Overview

Formulary Drug Coverage 100% of formulary drugs, member and dependent, to a max of $2,000 per calendar year
Dental Coverage - Basic 100%, member only, to a max of $2,000 per calendar year
Basic Life Insurance
2x of annual earnings rounded to the next highest $1,000 to a maximum of $500,000
Business Travel Accident Insurance For travelling on authorized university business, $100,000

Life Insurance

Basic Life Insurance Plan
The Basic Life Insurance Plan provides a lump sum benefit to your beneficiary in the event of your death.

Benefits
In the event of your death from any cause at any time or place while you are insured, your beneficiary or estate will receive:

  • 2 times basic annual earnings, adjusted to the next higher $1,000 (if not already a multiple of $1,000) subject to a maximum benefit of $500,000.

Death benefits may be paid in one lump sum or, if elected, under settlement options offered by Sun Life.

Beneficiary
When you become eligible for the Basic Life Insurance plan, your beneficiary designation will automatically be your estate. You may change your beneficiary at any time by completing a Beneficiary Nomination form available upon request from Human Resources. Any nominations you make are revocable, unless prohibited by law or you stipulate otherwise.

It is your responsibility to keep your beneficiary designation up-to-date.

Disability Provision
If you become totally disabled before your 65th birthday and are unable to work at your own or any other job, you may apply to have your Basic Life Insurance continue without payment of premium until you recover, retire or on your normal retirement date. Application must be made before the end of your first year of disability. You will be required to submit medical proof of your disability. Any amount of insurance continued is subject to the terms of the group contract.

Conversion Privilege
If your Basic Life Insurance is reduced (e.g., because your hours are reduced) or terminated (e.g., because you retire or terminate employment), your coverage will be continued without cost for a 31-day conversion period. During this time, you may convert your coverage to an individual policy without providing medical evidence. For information on conversion, contact Human Resources for the insurance company agent’s name and phone number within the 31 day conversion period.

In the event of your death, during the 31-day conversion period, the full amount of your coverage will be paid to your beneficiary or estate.

Claims
In the event of your death, Human Resources will assist your beneficiary or executor in submitting a claim. Claims should be submitted as soon as possible.

Government Plans

Canada Pension Plan
A lump sum death benefit may be payable to your spouse or estate. In addition, a survivor’s pension may be payable to your spouse or an orphan’s pension may be payable to your dependent children.

Workers’ Compensation
If your death is the result of a work-related accident, a lump sum death benefit will be paid to your spouse. In addition, a specified monthly amount may be paid to your spouse or dependent children.

Business Travel Accident Insurance

Business Travel Accident Insurance Benefits
In the event of your accidental death while travelling on authorized university business, your estate will receive $100,000. This benefit is in addition to other life and accident insurance benefits which may be payable.

There is an overall maximum of $500,000 payable for all losses resulting from the same accident, regardless of the number of insured persons involved. In the event of a single accident resulting in the death of more than one employee, the benefit will be pro-rated among the estates within the $500,000 maximum.

Benefits are also provided for accidental loss of limb, sight, or hearing while travelling on authorized university business. These benefits are detailed in the Specific Loss Accident Indemnity section of the Business Travel Accident Insurance Plan policy.

The Corporate Administration Office has the necessary claim forms and will provide assistance in completing them.

Business Travel does not include everyday travel to and from work.

Dental Plan

The Dental Plan will reimburse you for 100% of basic dental services, up to a maximum of $2,000 per year.

The plan has no deductible. Dependants are not covered for dental benefits.

For each dental procedure, only reasonable expenses will be covered, up to the usual charge for the most economical alternate procedure, service or treatment consistent with accepted dental practice. See exclusions and limitations below.

Pre-Treatment Plan

If your dentist recommends any dental procedure that is expected to cost over $500, you should have your dentist complete a pre-treatment plan. Submit this plan to the insurer, and you will be advised of the benefits payable for the course of treatment.

Submitting a pre-treatment plan ensures that there are no misunderstandings about what reimbursement you will receive for expensive courses of treatment.

