Dental

 

CUPE 3906 provides dental coverage for Unit 1 members (excluding undergraduate students) who have a TAship or RAship in lieu of a TAship worth 130 hours or more. Unit 1 consists of Teaching Assistants, Demonstrators, Tutors and Super Tutors, Markers and Research Assistants who have an RAship in lieu of a TAship.  Please note that if you are eligible for the CUPE Dental Plan, you are not eligible for the Graduate Students’ Association Dental Plan.  As such, you cannot enroll in GSA dental coverage and opt-out of CUPE 3906 coverage.

Eligibility for the Dental plan runs by academic year (i.e., Sept 1st to Aug 31st).  The eligible amount for reimbursement (i.e., the money that is available to you) runs by calendar year.  This means that if you are only employed for one academic year your coverage will be terminated at the end of that academic year (i.e., August 31st).  If you are returning as a TA (or an eligible Postdoctoral Fellow member) in the subsequent academic year, your reimbursement funds will not be renewed until January 1st of that academic year.

Any questions about the CUPE dental plan should be directed to administrator@cupe3906.org

Unit 1 Dental rates for 2013 – 2014 are:
SINGLE - $8.92 per month
FAMILY – $67.85 per month

*Please note that claims that are submitted in September may initially be rejected by the insurance company even if you are eligible for dental benefits.  This is likely due to a payroll processing delay period and has nothing to do with your eligibility.  If you meet the eligibility criteria and your claim is rejected, please contact administrator@cupe3906.org.  You may experience a delay in your receipt of reimbursement cheques in September.*

Members who qualify for the CUPE plan are automatically enrolled in single coverage. Members wishing to enroll in family coverage must fill out a family coverage enrollment form (see below).

*Please click here for important information about opting out of the dental plan or enrolling in family coverage for the 2013-2014 academic year.  This message contains information about important opt-out and enrollment deadlines.  Please note that the deadlines may require your immediate attention and action.*

You can find the following information on this page:

 


Who is eligible for the CUPE 3906 plan?

  1. Unit 1 members who are currently working at least a 130 hour TAship (or RA in lieu of a TAship) who are NOT undergraduate students at McMaster.

Full time undergraduate students at Mac have dental coverage through the MSU. Any questions about the MSU plan should be directed to Victoria Scott at 905-525-9140 ext. 23251 or via email at adminasst@msu.mcmaster.ca

Graduate Students who do not qualify for the CUPE 3906 dental plan are covered by the GSA dental plan.  Those eligible for the CUPE plan are not eligible for the GSA plan.  Any questions about the GSA plan should be directed to macgsa@mcmaster.ca

If you are eligible for the CUPE plan before September 30, you will be automatically opted-out of the GSA plan. Regardless of what is listed on your schedule of fees – YOU WILL NOT BE CHARGED for the GSA plan.

Click here for an important update regarding the CUPE Dental Plan and the new Dental Plan offered by the GSA.

If you become eligible for the CUPE plan after September 30, you may still be charged the GSA dental fee. Please contact administrator@cupe3906.org to discuss your individual situation.

A family dental plan is available for members who wish to enroll their spouse and/or dependents in the CUPE 3906 dental plan. Please note that this plan costs $67.85 per month. You can enroll unlimited dependents and receive $2000 worth of coverage for the calendar year. Members are responsible for the additional premiums.

Please note that the eligibility period runs by academic year but the amount of money available to you is determined by calendar year.  This means that if you are only employed for one academic year your coverage will be terminated at the end of that academic year (i.e., August 31st).  If you are returning as a TA the subsequent academic year, your reimbursement funds will not be renewed until January 1st of that academic year.  (Essentially, your coverage will be terminated on August 31st of the last academic year in which you TA and are eligible for dental coverage.)

If you become a member of another unit of the local (e.g., an eligible Unit 3 Postdoctoral Fellow) in a subsequent academic year or term, the amount of money available to you does not get “reset.”


Accessing Your Dental Benefits

To access your dental benefits, bring a copy of the dental booklet (available for download below) and/or the following information to your dental appointment:

Insurance Provider: Equitable Life of Canada
Policy #: 97528
Division #: Division #1
Certificate #: your student ID # (If your dentist requires a 10-digit number, add three zeros to the beginning of your ID number.)

With this information your dentist should be able to process the claim electronically and bill the insurance company directly.

If the dentist cannot process your claim electronically, you will have to pay for your dental work at the time of your appointment then submit a dental claim form (available for download below) for reimbursement. The insurance company will mail a cheque to you at your home address.

Some dentists may require that you pay for the dental work at the time of your appointment even if they can submit the claim electronically. In this case, the insurance company will mail you a cheque to reimburse you for your dental work. The claim will be submitted by the dentist and you will not have to fill out any paper work.

