - Professional Staff

    This plan applies to individuals engaged in funded research. Grant holders, subject to the ability of the grant to pay the employer's share of benefit costs, can decide to extend benefit coverage to all of their eligible employees. If the grant holder or principal investigator is unable to authorize coverage due to lack of funds, benefits can be offered when the grant is renewed and budget is provided for this item.

    Eligible employees are employees who work at least half time and are in a term appointment of at least six months. The eligibility date is defined as the date the grant holder offers the benefit package to an eligible employee. If a benefit package is offered, benefits cannot be cancelled at any time throughout the duration of the employee's contract.

    Eligibility to participate in the benefit plans is based on the length of appointment.

    6 months                                                          Life Insurance, Dental, Health

    Greater than 6 months but less than 2 years   Life Insurance, Dental, Health, Pension

    2 years or greater                                              Life Insurance, Dental, Health, Pension, Disability

    Research - Administrative, Technical & Support Staff

    This plan applies to individuals engaged in funded research. Grant holders, subject to the ability of the grant to pay the employer's share of benefit costs, can decide to extend benefit coverage to all of their eligible employees. If the grant holder or principal investigator is unable to authorize coverage due to lack of funds, benefits can be offered when the grant is renewed and budget is provided for this item.

    Eligible employees are employees who work at least half time and are in a term appointment of at least six months. The eligibility date is defined as the date the grant holder offers the benefit package to an eligible employee. If a benefit package is offered, benefits cannot be cancelled at any time throughout the duration of the employee's contract.

    Eligibility to participate in the benefit plans is based on the length of appointment.

    6 months                                                         Life Insurance, Dental, Health

    Greater than 6 months but less than 2 years   Life Insurance, Dental, Health, Pension

    2 years or greater                                             Life Insurance, Dental, Health, Pension, Disability

    Research Staff (not eligible for full-time benefits)

    This plan applies to individuals engaged in funded research. Grant holders, subject to the ability of the grant to pay the employer's share of benefit costs, can decide to extend benefit coverage to all of their eligible employees. If the grant holder or principal investigator is unable to authorize coverage due to lack of funds, benefits can be offered when the grant is renewed and budget is provided for this item.

    Eligible employees are employees who do not qualify for full-time benefits, who work 390 hours during the initial qualifying period of 26 consecutive weeks following their date of hire. The eligibility date is defined as the date the grant holder offers the benefit package to an eligible employee. If a benefit package is offered, benefits cannot be cancelled at any time throughout the duration of the employee's contract. It is the grant holders responsibility to monitor hours during the 26 week period from the date of hire and to notify Human Resources when an employee is eligible for this benefit plan.

    Eligibility

    390 hours within 26 weeks from date of appointment        Life Insurance, Dental (single), Health (prescription drugs, family)

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