WHO IS ELIGIBLE FOR COVERAGE?

As a full time student, under the age of 70, registered in any term, you are automatically covered for that term under this Plan, provided you are covered by your provincial health plan or have an OHIP equivalent plan.

WHEN WILL I RECEIVE MY DRUG CARD?

Cards can be picked up during bus pass distribution or at the SOGS Office. The drug cards will not be activated until mid-October, after the Opt-Out process is completed.

HOW DO I MAKE A DENTAL CLAIM?

To make a dental claim, obtain a completed Standard Dental Claim Form from your dentist's office and submit it to the SOGS Office. Your dentist can send your dental claim electronically to RWAM Insurance Administrators Inc. using carrier ID#610616 and referring to Group Policy Number 490010 and your student number.

CO-ORDINATION OF BENEFITS (COB)

Where you or your dependents have coverage with more than one carrier, claims shall be coordinated so that reimbursement from all coverages shall not exceed 100% of the actual claim.  Please contact Olga Sauer for more information.

If both the Student and their spouse have group insurance benefits, then claims must be submitted to the primary carrier first. Your claim would be sent to RWAM and his/her spouse’s claims would be sent to their insurance carrier for reimbursement.

Any claims for children are to be reimbursed under the parent whose date of birth falls first in the calendar year. If any portion of any claim is not reimbursed by the primary carrier, the remainder can be sent to the spouse’s insurance company for consideration.

In situations where parents are separated/divorced, the following order applies:

i.        the plan of the parent with custody of the child,
ii.        the plan of the spouse of the parent with custody of the child,
iii.        the plan of the parent not having custody of the child,
iv.        the plan of the spouse of the parent not having custody of the child.

In situations where more than one source of insurance exists, priority goes to:

i.        the plan where the individual is an active full-time employee,
ii.        the plan where the individual is an active part-time employee,
iii.         the plan where the individual is a retiree

WHAT IF I ALREADY HAVE HEALTH AND DENTAL CARE COVERAGE?

This plan has been designed as a supplement to existing Health Care Insurance.

This plan is not a replacement for the Provincial Health Insurance Plan. Check carefully the benefits offered under this plan. Many students find that this plan, when combined with their existing plan, provides more complete coverage. The deadlines for opting out are:

•  1st term - by September 30
•  2nd term - by January 31
•  3rd term - by May 31

In order to opt-out, you must provide proof of alternative health insurance, this is not provincial health, but a privately purchased benefit plan. If approved, you will receive a cheque once the opt-out period is completed.

Students who wish to waive benefits must provide proof of alternate coverage. Opt Out forms are available in the SOGS Office or online at http://uwo.ca/sogs/Benefits/Forms/OptOutForm.pdf

HOW DO I REMIT AN EXTENDED HEALTH CARE CLAIM?

For prescription drug claims you simply present your Drug ID Card to a pharmacist. You will be responsible for 20% of the cost of the prescription. The pharmacist will deal directly with the drug card provider for the remaining 80%, using the prefix SOG and your student number. Should the pharmacist encounter any problems when submitting a claim, ask the pharmacist to call 1-888-711-1119 for confirmation.

All other claims must be submitted to the SOGS Office on a Claim for Health Expense Benefits form. Please ensure that your Student ID number and date of birth are shown on the claim form.

IMPORTANT: To speed up claim service, you must attach ALL original receipts and ensure that the claim forms are completed in full. All claims must be submitted within 90 days of your termination date.

Accidental claims will be paid on a reimbursement basis and are to be sent through the SOGS Office.

WHEN DOES MY COVERAGE BEGIN?

As an eligible student your coverage starts September 1, 2008 and will continue until August 31, 2009 for September enrolments. For second semester students, your coverage period is January 1, 2009 to August 31, 2009. For third semester students, your coverage period is May 1, 2009 to August 31, 2009. Time is required to co-ordinate the student enrolment and coverage will not be active until after the opt-out process is complete.

IF I AM NOT REGISTERED IN THE FALL TERM BUT AM REGISTERED AS FULL TIME IN THE WINTER OR SPRING TERM CAN I STILL BENEFIT FROM THIS PLAN?

Provided that your SOGS second term fees have been assessed and paid for, you may be eligible for benefits for an 8 month period commencing January 1, 2010. If third term fees have been assessed and paid for, you may be eligible for a 4 month period commencing May 1, 2010.

Also, provided your SOGS fees have been assessed and paid for, you may be eligible for benefits commencing with your first term of enrolment.

IS DEPENDANT COVERAGE AVAILABLE?

Yes. However, you must pay an additional fee. You can enroll your spouse and dependant children in the SOGS Office.

Dependants include common-law/same sex spouses with whom you have been cohabitating with for a period of 12 months. Dependant children are eligible up to the date they turn 21 or 25 if enrolled and in full-time attendance at an accredited college or university. Family coverage forms are available in the SOGS Office and online at http://uwo.ca/sogs/Benefits/Forms/OptInFamilyForm.pdf

The deadlines for adding family coverage are:

• for students enrolling in the 1st term - by September 30
• for students enrolling in the 2nd term - by January 31
• for students enrolling in the 3rd term - by May 31

WHERE CAN I FIND INFO ON LIFE INSURANCE?

Should you require information or quotes with regards to Life Insurance, please contact:

Drew Martin

6-22425 Jefferies Road

Komoka, ON

N0L 1R0

1-888-918-5056

drew.martin@campbellandco

An active student on the Health and Dental Plan has 1 year to submit a claim after a service has been rendered.  A student who has graduated, and their coverage has terminated, they have 3 months to submit any eligible claims for reimbursement.