NOTE: The dental plan covers basic dental services such as cleanings and fillings to a maximum of $1000 per calendar year (or $2000 for family coverage). If you require major restorative work such as a crown or a bridge, a non-standard procedure, or one that could cost more than $200, we strongly advise that your dentist submit an estimate to the insurance company, checked against your coverage, before paying anything.

If you have any questions, please check with the union office BEFORE going to the dentist.


Coverage Booklet

Coverage Booklet now includes both single and family coverage:Click here to download dental coverage booklet


Forms

Unit 1 Family Coverage Enrollment 2013-14 & Dependent Information Form: Unit 1 family dental enrollment form SEPT 2013. (These forms are used to add family members to the dental plan). Dependents may only be added during the month of September each year. You cannot add dependents after Sept. 30th unless your family status has changed (e.g. you got married and wanted to add your spouse). Those who start their programs and/or become newly eligible for CUPE dental coverage in January can opt-in to family coverage during the month of January.

Dental Opt-out Form: UNIT 1 DENTAL OPT-OUT SEP 2013 -  The opt-out period runs for the month of September each year. To opt out you must provide proof of alternate coverage with your own name on it. To have your opt-out processed in time for September payroll, you must submit it by September 9, 2013. You cannot opt out after Sept. 30th.

Dental Claim Form – Only use this form if your dentist was unable to file the claim electronically.


FAQs

How do I get in touch with the insurer?

Equitable Life of Canada can be reached at 1-800-265-4556. Remember to have the group policy number (97528), division (1) and your personal certificate number (your student or employee number) on hand. You can also check the status of your claim online by going to the plan member website at www.equitablehealth.ca

How much coverage do I have?

Members are entitled to $1000 per calendar year for basic dental services such as cleanings and fillings.  Members enrolled in family coverage are entitled to $2000 per calendar year. See our dental booklet for a full list of procedures covered.  (Please note that the eligibility year follows the academic year–September 1st to August 31st.   See the “Eligibility” section for more information on this.  If your coverage expires, you are not eligible for reimbursement regardless of how much money you did not claim when you were eligible.)

I am not sure if my dental coverage is current. How do I find out?
Contact administrator@cupe3906.org or drop in to the CUPE office in KTH B111 and speak to Mary Ellen Campbell. You can contact Equitable Life of Canada at 1-800-265-4556. Remember to have the group policy number (97528), division (TAs: 1; Postdocs: 2) and your personal certificate number (your student or employee number) on hand.

I am sure that I qualify for the CUPE 3906 dental plan, but my dental office informed me that I do not have dental coverage.

Dental offices often contact the wrong insurer, especially if they have other patients from McMaster (other groups of employees have different insurers). Your first step should thus be to confirm the insurance information that your dental office has on file. Our insurer is Equitable Life of Canada. The group policy number is 97528. Unit 1 members are part of Division 1. Your personal certificate number (your student or employee number).

If your insurance information is correct, contact administrator@cupe3906.org or drop in to the CUPE office in the basement of Wentworth Hall and speak to one of our staff representatives.

I was employed last academic year/term as a TA at McMaster in my Master’s/PhD program but this year/term I am employed as a TA for a new graduate degree or as a Postdoctoral Fellow.  Does this mean that the reimbursement money that is available to me gets “reset” since I’ve started a new program/job classification?

No.  You receive these benefits as an employee, not as a student, so a change in your student status (as a graduate student) does not “reset” your plan/eligibility amount.  Similarly, a change between your employment status between units (e.g., from TA to Postdoc) does not “reset” your plan/reimbursement eligibility.  At present, our Unit 1 and Unit 3 members are enrolled in the same plan, which is in part why we can offer single coverage at a relatively low premium cost to members.  These kinds of restrictions are typical of premium-based plans and coverage in many workplaces.

Change of Coverage & Family Coverage

Can I opt out of the dental plan after September 30th?

  • Members must opt out of the dental plan during the month of September.
  • Members who are admitted to their program and/or become a CUPE 3906 member in January may opt out during the month of January instead.
  • Members seeking to opt out of the plan outside of these “change of coverage” periods should contact the benefits officer about their individual circumstances.
  • Please note that exceptions are rarely permitted by the insurer

If I opt out of the CUPE 3906 dental plan, will I still have coverage through the GSA?

No, opting out of the CUPE 3906 plan will mean that you do not have dental coverage at McMaster.  In fact, those eligible for the CUPE are not eligible for the GSA plan, and cannot opt-in.

I opted out of the dental plan in September, but have since aged out of my parent’s alternate coverage. Can I opt back into the CUPE 3906 plan?

Yes, you can opt into the CUPE 3906 plan, but you may have to pay back premiums to bring your coverage up to date. Please contact administrator@cupe3906.org for more information on restarting your coverage.

