Your 2018-19 ETFO ELHT Benefits

September 25, 2018

Dear ETFO ELHT Member,

Welcome to the 2018-19 school year!

Among many things, the start of a new school year means the start of a new benefit year from September 1, 2018 to August 31, 2019. With that in mind there are some important things to be aware of when it comes to your benefits coverage.

Your plan in 2018-19

ETFO ELHT plan rates for the 2018-19 benefit year will not be changing.

Effective September 1, 2018, psychotherapy is covered under the plan, up to $1,500 per benefit year, combined with services provided by a psychologist, marriage and family therapist and social worker. Approved services of a registered psychotherapist incurred on or after September 1, 2018 will be eligible.

If you have opted for supplemental life coverage and have experienced a salary increase, you will see a small increase in supplemental life premiums.

Managing your benefits

As a member of the ETFO ELHT Benefits Plan, managing your benefits coverage, including submitting claims on time and updating your coverage within 31 days of a life change (i.e. birth/adoption of a child, marriage, loss of spousal coverage, change in FTE), is your responsibility.

Learn more about how a life event can affect your benefits coverage and how to make changes to your coverage online.

Did you know there are multiple ways to submit a claim?

You have one year from the date you receive a service to submit a claim through your plan or 90 days after your benefits have ended, if applicable, whichever occurs first.

Always keep your receipts in the event the insurance carrier requires them.

Has your work status changed?

If you are a permanent member who has experienced a change in work status (i.e. return from leave, commencing a leave, change in FTE), you will receive an email from OTIP inviting you to review and update your benefits coverage within 31 days.

New member? Don’t wait to enrol in the plan!

If you have started a new permanent position or an eligible long-term occasional (LTO) position on or after September 4, 2018, you will receive an email to enrol in the ETFO ELHT Benefits Plan. If you do not receive an enrolment email from OTIP to your board email address within four weeks of your start date, please contact OTIP Benefits Services at 1‑866‑783‑6847.

You will have 31 days from the date you receive your email from OTIP to complete your enrolment. If you do not complete your enrolment within 31 days, you will be set up with the default coverage determined by the rules laid out in the plan. The default coverage may be minimal, or in some cases, may result in no coverage.

Your benefit premiums

Benefits and any applicable premiums are effective retroactive to the first day of your eligible work assignment. Members in part-time permanent or eligible part-time LTO positions (i.e. less than 1.0 FTE) are standardly required to pay the pro-rated share of their health and dental benefits premium based on their FTE status. When you enrol or re-enrol on the secure member site, you will see the cost of any monthly premiums that you are required to pay.

If you are enrolling in the plan and are responsible for paying for optional life coverage or pro-rated health and dental premiums, you will have a current month deduction plus a retroactive deduction on the next month’s payroll schedule to catch up on monthly premiums since your eligibility date.

For example, if you started an eligible permanent or long term occasional position on September 4, 2018 and your monthly premium is $55, your total premium payment in October will be $110.

Learn more

Your ETFO ELHT Benefits Plan helps to take care of what’s important to you – your health and your family. For more information about your benefits coverage, eligible expenses, premiums, and how to make claims, please log in to OTIP’s secure member website at www.otip.com.

Wondering if you’re eligible for the ETFO ELHT Benefits Plan? Please visit Am I Eligible to learn more.

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