ACCESSING YOUR DENTAL BENEFITS
FORMS, OPT-OUTs, & FAMILY ENROLLMENTS
If your dentist is unable to electronically submit a claim on your behalf, dental claims can be submitted by emailing them to email@example.com. Members can also upload claims to their online account at www.equitable.ca. To upload your own claims for processing, please go to Equitable.ca, and create an account/log-in with the Policy Number (97528) and your certificate number (your employee number). Follow the directions on the site to create a log-in and submit a claim.
Also, your dentist should be able to submit dental claims for you from the dental office. They simply need your Policy Number (97528), Certificate Number (your employee number) and your division (002 for Postdoctoral Fellows). You can still create a log-in at www.equitable.ca to view updates of your claim status and sign-up for direct deposit.
You can also contact Equitable Life’s Group Claims Department at 1-800-265-4556.
CUPE 3906 provides dental coverage for Unit 3 members (Post Doctoral Fellows). Employee dental rates as of September 1, 2022 are:
SINGLE $7.29 / month
FAMILY $71.94 / month
*Please note that dental benefits are processed through Equitable Life of Canada, not Sunlife.*
*Please also note that dental benefits will expire the day that your contract is over*
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:
Policy #: 97528
Division #: Division #002
Certificate #: your employee ID #
Insurance Company: Equitable Life of Canada
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. You can also go to equitable.ca and sign-up for an online profile to update information such as mailing addresses, and/or arrange to have payment made through direct deposit.
Please make sure that your dentist’s office submits the correct division number for Postdoctoral Fellows (i.e., Division 2). (If your dentist has the incorrect division number, your claim will likely be rejected.)
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.
Normal cleanings and fillings are covered (but there is a nine-month recall limitation for check-ups). If you require a non-standard procedure, or one that could cost more than $200, we strongly advise that you get an estimate, checked by the dentist against your coverage, before paying anything. We encourage you to contact the Equitable Life group claims department (1-800-265-4556) if you are uncertain if your check-up is subject to the recall period limitations.
IMPORTANT! PLEASE NOTE! If you have worked as a CUPE 3906 Unit 1 member (TA or RA in lieu) or as a CUPE 3906 Unit 2 (Sessional Faculty) member in the same academic year (Sept 1-Aug 31) as your Unit 3 (Postdoctoral Fellow Appointment), your $1,000 single (or $2,000 family) entitlement DOES NOT renew as of the start of your Unit 3 contract. TAs, RAs in lieu of TAs, Sessional Faculty, Hourly Rated Sessional Music Faculty, and Postdoctoral Fellows are on the same policy (97528) and you are only entitled to $1,000 for single (or $2,000 for family) worth of coverage per benefit year regardless of the number of contracts you have as a CUPE 3906 Unit 1, Unit 2, and/or Unit 3 member. Please contact us if you have any questions about this.
If you have any questions, please check with the firstname.lastname@example.org BEFORE going to the dentist.
Our Coverage Booklet now includes both single and family coverage: Click HERE for the Dental Coverage Booklet.
*Please note that members who enroll in family coverage are coded as Classification B. (Members enrolled in single coverage are coded as Classification A).
The Unit 3 Family Dental Enrollment Form is used to enroll family members in the dental plan. The 2022/2023 family dental rate is $71.94 per month. This package includes the family plan enrollment form and the dependent information form. (Please see below for the family dental rebate form.) NOTE – You have 30 days after the start of your contract to enroll in the family plan. You will be re-enrolled in family dental automatically each year unless you provide CUPE with a written letter of request to terminate your family dental benefits. Change of coverage requests can only be made during your 30 day change of coverage period (which starts on the first day of your contract or in subsequent years, the anniversary of the first day of your contract) . For instance, if you started your contract on June 1, 2018 your change of coverage period is from June 1 to June 30 every year.
Dental Opt-Out The Dental Opt-Out Form (This form is a PDF that can be filled out on screen. You will need to print out the completed version and sign it before submitting the claim) – NOTE – You have 30 days after the start of your contract to opt-out, after which point you are not able to leave the plan. To opt out you must provide sufficient PROOF OF ALTERNATE COVERAGE with your own name on it (not your spouse’s or your parent’s).
Dental Claim Form – Only use this form if your dentist was unable to file the claim electronically.
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 (002) 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.equitable.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.
I am not sure if my dental coverage is current. How do I find out?
Contact email@example.com or drop in to the CUPE office in KTH B111 and speak to Mary Ellen Campbell. You can also contact Equitable Life of Canada at 1-800-265-4556. Remember to have the group policy number (97528), job title (TA or RA in lieu, Post Doctoral Fellow or Sessional Faculties) and your personal certificate number (your student or employee number) on hand.
How do I sign up for direct deposit and/or create an online profile?
To view updates of your claims, to sign up for direct deposit, and to view/update your personal information with Equitable Life, you need to create a user profile at www.equitable.ca. Go to the top left corner, click “log in” and select “plan member.” This should take you to a page where you can select “active account” as on the right-hand side of the page. Select “plan member”. You will require your name, date of birth, Group Policy number (97528) and certificate number (your student/employee number). Please note! You cannot create a user profile online until your information and premiums have been remitted to the insurance company. If you have questions about the timing of this, please contact firstname.lastname@example.org. Also, you must provide Equitable with your direct deposit information through your online profile if you wish to sign up for direct deposit. Equitable has no way of paying your claims through the McMaster payroll system. *Tip! If you are having trouble logging on, try using your first and middle name as your “first name.”
Equitable Life has my incorrect address. How can I change it?
For a helpful video on updating your person information, please visit: https://www.equitable.ca/en/our-products/group-benefits/how-to-review-and-update-your-information-for-group-benefits/
If you do not have an online profile, you will need to fill out the relevant parts of the following form (i.e., “Plan Member Information”, Part 7, and Part 10) and drop it off a the CUPE 3906 Office (KTH B111): https://cdn.equitable.ca/forms/unsecured/group/438.pdf
*Tip! Equitable receives your address from the Employer. It’s a good idea to make sure that you update your address on MOSAIC.
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 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. Postdocs are part of Division 2. Your personal certificate number is your employee number.
If your insurance information is correct but you are still having trouble making a claim, contact email@example.com or drop in to the CUPE office in the basement of KTH (room B111) and speak to one of our staff representatives.
Can I get my dental work done internationally and have the claims paid by this plan?
No. Equitable will not pay dental claims for expenses incurred outside of Canada. Also, they only pay procedures at the Ontario rate, so if you get dental work done in another province and that province charges for procedures at a higher rate than Ontario dentists charge, you must pay the difference. If possible, get your dental work done in Ontario, and only visit registered practitioners.
Denied Dental Claims
My dental claim was denied. What can I do?
- Contact the benefits officer at firstname.lastname@example.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 (002) 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.equitable.ca or by calling Equitable at 1-800-265-4556. Remember to have the group policy number (97528), division (002) 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 email@example.com or drop by the CUPE office KTH B111 and speak to Mary Ellen Campbell.
Do I remain eligible for the CUPE 3906 dental plan while on pregnancy and/or parental leave?
- Yes, you remain eligible for dental benefits while on pregnancy leave.
- Please contact firstname.lastname@example.org or email@example.com to find out about your options while on pregancy/parental leave(s).
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
- Please contact firstname.lastname@example.org or email@example.com to find out about your options while on leave.
How often can I go for check-ups? There is a 9-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.