Question 1

Health and Dental Plan Claims

Accepted Answer

|| How do I submit a claim? Information about claiming is here. You can submit your claim through a physical claim form by mail or electronically through GSC Everywhere (starting September 1, 2021).

Note: As of September 1, 2021, the UTSU will no longer be accepting physical claim forms at our office to mail to our insurer. We advise our members to visit GSC Everywhere to submit their claims.

|| Which form should I submit to the insurer? You can find the appropriate claims form and mail directly to the insurer at the appropriate address listed on the form. You can also claim electronically via GSC Everywhere after creating an account.

|| How can I use my Plan at the dental office/pharmacy? If you print off the pay-direct card and fill in your details, you'll be able to show it to a clinician or pharmacist to have them charge the plan directly. Otherwise, you can pay upfront and submit a claim for reimbursement using either of the methods described above.

|| How do I check the status of my claim(s)? Please visit the GSC website and register your account to view your claim's status. If you have any questions about a claim, you can contact the GSC Customer

Question 2

UTSU Opt-Out Eligibility/Process

Accepted Answer

|| Who is eligible to opt out of the UTSU plan? UTSU members who are already covered by an equivalent health and/or dental plan (such as a parent's or spouse’s employee benefit plan) can opt out during the Change-of-Coverage Period. You must pay all university fees even if you are opting out of the UTSU Health & Dental Plan.

|| When is the Change-of-Coverage Period? Fall 2024: September 5 – September 30 Winter 2025: January 6 – 31, only for new academics starting on January of the same year.

|| What fees can I opt out of? Students can request to opt-out of health & dental coverage separately or at the same time.

|| What is the process to opt out of the plan? Opt-out requests are submitted online through Studentcare. Choose UTSU and click Opt Outs on the right hand menu of the website. Students are required to upload a proof of coverage of an equivalent health plan before the end of Change-of-Coverage period. Your provincial healthcare or other primary healthcare does not qualify as proof of coverage. For more information, visit this page.

|| How can I know if my proof of coverage is acceptable? Students will be informed by email if the proof of coverage upload is acceptable.

|| When is the opt-out option valid? Opt-outs are valid for the whole policy year, from September 1 to August 31. If you return as an eligible student in September,

Question 3

Dental

Accepted Answer

The maximum paid by the insurer per policy year on the insured portion of the Dental Plan is $800 with the following considerations:

Percentage of Provincial Dental Fee Guide Cost for General Practitioners (province where service was performed).
Recall oral examinations, polishing, and fluoride treatment are covered once per 12 months. Bitewing x-rays are covered once every 9 months. Oral hygiene instruction is covered once every 12 months. A complete exam (sometimes called a new patient exam) is only covered once every 5 years. Periodontal scaling is covered up to 2 units per policy year.
Amalgam, tooth-coloured filling restorations, and temporary sedative fillings are covered.
Total coverage cannot exceed 100%.
Prior to work that is expected to cost $300 or more, students should submit a treatment plan to the insurer for approval.

Dental coverage information is here with the full coverage chart.

Question 4

UTSU Office

Accepted Answer

|| When is the office operating? The UTSU office is open from Monday to Friday between 9am to 5pm (no financial transactions 30 minutes prior to closing).

Find us at:

Student Commons 230 College Street, Room 164 Tel: (416) 978-4911 Email: hello@utsu.ca

Question 5

Studentcare Network

Accepted Answer

|| Where can I find a chiropractor with a student discount? Check out the Chiropractor Network for professional service providers offering additional savings.

|| Where can I find a dentist with a student discount? Check out the Dental Network for professional service providers offering additional savings.

|| Where can I find a massage professional with a student discount? Check out the Massage Therapy Network for professional service providers offering additional savings.

|| Where can I find a pharmacy that provides a student discount? Check out our pharmacy partner, Rexall, for 20% off on regularly priced Rexall brand products when you present your Rexall Exclusive Savings Card and your valid Student ID card at time of purchase.

|| Where can I find a physiotherapist with a student discount? Check out the [Physiotherapy Network](http://studentcare.ca/hcn/en/IHaveAPlanUTSUHealthCareMenu_MapA/?serviceModule=searchResult&searchMode=AroundCampus&viewMode=Ls&CampusId=377&HCNNetwo

Question 6

Summer Insurance Coverage

Accepted Answer

|| Am I covered during the summer if I'm not studying during the Summer session? If you remained a full-time undergraduate student at St. George in the Winter term and didn't opt out of the Health & Dental insurance, then you'll be covered right until August 31. The insurance fees that you pay for the Winter term are also for the Summer, so you'll be covered regardless of whether or not you're in summer classes.

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