MCMASTER UNIVERSITY

The MSU Dental Insurance plan covers full-time undergraduate students at McMaster University enrolled in 18 units or more.
Coverage runs from September 1st to August 31st.
Through contractual agreements, the following McMaster students are also covered:
• Midwifery Students
• MBA Students
• Commerce Internship Students
• Undergraduate Medical Students
Part-time Students may opt into the MSU plan. Please visit the MAPS website for more information.
Graduate Students are NOT covered by this plan. Please see GSA section for graduate students’ coverage.

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McMaster Undergraduate Student Dental Plans

$600 Maximum

Basic & Preventative Services

• 80% of one examination and consultation, including any necessary x-rays and diagnostic services at time of exam, during each policy year. (100% at Westdale Dentistry)
• 80% of one cleaning and one unit of polishing; includes up to 4 units of scaling (above the gum line) (100% at Westdale Dentistry)
• Fluoride treatments will be limited to one per policy year.

Minor Restorative

• 50% of the cost of amalgam, silicate, composite or tooth-coloured fillings and space maintainers. (75% at Westdale Dentistry)

Extractions and Oral Surgery

• 50% coverage of extractions and residual root removal including wisdom teeth (limit of two per policy year). (75% at Westdale Dentistry)

Other

• Endodontics, Periodontics, and Major Restorative are covered at 10%. (35% at Westdale Dentistry)

Graduate Student Association (GSA) Dental Insurance Plan offers various dental coverages, including teeth cleaning, repair, and other services. Your Plan will cover at least 70% of your dental costs.

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1.Dental Coverage:
$750 per policy year for dental visits

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2.Dental Accident:
Repair/replacement of natural teeth damaged through an external accidental blow to the mouth

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3.Studentcare Dental Network:
Studentcare Dental Network members offer 20% to 30% off dental services

FREE Take-Home Teeth Whitening Kit

For New Patients with New Patient Exam and Cleaning. Conditions Apply!

Dental Benefits

McMaster GSA Dental Plan Coverage Chart

Insured Portion1 Studentcare Dental Network Savings Total Coverage
Preventive Services
– Recall exams2
– Cleanings2
– Extraction of impacted teeth3
70% 30% 100%
Basic Services
– Fillings4
– Oral surgery
– Endodontics (root canal)
– Periodontics5 (gum treatment)
70% 20% 90%
Major Restorative
– Crowns
– Vridges
– Posts
Not Covered 20% 20%

The maximum paid by Sun Life Financial per policy year on the insured portion of the Dental Plan is $750.

1.Percentage of Provincial Dental Fee Guide Cost for General Practitioners (in the province where service was performed).

2.Recall exams, cleaning/polishing, bitewing x-rays, oral hygiene instruction and the application of fluoride are covered once per 9 months. Scaling and root planing are both covered up to 4 units per policy year. A complete exam (sometimes called a new patient exam) is only covered once per 36 months.

3.The extraction of impacted teeth is considered to be part of preventative services by Sun Life. The Studentcare Dental Network reduction, however, will be 20% as this is considered oral surgery in the Provincial Dental Fee Guide for General Practitioners.

4.Fillings in amalgam (metal) are covered for all teeth. Composite (white) fillings are covered for the front teeth and pre-molars only. If you choose to have your back (posterior) teeth filled in composite, your claim will be reimbursed according to the amalgam fee.

5.Certain maximums exist. Contact Studentcare for more details.

Certain exclusions and limitations may apply. Prior to dental treatment for work that is expected to cost $300 or more, students should submit a treatment plan (obtained from your dentist) to Sun Life Assurance Company of Canada for approval.

Note: Services performed by an orthodontist aren’t covered by the Dental Plan.

CUPE 3906 Dental Plan

CUPE 3906 provides dental coverage for Classification A Unit 1 members (excluding TAs and RAs in lieu who do not hold an undergraduate degree) who have a TAship or RAship in lieu of a TAship within the current academic year. 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 (unless otherwise specified by the GSA). 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 Sessional Faculty or Postdoctoral Fellow member) in the subsequent academic year, your reimbursement funds will not be renewed until January 1st of that academic year.
*IMPORTANT! *Please note that the Employer will ONLY collect your individual dental premium contributions from your TA/employment pay (NOT your academic funding). The Employer will deduct the entire year’s single premium costs from the first pay of the year.
*IMPORTANT! BLACKOUT PERIOD *Please note that claims that are submitted in September may be initially rejected by the insurance company even if you are eligible for dental benefits. This is likely due to a payroll processing delay and benefit enrollment period and has nothing to do with your eligibility. Alternatively, if you are not receiving employment payment as TA/RA in lieu in the fall term you will not appear on Equitable Life’s eligibility list [and will have to submit your claims in the winter and/or spring/summer term(s)]. If you meet the eligibility criteria and your claim is rejected, please contact administrator@cupe3906.org. All eligible members may experience a delay in their receipt of reimbursement cheques for claims made 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).

