To file a claim, fill out the form available at the Union office or on our website HERE (This form is a PDF that can be filled out on your computer.)
A Health Care Spending Account (HCSA) exists for all TAs and RAs (in lieu). As a result of our success with collective bargaining in late 2022, we have been able to expand the maximum entitlement for members. Collective Bargaining works! Effective January 30, 2023, the maximum entitlement is now $350 per twenty four month period. (This period is currently calculated retroactively from September 1st of the academic year in which you use up your entitlement. For example, if you make a $350 claim in November, 2022, the next time you will be eligible to make a claim will be September 1st, 2024, provided you are still a member/meet the eligibility criteria. The entitlement period is subject to change pending funding.) Previously, the maximum entitlement was $250 per twenty four month period.
The Health Care Spending Account (HCSA) enables members to claim a wide range of medical, dental and pharmaceutical expenses not covered (or inadequately covered) by OHIP, UHIP and student extended health plans administered by the GSA and MSU. Vision care products and services such as glasses, contacts and eye exams will remain eligible expenses.
Click here for a full list of HCSA eligible expenses determined by the Revenue Canada Agency. You can also visit the CRA’s list of authorized practitioners according to province here.)
**Please note that prescription eye glasses are on the eligibility list. They are listed by as: “Vision devices – including eyeglasses and contact lenses to correct eyesight – prescription required.” If you are only getting frames, you need proof from the optometrist that they inserted prescription lenses into the frames. (They should be able to indicate this on your receipt.)**
This benefit is open to ALL Unit 1 (Teaching Assistants or RA in lieu) members in good standing. If you hold a TA or RA in lieu contract for the 2022-2023 academic year (September 1st, 2022 to August 31st, 2023), you are be eligible to make a HCSA claim this academic year (provided you have not “maxed out” your entitlement in the past academic year).
Your eligibility for this benefit expires on August 31st of the current academic year, and will not be renewed in September unless you hold a contract for (or have a reasonable expectation to hold a contract for) the next academic year. (Please note there are some additional limitations to this eligibility period in very rare circumstances. If you have any questions, please contact administrator@cupe3906.org.)
After an approved claim is made, a cheque will normally be mailed to the address provided on the claim form in about 4-6 weeks.
Please note that you must normally submit your HSA claim within 60 days of purchase of your health-related product or service. Some exceptions may be possible. For more information, contact administrator@cupe3906.org.
Health Care Spending Account claims can be emailed to: claims@prosure-group.com until further notice. Please note that you must fill out and sign the form, and submit a clear scan or image of the form and your supporting documentation. Please mention that you are a CUPE 3906 member in your email. You no longer need to obtain an “Authorized CUPE rep signature”. Also, please make sure to hold on to your original form and receipts for at least 1 year if you submit claims via email.
We have returned to our on-campus office at Kenneth Taylor Hall, B111. Paper claims may be left in the office, or deposited in the drop box to the left of our entrance in KTH B111.
Until further advised, masks will be mandatory for those visiting the office.
You can also submit forms via mail directly to the Prosure Group, although processing hard copies submitted by mail might result in delays. Please make sure that you sign your form with pen-and-ink, and include original receipts. Claims can be mailed to:
THE PROSURE GROUP
2255 Sheppard Avenue East
SUITE 202, Atria 1
Toronto, ON M2J 4Y1
__________________________________________________________________________________________________
FAQs
Who is eligible for the Health Spending Account?
The Health Spending Account is open to ALL Unit 1 members regardless of how many hours you are contracted to work. You are a Unit 1 member if you are currently working as a TA or RA in lieu at McMaster. The eligibility period runs September 1st to August 31st. You can claim at any time in the academic year.
What sorts of expenses does the Health Spending Account Cover?
The Health Spending Account is meant to help members with the cost of medical, dental and pharmaceutical costs that are not adequately covered by OHIP, UHIP or the GSA plan. Eligible expenses included, but are not limited to: prescription drugs, glasses, contact lenses, eye exams, dental procedures such as crowns or bridges, casts, crutches, etc. A full list of eligible expenses is available on the Revenue Canada website here. Most members use the HCSA to cover vision-related costs that are not covered by the OHIP, UHIP, GSA or MSU plans (e.g., prescription eye wear, eye exams).
Psychotherapists, psychiatrists, psychologists, and Registered Social Workers are eligible expenses to claim via our Health Care Spending Accounts, as long as they are registered/licensed.
Not sure if an expense will qualify? Email: administrator@cupe3906.org
I have multiple health expenses. Can I claim up to $350 of each kind of medical expense?