My family member needs dental work done but I missed the opt-in deadline. Can I enroll my family member in the CUPE 3906 dental plan after September 30th?
Exceptions to the change of coverage period can only be made in exceptional circumstances.  Members can opt-in to family coverage outside of the change of coverage period ONLY if there has been a change in their family status (e.g. they got married or their spouse’s alternate coverage was terminated).  To see if your particular circumstances qualify, please contact administrator@cupe3906.org. Members are encouraged to make decisions about their dental coverage needs for the academic year in September.

I want extra dental coverage, can I opt into the GSA dental plan?
No, students with CUPE 3906 coverage are excluded by definition from the GSA plan

Why? The referendum that set up the GSA plan restricted it to graduate students without dental coverage. Another referendum would have to be conducted to extend access to people who have CUPE 3906 coverage.

I want family dental coverage, but the CUPE 3906 premium is too expensive for me. I don’t care about the level of coverage. Can I enroll my family in the GSA plan instead?
You must be enrolled in the GSA plan to enroll your family in a GSA family plan. Students with CUPE 3906 coverage are excluded by definition from the GSA plan.

Why? The referendum that set up the GSA plan restricted it to graduate students without dental coverage. Another referendum would have to be conducted to extend access to people who have CUPE 3906 coverage.

The CUPE 3906 plan is more expensive because it offers a much higher level of family coverage than the GSA plan. All procedures are covered 100% to a maximum of $2000.    A family dental rebate is now available to help differ the cost of the premiums. The amount of the rebate varies depending on the number of people enrolled in the family plan.  Last year’s rebate amount was $480, roughly 64% of the annual premium.

I only want dental coverage for my spouse or one child.  Can I enroll my spouse or child in the GSA dental plan since the CUPE 3906 plan does not offer a similar level of coverage geared towards couples or one child?
You must be enrolled in the GSA plan to enroll your family in a GSA family plan. Students with CUPE 3906 coverage are excluded by definition from the GSA plan.

Why? The referendum that set up the GSA plan restricted it to graduate students without dental coverage. Another referendum would have to be conducted to extend access to people who have CUPE 3906 coverage.

Why is the CUPE 3906 family plan so much more expensive than single coverage?

There are two major reasons for the higher premiums: family coverage is not subsidized by the Employer (single coverage is), there are fewer people in the family plan, which tends to push premium costs up, and the family plan permits members to insure multiple family members for the same rate. The CUPE 3906 plan offers a much higher level of family coverage than the GSA plan. All procedures are covered 100% to a maximum of $2000.

Thanks to our success in bargaining last fall, a family dental rebate is now available to help differ the cost of the premiums. The amount of the rebate varies depending on the number of people enrolled in the family plan.  Last year’s rebate amount was $480, roughly 64% of the annual premium.

How do I access the family dental rebate?
Rebate cheques will be issued to members who are enrolled in the family plan twice each academic year. Members who are enrolled in the plan for the whole year will receive cheques in the fall and winter terms. Members who begin their appointments in January and enroll in the family plan then will receive one cheque in the winter term.  This system was set up to ensure that members who enroll in the winter term were not excluded from the rebate.

Members will be emailed when the cheques are ready for pickup. If you believe that you’re entitled to a rebate but have not heard from us by the end of November or February, please contact the union office or email administrator@cupe3906.org.

Denied Dental Claims

My dental claim was denied. What can I do?

  • Contact the benefits officer at administrator@cupe3906.org or drop by the CUPE office in KTH B111 and speak to one of our staff representatives.
  • The benefits officer or staff rep will be able to serve you better if you know why the claim was denied. If you received an explanation of benefits in the mail, it should state a reason why the claim was not paid out. If you are unsure why the claim was denied call Equitable at 1-800-265-4556.
  • Remember to have the group policy number (97528), division (1) and your personal certificate number (your student or employee number) on hand

How can I find out if the dental plan covered my dental work? 

  • Check on the status of your claim by going to the plan member website at www.equitablehealth.ca or by calling Equitable at 1-800-265-4556.    Remember to have the group policy number (97528), division (1) and your personal certificate number (your student or employee number) on hand.

My dental claim was denied because my coverage was terminated. What should I do?

  • Contact administrator@cupe3906.org or drop by the CUPE office KTH B111 and speak to Mary Ellen Campbell.

Leaves

Do I remain eligible for the CUPE 3906 dental plan while on pregnancy leave?