Fee Guide: The current fee guide for general practitioners approved by the Dental Association in the employee's province of residence.

Basic Services

Basic Services include the following Preventive dental procedures and Basic Procedures:

Preventive dental procedures

  • complete exam once every 36 months
  • recall exam once every five months, to a maximum of two exams per benefit year
  • emergency or specific exams limited to two per benefit year per type of exam
  • complete series of X-rays OR one panorex once every 36 months
  • bitewing x-ray once every five months, to a maximum of two sets per benefit year
  • radiograph to diagnose or examine progress
  • required consultations with another dentist
  • polishing/cleaning and topical fluoride treatment every five months, to a maximum of two per benefit year
  • emergency or palliative services
  • diagnostic tests and lab exams
  • removal of impacted teeth and anaesthesia
  • space maintainers for primary teeth
  • pit and fissure sealants
  • oral hygiene instruction once per benefit year

Basic procedures

  • fillings:
    • amalgam (silver)
    • composite (white) on all teeth − acrylic (replaced by composite)
  • removal of teeth (except impacted teeth)
  • prefab metal restorations/crowns and repairs (not custom made)
  • endodontics (root canal therapy/fillings, treat disease of pulp tissue)
  • periodontics (treatment of bone and gum disease)
    • root planing and scaling (8 units each per year)
    • occlusal adjustment
    • provisional splinting
    • supplies usually intended for sport use (eg. mouthguards)
    • transplants and repositioning of the jaw
  • surgery and related anaesthesia (except removal of impacted teeth)
  • repair of bridges or dentures
  • rebase or reline denture

General Exclusions and Limitations

Sun Life will not pay for services or supplies payable or available (regardless of any waiting list) under any government-sponsored plan or program unless explicitly listed as covered under this benefit.

Sun Life will only pay for a procedure that has a reasonably favourable prognosis in the opinion of Sun Life.

Sun Life will not pay for:

  • procedures performed primarily to improve appearance.
  • the replacement of dental appliances that are lost, misplaced or stolen.
  • charges for appointments that a person does not keep.
  • charges for completing claim forms.
  • services or supplies for which no charge would have been made in the absence of this
  • coverage.
  • procedures or supplies used in full mouth reconstruction (capping all of the teeth in the mouth), vertical dimension corrections (changing the way the teeth meet) including attrition (worn down teeth), alteration or restoration of occlusion (building up and restoring the bite), or for the purpose of prosthetic splinting (capping teeth and joining teeth together to provide additional support).
  • charges related to the temporomandibular joint (TMJ) treatment, except otherwise indicated in the list of covered expenses.
  • experimental treatments.

Sun Life will also not pay for dental work resulting from:

  • the hostile action of any armed forces, insurrection or participation in a riot or civil commotion.
  • dental services required due to congenital malformation.
  • participation in a criminal offence.

Formulary Drug Coverage

Benefits

The Formulary Drug Plan will reimburse you and each of your eligible dependents for 100% of formulary drugs, to a maximum of $2,000 per person per calendar year.

The plan has no deductible.

Eligible dependents

Your dependents are eligible for Formulary Drug Coverage. Learn who your eligible dependents include.

Covered Formulary Drugs

The Plan reimburses prescribed formulary drugs which:

  • have been approved by the Federal Drug Information Division, Health Protection Branch, for resale by licensed retail pharmacies,
  • have been assigned a drug identification number in Canada,
  • are listed in the current Saskatchewan Prescription Drug Plan Formulary,
  • have been prescribed by a physician or dentist and dispensed by a licensed retail pharmacy or attending physician, and
  • are not normally available over the counter.

Sun Life will cover the cost of the following generic drugs and supplies that are prescribed by a doctor or dentist and are obtained from a pharmacist. As mandatory generic substitution is a feature of your drug plan, the plan will only reimburse your prescription drugs up to the lowest priced (usually generic) equivalent, if one exists.

There may be valid medical reasons for not substituting your brand name drug with a lowest priced equivalent. If so, you and your doctor will need to complete a Drug Exception Application form. If the reasons are accepted by Sun Life, the plan will cover the cost of the brand name drug. Drugs covered under this plan must have a Drug Identification Number (DIN) in order to be eligible.

