Important benefit reminders for end of school year

May 17, 2024

A family outside with son on father’s shoulders

Summer is now just around the corner!

Here are some important reminders to help you with your ETFO Employee Life and Health Trust (ETFO ELHT) benefits coverage during the summer months.

 

Updating coverage for you and your family

Add your spouse/partner or child:* You have 31 days from the date of a life event (e.g. marriage, divorce, common-law qualification, birth/adoption of your child, spouse/partner loses coverage) to add your spouse or child to your plan. Adding your family member before the deadline will ensure they have the coverage they need and avoid being a late entrant/applicant. Missing the 31 days deadline can result in limited or denied coverage.

Add Child Optional Life:* You must do this within 31 days of your child(ren) being eligible (i.e. when you become eligible for coverage upon hiring or the birth/adoption of your child). This benefit cannot be added after the 31 days, even with proof of good health (evidence of insurability).

Confirm coverage for your over-age student (OAD):* Your child is eligible for coverage under the ETFO ELHT plan if under age 21 OR as an over-age student under age 25 if they are a full-time student at an accredited school, college, university or educational institution. If you have an over-age student covered under your plan, you must let us know every year that they need coverage and will be attending school in the fall. You will receive reminders starting in June to complete this confirmation. If you do not complete the confirmation, benefits for your over-age student will end on the earliest of August 31 or the date that your dependant turns 25.

IMPORTANT: In some instances, your over-age dependant may be eligible to maintain their coverage as a disabled dependant (OADD). You will have 31 days after they are no longer eligible for coverage to contact OTIP Benefits Services for next steps.

Update your beneficiary designation: We strongly encourage that you review your beneficiary designation for your life insurance at least once a year or whenever you experience a life event (see above) to ensure your beneficiaries are protected. If a death claim is made and you have not completed the beneficiary designation process, any eligible life insurance will be paid to your estate.

*Check your benefits booklet to confirm if your spouse/partner, natural child, adopted child, stepchild or foster child is eligible for coverage.  

 

Employment ending or retiring

If your employment status is changing soon, here are some important reminders about the impact on your benefits coverage.

NOTE: When you are no longer eligible for coverage under your group benefits plan, please ensure that you inform your pharmacy, dental office and/or service providers to avoid overpayments.

Long-Term Occasional Teachers

If your eligible LTO teacher assignment is ending AND you have health and/or dental coverage under the ETFO ELHT:

  • Coverage ends at 11:59 p.m. on the last day of your eligible assignment.
  • You will receive a communication from OTIP to confirm the date your coverage ended or will end on the last day of your assignment. Claims incurred after that date will not be eligible for reimbursement.
  • You will have 90 calendar days from the date your coverage ends to access OTIP’s plan member site and submit any eligible claims incurred up to and including your last day of coverage. All eligible claims received after this 90-day period will be declined.

Retirement

Congratulations on your retirement!

  • Coverage ends at 11:59 p.m. on the date of your retirement (e.g. If you retire on March 31, coverage ends at 11:59 p.m. on March 31; if you retire on June 30, coverage ends at 11:59 p.m. on June 30)
  • You will receive a communication from OTIP to confirm the date your coverage ended or will end. Claims incurred after that date will not be eligible for reimbursement.
  • You will have 90 calendar days from the date your coverage ends to access OTIP’s plan member site and submit any eligible claims incurred up to and including your last day of coverage. All eligible claims received after this 90-day period will be declined.
  • Looking for retiree health insurance options? One of your options is to check out OTIP’s health, dental and travel insurance options for retirees at otip.com/for-retirees, or call OTIP at 1-800-267-6847.

Life Conversion

If you are retiring or your eligible LTO teacher assignment is ending: You may be eligible to convert your group life insurance (if applicable) to an individual policy without having to provide evidence of good health or undergo a medical exam, provided you do so within 31 calendar days of your coverage ending.

To learn more about converting any group life insurance to an individual policy, you can review the description for the Group Benefits Life Conversion Option form (found under Life Insurance forms).

 

Frequently asked questions

How do I update my email address over the summer?

Your board email address may be your default email address for OTIP notifications. Consider updating your preferred email address to your personal email. This way, you won’t miss any important information concerning your benefits over the summer.

How do I update my personal information?

If your mailing address, phone number or name changes, it is important that you update this information with your employer as soon as possible. This ensures that your employer reports the most up-to-date information to OTIP. Please note that it may take a few weeks for the update to be reflected in our system.

I’m going on a leave in the 2024-25 school year – what do I need to do?

Keep an eye out for an email from OTIP in the fall to review and update your benefits

How long do I have to submit my health and dental claims?

Make sure that you submit your health and dental claims on time to ensure you will be reimbursed. As an active plan member, you have up to 12 months to submit an eligible claim from the date it is incurred. If your coverage has ended, you have 90 days to submit claims incurred on or before the last day of your coverage.

How do I submit an estimate for expensive health and dental products/services?

Just like any other big-ticket item you purchase, you should ‘shop around’ for the best available option and get an estimate on any potentially expensive claims. This will help you to plan and will also minimize surprises and disappointment if your claim is not eligible for full or partial reimbursement.

 

Important resources

  • Check your coverage: For up-to-date details on your plan, including coverage amounts for paramedical, vision and dental services, check your benefits booklet on the OTIP plan member site. You can also check your remaining balances for health and/or dental services.
  • Your benefits card contains important information, including your plan member details and emergency contact information. You can print or download additional copies of your benefits card for yourself or your eligible dependants from the OTIP plan member site.
  • Looking for assistance with your claims, coverage, and administrative benefit needs? Call OTIP Benefits Services at 1-866-783-6847, Monday to Friday, 8 a.m. to 7 p.m. (ET).

We wish you a safe and happy summer vacation!

Questions?


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