  • Yes, you remain eligible for dental benefits while on pregnancy leave.
  • Members who qualify for Pregnancy Supplementary Unemployment Benefits (SUB) under Article 19.06 of the collective agreement will have their dental benefits maintained during their pregnancy leave at no cost to them.
  • Members who qualify for CUPE dental but do not qualify for SUB can maintain their dental coverage during their pregnancy leave but must a) inform CUPE of their intentions and b) remit their portion of the premiums to Grad Studies.
  • Members who would qualify for CUPE dental because of a guarantee but do not qualify for SUB must a) inform CUPE of their intentions by September 30 and b) remit their portion of the premiums to Grad Studies.

Do I remain eligible for the CUPE 3906 while on parental leave?

  • Yes, members with CUPE dental are entitled to dental coverage during their parental leave but must remit their portion of the premiums to Grad Studies
  • Members who begin parental leave in September but would qualify for the CUPE dental plan because of a guarantee are entitled to dental coverage but must a) inform CUPE of their intentions by September 30 and b) remit their portion of the premiums to Grad Studies

I was contracted to work for 130 hours or more this academic year, but because will actually work less than 130 hours because of a parental leave. Am I still eligible for CUPE 3906 dental benefits?

 Yes, you are still entitled to CUPE dental benefits but must a) inform CUPE of your intentions and b) remit your portion of the premiums to Grad Studies

Do I remain eligible for the CUPE 3906 dental plan while on sick leave, bereavement leave, jury leave or reservist leave?

  • Yes, members remain entitled to dental benefits while on these temporary leaves
  • Members on sick leave may have to remit their portion of the premiums to Grad Studies after a certain amount of time. Please contact benefits@cupe3906.org about your individual situation.

I was “bought out” of my TAship, will I still have access to the dental plan?

It depends. The dental plan is only open to CUPE 3906 members who have a TA or RA in lieu contract worth 130 hours or more.  When a TAship is “bought out,” it is most commonly converted to a scholarship or some other type of non-Unit 1 work. Members in this situation no longer have access to the CUPE 3906 dental plan. They are enrolled in the GSA plan instead.  In rare situations, a TAship is converted to an RA in lieu instead. In such cases, you would remain eligible for CUPE 3906 dental benefits.  If you are not sure of your status, contact your Department or ask one of the CUPE 3906 staff representatives to look into it.

Coverage Questions

How often can I go for check-ups?  There is a nine-month recall limitation on regular check-ups.  If you are uncertain if your check-up will be covered, please confirm with the Equitable Life of Canada group claims department (1-800-265-4556)  prior to having your check-up performed.

Will the dental plan cover work done in another province?
You can you use your dental benefit in any province within Canada, but the benefit coverage only pays out on Ontario rates. This means that if a procedure costs $200.00 in Ontario, but $250. 00 in BC, the insurance provider would only pay $200.00. More information is available in our single coverage or family coverage booklets.

Does the dental plan cover crowns?
No, the CUPE 3906 dental plan covers basic dental care. Crowns are considered “major restorative” work and are not covered by the plan. More information is available in our single coverage or family coverage booklets.

Does the dental plan cover bridges?
No, the CUPE 3906 dental plan covers basic dental care. Bridges are considered “major restorative” work and are not covered by the plan. More information is available in our single coverage or family coverage booklets.

Please remember that your insurance coverage can be complicated!  When in doubt, ask your dentist to submit an estimate to Equitable Life in advance of any procedures to make sure that something is covered.  The insurance company can require detailed and specialized information about tooth surfaces, procedural codes, etc., to confirm coverage.

Extended Health Coverage

I am graduate student who is excluded from the GSA dental plan because I have coverage through CUPE 3906. What happens to my extended health insurance plan?  Is it through the union as well?

  • All Graduate Students are covered under the GSA Health Plan for extended health benefits. For more information on this plan visit www.ihaveaplan.ca.
  • All CUPE members in Unit 1 (TAs and RAs in lieu) also have access to the following benefits: Vision Care, Childcare, UHIP rebate, and the Hardship Fund. More information is available on our website here: http://cupe3906.org/benefits-forms/unit-1-benefits
  • Questions about the GSA health plan should be directed to macgsa@mcmaster.ca
  • Questions about CUPE 3906 benefits should be directed to administrator@cupe3906.org

I am a graduate student and CUPE 3906 member. Do I have extended health insurance?

Yes, all Graduate Students are covered under the GSA Health Plan for extended health benefits. For more information on this plan visit www.ihaveaplan.ca. Any questions about the GSA plan should be directed to macgsa@mcmaster.ca.

I am TA at McMaster who is not a graduate student. Do I have extended health insurance?

  • CUPE 3906 does not provide extended health benefits to its members.
  • All CUPE members in Unit 1 (TAs and RAs in lieu) have access to the following benefits: Health Care Spending Account, Childcare, UHIP rebate, and the Hardship Fund. More information is available on our website here: http://cupe3906.org/benefits-forms/unit-1-benefits
  • Only graduate students are eligible for the GSA extended health plan
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