General Exclusions and Limitations

Anti-smoking drugs are limited to a six month supply, once per lifetime.

Benefits will not be payable for charges in connection with the following:

  • non-formulary drugs,
  • vitamins, dietary aids, experimental drugs, fertility drugs, Rogaine, and any other drug required for cosmetic purposes,
  • Services covered by the Canada Health Act, Saskatchewan Medical Care Insurance Act, or Saskatchewan hospital Services Plan as of July 1, 1991 whether such services continue to be provided pursuant to legislation.
  • Medical examinations or routine general checkups required for the use of a third party.
  • Charges for rest cures, convalescent care, custodial care, rehabilitation services in a hospital for the chronically ill or a chronic care unit of a general hospital, of Sun Life, proper treatment should be in a chronic care unit or institution for the chronically ill.
  • Charges relating to elective services obtained by a participant outside his province of residence when his provincial government health care programs have not accepted liability for those items normally covered in the participant’s province of residence.
  • Any services and supplies to which the participant is entitled under any Workers’ Compensation statute or any other legislation.
  • Charges which normally would not be made if the participant were not covered by this plan.
  • Services for cosmetic purposes or conditions not detrimental to one’s health.
  • Any services and supplies normally available without cost, or at a nominal cost, under any government statute on the effective date of this plan.
  • Mileage and/or delivery charges to or from a hospital, physician, dentist or other provider of services and supplies.
  • Services in connection with an injury or disease resulting from riot, insurrection or war, whether war be declared or not. This includes any condition caused directly or indirectly by any armed forces.
  • Any item or service not listed as a benefit in this plan.
  • Medications restricted under federal or provincial legislation which are prescribed and/or dispensed despite such regulations.
  • Registration charges or non-resident surcharges in any hospital.
  • Services required as a result of attempting to commit a criminal act.
  • Services performed by an unqualified practitioner.

Coordination of Benefits

If you and your eligible dependents are covered for similar benefits under two plans, you can maximize the amount of money you get back by coordinating your benefits.

Claims

View claim procedures including coordination of benefits and submission deadlines.

Coverage and Eligibility

Eligibility

Eligibility to participate in benefit plans is based on your job status and/or the length of appointment. 

Qualifying Period 
The initial qualifying period is 26 consecutive weeks of employment from your date of hire.

Commencement of Coverage

  • Your coverage begins after you have worked at least 390 hours during the initial qualifying period, or 780 hours in a 12 months period.
  • Employees who are eligible will be notified by Connection Point.
  • Please note that, notwithstanding any other plan provisions, you must be actively at work during a month in order to be covered by the benefits plan for that month.

Your coverage status will be reviewed at the end of each full calendar year. In order to remain eligible for coverage, you must have worked at least 780 hours during the previous calendar year (January-December).

Cost of Coverage 
Cost sharing of your benefits coverage will remain consistent with that of the full-time group. You may be required to contribute to the cost of the plans by payroll deduction.

Learn more about:

  • Eligibility and effective date of coverage for you and your dependents.
  • Termination of Coverage
  • Converting your benefits to an individual plan
  • Proof of Coverage for Health and Dental Benefits
  • Premiums

This description is intended as a summary of the benefit plans sponsored by the University of Saskatchewan. In the event of any misunderstanding or discrepancy, benefits will be paid according to the terms of the official plan documents and applicable legislation.

Getting Help

Sun Life Customer Call Centre

Sun Life has a Customer Call Centre that provides information directly related to your benefits, claims submitted and status of your claim. Other questions or scenarios that Sun Life can assist with are:

 1-800-361-6212 during the work week from 8am to 8 pm EST.

Or connect online through your MySunLife account. Visit www.mysunlife.ca and enter your access ID and password. 

Connection Point 

Types of questions Connection Point can assist with:

Come See Us 
Arts Building, Room 258
Monday to Friday, 8:00 am to 4:30 pm

(306) 966-2000
1-844-697-4865 
 connectionpoint@usask.ca