FAQs for CUPE 3906 Members

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.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. (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. 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 Facultys) 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 administrator@cupe3906.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. Unit 1 members are part of Division 1. (Postdoctoral Fellow members are part of Division 2.) Your personal certificate number is your student number (or, for Postdoctoral Fellows, your employee number).
If your insurance information is correct but you are still having trouble making a claim, contact administrator@cupe3906.org or drop in to the CUPE office in the basement of KTH (room B111) 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 Sessional Faculty or 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. As of September 1, 2018, all of our Units 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.

Why am I seeing premium deductions over multiple pay statements?

You should only have the single dental premium deducted once per academic year. When the deduction is made, it will show up in the “current deduction” column of your pay statement. The Employer dental benefit contribution appears in the column that also lists statutory contributions that the Employer must pay on your behalf. (Please note that you are not being charged/deducted the amounts shown in the Employer contribution column.) Your premium deduction will likely show in the “year-to-date” column of your pay statement until the end of the calendar year, but no further current “CUPE Dental” deductions should appear in the “current” deduction column for the remainder of the academic year. (If this happens, please contact our Staff.)

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.

How can I get outstanding dental claims paid?

• The easiest way to get eligible expenses paid from an outstanding claim is to have your dentist resubmit the claim electronically to Equitable Life of Canada.
• If your dentist is not willing to resubmit your claim, ask them to give you/send you a copy of your claim. Please note that a claim is not the same thing as a receipt. A claim lists precise tooth surface codes and procedural codes (in addition to the cost) that are not listed on a receipt. The insurance company needs these codes to pay out eligible claims. Your dentist’s office should be aware of the difference between a copy of the claim and a receipt.
• You can submit the claim yourself online if you have created a profile at www.equitable.ca. (For instructions on how to create a profile, please see below).
• If you are unable to submit the claim online, you can email a copy of the claim to administrator@cupe3906.org and request to have the Local submit the claim for you. This might add a bit of time to the process.
• Alternately, you can email the claim to Equitable Life of Canada at group-dental-claims@equitable.ca. We have been informed that Equitable prefers to receive forms through the online profile, so it’s best to try to create a profile and submit a claim through the website before trying this method.
• TIP! Please make sure that your personal contact information (e.g., mailing address) is up-to-date on the claim form. Many payments go missing because the dentist has an old address on file.

• TIP! Make sure that you have the correct coverage information. The Policy number is 97528. The Certificate Number is your student/employee number. The Division is 001 for TAs, 203 for Sessional Faculty, and 002 for Postdoctoral Fellows. The Employer is McMaster University. The plan holder is CUPE Local 3906.

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 administrator@cupe3906.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.”
For more information, please visit CUPE 3906 Website.

MOHAWK COLLEGE

MSA Dental Plan Coverage Chart

Insured Portion1 Studentcare Dental Network Savings Total Coverage
Preventive Services
– Recall exams2
– Cleanings2
70% 30% 100%
Preventive/Basic Services
– Extraction of impacted teeth
50% 20% 70%
Basic Services
– Fillings3
70% 20% 90%
Basic Services
– Oral surgery
– Endodontics (root canal)
– Periodontics (gum treatment)
20% 20% 40%
Major Restorative
– Crowns
– Bridges
– Posts
Not Covered 20% 20%

You have access to preventive care with a Plan that offers up to $750 in coverage for dental visits per policy year.
The policy year is from Sept. 1 – Aug. 31.
Your Plan covers 20% to 70% of your dental costs and by visiting a Studentcare Dental Network member, you’ll receive an additional 20% to 30% off dental services. This enables you to have up to 100% of your dental costs covered by the Dental Plan.
The maximum paid by Sun Life Financial per policy year on the insured portion of the Dental Plan is $750.

1.Percentage of Provincial Dental Fee Guide Cost for General Practitioners (in the province where service was performed).

2.Recall exams, cleaning/polishing, bitewing x-rays, oral hygiene instruction, and the application of fluoride are covered once per 12 months. Scaling is covered up to 2 units per policy year. A complete exam (sometimes called a new patient exam) is only covered once per 36 months. A complete set of x-rays or panorex x-rays is covered once per 36 months.

3.Fillings in amalgam (metal) are covered for all teeth. Composite (white) fillings are covered for the front teeth and pre-molars only. If you choose to have your back (posterior) teeth filled in composite, your claim would be reimbursed according to the amalgam fee.

Certain exclusions and limitations may apply. Prior to dental treatment for work that is expected to cost $300 or more, students should submit a treatment plan (obtained from your dentist) to Sun Life Assurance Company of Canada for approval.

Note: Services performed by an orthodontist aren’t covered by the Dental Plan.