No. The HCSA is $350 total, per member, per twenty four month period. This is why we recommend that you make the most of alternate extended health coverage first (e.g., through the GSA or MSU) so that you do not use up your entitlement on an expense that would have otherwise been covered by a premium-based/alternate plan. This is also why most members still use this fund for vision-related expenses (and other costs that are not covered by student plans). Remember, this is not an extended health coverage plan–it is additional money to cover the cost of medical expenses that we negotiate for our members in contract negotiations, at no premium cost to members.
I maxed out my $350 entitlement. When will I be able to make another HSA claim?
You are entitled to $350 over a 24 month period. If you became eligible for the benefit on September 1, 2022 and used the benefit in the 2022-2023 academic year, then you are entitled to another $350 on September 1, 2024 (provided you are returning as a TA that academic year). Currently, the HSA rolls over every twenty four months on September 1st.
Also, please note that the renewal of this benefit depends on the academic year in which you reach the $350 maximum allotment. For example, if you claim $90 of eligible medical expenses in September, 2022, return as an eligible member in September 2022, and make a second claim for the remaining $260 in September 2022, your eligibility for this benefit will not be renewed until September 2024 (provided you meet the eligibility criteria at this date).
Will I be able to use the Health Spending Account for the vision-related expenses I used to be able to claim with Vision Care?
Yes. Prescription glasses, contact lenses, eye exams and any other vision-related expenses formerly covered by the Vision Care Benefit can claimed using the Health Spending Account.
I have alternate insurance that covers health-related expenses. Can I use both the health spending account and my alternate insurance?
Yes. If possible, you should submit the claim to your alternate insurer first. If your alternate insurance does not cover the entire cost of the claim, you can then make a CUPE 3906 Health Spending Account claim for the remainder of the cost (to a maximum of $250). Instead of the receipt, you should attach the explanation of benefits you received from the other insurer in the mail. If no claim was paid out from your other insurer, you will still receive an explanation of benefits stating that the claim was denied. Again, that functions as a receipt when you make the CUPE 3906 claim.
If you are unable to use your alternate insurance first you can reverse the procedure described above and make a health spending care claim first. However, since explanations of benefits are not standard issue with this type of benefit, you must email administrator@cupe3906.org to request that one be produced when you make your claim. Unfortunately, we cannot guarantee that other insurance companies will accept the explanation of benefits produced by our carrier company due to the nature of the benefit.
I can’t remember when I made my last health spending or vision care claim (for claims submitted before September 2012). How do I find out?
You can find out when your last health spending or vision care claim was made by emailing administrator@cupe3906.org.
I didn’t make a claim last academic year, but I was eligible. Can I carry-forward any money?
No. Not only is it not feasible for us to pay out hundreds of dollars of claims past the eligibility period, it may be a violation of tax law (or even constitute tax fraud) in certain instances. This is standard for this kind of benefit (and any premium-based benefit) in virtually all workplaces.
How is the two year period calculated?
The date that matters is the date on the receipt, not the date when you submit your claim. For instance, if you purchased a pair of $350 glasses on September 9, 2022, you will be eligible to make another health care spending account claim on September 1st, 2024 regardless of when you submitted your claim to the union office. If you then purchased a new pair of glasses on August 30, 2023 but submitted the claim on September 10, 2023 your claim would be denied because the two year period had not yet elapsed since your last purchase. Please note that we usually cannot accept receipts beyond 60 days after the purchase date.
My immediate family member(s) has/have also incurred medical expenses. Does the HCSA offer $350 per family member?
Unfortunately not. We cannot afford to extend the full amount of this benefit to family members. That being said, you may elect to use your $350 allotment (in whole or in part) to cover the cost of eligible expenses incurred by your spouse or dependents. There is a space on the form to indicate if the expense you are claiming is for yourself, your spouse, or your dependent. Please note that the same 24 month eligibility/renewal limitations apply to a claim you make on behalf of a family member.
I am still a student and I was a TA/RA in lieu in the last academic year but I don’t hold a contract for the current academic year. May I still access the fund?
Unfortunately not. This benefit depends on your employment status in a given academic year, not your student status. If you have any doubts about your eligibility or employment status, please do not hesitate to contact Mary Ellen at administrator@cupe3906.org or our staff at staff@cupe3906.org.
I have no use for extra health coverage, child care or the UHIP rebate. Can I opt out of these benefits?
Since the above named benefits are provided at no cost to members (claims are paid out with money from the Unit 1 Benefits Fund, which is in turn 100% funded by the Employer), there is no way to opt out of these benefits. To put it another way, you cannot opt out of a benefit that you do not pay into. Members with alternate coverage may opt out of the dental plan, which is a traditional premium-based plan that members do contribute to.