Health and Dental Forms, Benefits and Card

1. Individual Opt-In Form (.pdf format) (Fall 2014)

To add yourself to the plan, you must return this form to the Graduate Students' Union (GSU) by Wednesday, September 24th, 2014.

2. Family Opt-In (.pdf format) (Fall 2014)

Family coverage is renewed every September, for the full academic year (please see table cost). Limited exceptions apply, if you require more information please contact the GSU by Wednesday, September 24th, 2014.

You and your dependents need to be covered by a provincial medical plan (e.g. MCP, OHIP) in order to enroll into the GSU Health plan (please be ready to show your provincial health insurance card if requested).

Electronic forms of payment are available between 9:00am to 12:00pm, Monday-Friday at the GSU office (GH-2007, Feild Hall).

3. Individual Opt-Out Form (.pdf format) (Fall 2014)

To opt out of the GSU Health and/or Dental Plan(s) students will need to have alternate comparable health and dental coverage to that offered by the GSU (e.g. spousal, parental, etc.). You must return the completed form and supporting documentation (i.e., proof of existing coverage) by Wednesday, September 24th, 2014 to the Graduate Students’ Union.

*** Documentation of existing coverage must clearly show your name, the name of the Insurance Company providing the coverage, the policy number and main benefits (i.e. health, dental, drug, etc). Acceptable documentation is a certificate from the insurance company, a copy of your insurance policy or the membership card of your current plan. You must return the completed form and documentation, by the deadline, to the Graduate Students’ Union in person, by fax or email in order to be opted out of the plan(s) starting in the Fall 2014 semester. ***

In person: GSU office (GH-2007, Feild Hall) – 9am to 3pm, Monday to Friday.

Fax: 1.709.864.3395

Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

 

Health and Dental Claim Forms

Health and Dental Claim Forms are available in the GSU Office, or can be obtained online.

Please go to: Green Shield Canada Student Centre

1) Select your school and student union (Memorial University of Newfoundland and GSU).

2) On the top of the page select the “What you need” tab and select “Forms”.

3) You can then select the appropriate claim form. For example, to claim prescription medication - “General”.

4) All you need is to fill in the appropriate sections and send it to Green Shield (address is shown on the form), together with the original pharmacy receipt. Make sure to keep a copy of all documents.

5) You will either receive a cheque for the covered items or, you can set-up automatic payments. You can do this at the Plan Member Online Services

 

Benefits Booklet

To check what services and benefits are covered under your plan(s) please go to: Green Shield Canada Student Centre

1) Select your school and student union (Memorial University of Newfoundland and GSU).

2) On the top of the page select the “What you need” tab and select “What does my plan cover?”.

3) You can then select the tab - “Take a look at your benefit booklet

4) This will allow you to look at the most updated “Benefit Plan booklet” and see what services are covered as well as the limitations and coverage exceptions.

5) Also, we advise students to call Green Shield customer service to check on a specific service. They are very helpful and provide a much more accurate estimate of what is covered or not.

Customer Service Line: 1.888.711.1119

 

NOTICE: GSU Health and Dental Plan – Dental Cleaning Coverage

Due to a number of recent concerns brought to our attention, the GSU has decided to clarify the GSU Dental coverage regarding Dental Recalls/ Routine Dental Cleanings.

The GSU Dental plan covers a Dental Cleaning 100% every six months. Please be advised that included in the Cleaning/Dental recall there is only one unit of scaling covered 100% by Green Shield, any units of scaling beyond that are only covered 10%, while 90% is co-paid (paid by the student/member). This is because additional scaling units used during a routine cleaning or during a periodontal cleaning are considered to be a comprehensive basic service and therefore only 10% covered by Green Shield.

We advised students to always double check with Green Shield for eligibility for a dental recall/cleaning. You can do this by either:

1) Visiting the Plan Member Online services and logging in to your member page (on the right corner). You can then check the Eligibility for a Dental Recall Exam in the Benefit Eligibility Menu.

2) Or, by calling the Green Shield Customer Service number 1.888.711.1119. They will ask you for your membership number to confirm identity and will be able to provide you with the most updated and detailed information regarding your coverage.

Furthermore, we advise students to request a quote from their dentist office for any services for which they are not sure of coverage details, in order to avoid unexpected costs. Your dentist can access this information much quicker and easier than you. In this quote it should be clear what amount is covered by the insurance (Green Shield) and what amount is co-pay (paid by the student/member) for each individual item in a particular service.

If you have any questions please let us know,

GSU

In person: GSU office (GH-2007, Feild Hall) – 9am to 3pm, Monday to Friday.

Phone: 1.709.864.4395

Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

 

Health and Dental card

Green Shield no longer supplies us with physical cards, here is what you do to print your card:

Go to: Green Shield Canada Student Centre

1) Select your school and student union (Memorial University of Newfoundland and GSU).

2) On the top of the page select the “What you need” tab and select “My ID card”.

3) You can then select the option “Create my ID card

4) Fill in your name and Green Shield member number (GSU[your MUN student number]-00). If you have family insurance you can fill your dependent’s information on the back of the card.

5) You can then print your card.

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