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Frequently Asked Questions

• Who administers the Health Care Spending Account (HCSA)? What is the policy number of this plan?
• What happens if I elect to change my participation from single coverage to family coverage or from family coverage to single coverage?
• Where do I get the claim forms?
• I previously waived participation or would like to increase my level of coverage in the Optional Life Insurance plan, how do I enroll into this plan now?
• Where can I find the Benefit Application Change Form?
• Is there any circumstances in which I can increase my level of coverage in the Optional Life Insurance plan without a medical questionnaire?
• I have been appointed a regular full time academic position in the Schulich School of Medicine and Dentistry, how do I enroll into the Benefit and Pension plans?
• Which benefits are optional and which benefits are compulsory?
• I have the HCSA benefit, what types of expenses can be claimed against the HCSA?
• How do I access my HCSA information?
• Can I have my HCSA claim reimbursement direct deposited to my bank account?
• What is the HCSA benefit year and why is it important?
• How important is the effective date of a medical or dental expense in relation to the year in which the claim is made?
• What dollar amount do I have available in my HCSA?
• What happens if I change my family status throughout the year? Does my allotment increase from $1,000 to $2,000?
• When can I change my HCSA participation?
• I am a new Member hired on or after January 1, 2010, what level of HCSA do I receive?
• Can I enhance my HCSA by adding additional funds from elsewhere?
• If my spouse is also a Clinical Faculty member, can we each have an HCSA?
• My niece who lives with me and is dependent on me for support has a bill for new prescription glasses. I suppose the only thing I can do is claim it on my income tax to see if she is eligible?
• When I retire how long do I have to claim expenses that were incurred up to my retirement date?
• Will the Disability Insurance through Western offset disability benefits payable through other policies I may be covered under, for example OMA Group Disability Insurance?
• What benefits are included under Statutory and Other Benefits?
• How do I claim for Dependent Tuition Scholarship plan?
• Am I eligible for post retirement benefits when I retire from Western?
• How do I qualify for Post Retirement Benefits?
• What is included in the Post Retirement Benefits?
• If I have questions concerning the Clinical Faculty benefits program, who can I contact?
• If I have questions concerning my Health Care Spending Account, who can I contact?
• If I have questions concerning the Ontario Priority Insurance plan (OPIP) sponsored by OMA, who can I contact?

Who administers the Health Care Spending Account (HCSA)? What is the policy number of this plan?

Sun Life Financial (Sun Life) administers this policy. The policy number is 150033.

What happens if I elect to change my participation from single coverage to family coverage or from family coverage to single coverage?

Any unused amounts will be carried forward and added to your new balance.

Where do I get the claim forms?

Information regarding claim forms and how to submit claims can be found on the Claims Submission and Claim Forms pages on the right.

I previously waived participation or would like to increase my level of coverage in the Optional Life Insurance plan, how do I enroll into this plan now?

You will complete a Benefit Application Change Form indicating that you will like to enroll into the Optional Life Insurance plan and select the level of coverage in $50,000 benefit increments up to $500,000.  A health questionnaire and approval from our benefit carrier will be required in most cases.  The health questionnaire will be provided to you upon Human Resources receiving your Benefit Application Change Form.

Where can I find the Benefit Application Change Form?

You can request a Benefit Application Change Form by using ASK HR to contact Human Resources or you can call 661-2194.

Are there any circumstances in which I can increase my level of coverage in the Optional Life Insurance plan without a medical questionnaire?

Yes. Life changing events such as acquiring a new dependent through either birth of a child or marriage (including common law) would qualify.  An application would need to be received within 31 days of acquiring a new dependent to qualify without a medical questionnaire and additional requests for coverage have not been previously declined.

I have been appointed a regular full time academic position in the Schulich School of Medicine and Dentistry. How do I enroll into the Benefit and Pension plans?

The Benefit and Pension Application paperwork will be mailed to your Western email address.  If you do not receive this paperwork please use ASK HR to contact Human Resources or call 519-661-2111 ext.  82194. If the completed paperwork is not received within the enrollment period you will automatically be enrolled in the compulsory components. The enrollment period is 31 days after you have been issued the Benefit and Pension Application. You may opt into the optional benefits at a later date but may be subject to approval from our benefit carrier.

Which benefits are optional and which benefits are compulsory?

*See Summary of Benefit and Pension Plans booklet for full details on eligibility for post retirement benefits and the academic pension plan.

I have the HCSA benefit, what types of expenses can be claimed against the HCSA?

A HCSA is provided for reimbursement of medical expenses. Medical expenses, as defined by Income Tax Regulations, are eligible for reimbursement including premiums for other insurance programs, dental expenses, vision care expenses, drugs, hospital, supplies and various other items. The Canada Revenue Agency (CRA) defines which expenses can be reimbursed. A list of eligible expenses can be found on the CRA website .

How do I access my HCSA information?

If you don’t have an Access ID and password with Sun Life already, sign up for the web access. See the tutorial on the Sun Life website or call Sun Life directly at 1-800-361-6212.

Can I have my HCSA claim reimbursement direct deposited to my bank account?

Yes. When you sign on to Sun Life site, you will be asked to provide your banking information. In addition, you will be prompted to provide your contact information including your email address as you will be notified when your claim has been processed and has been deposited to your bank account.

What is the HCSA benefit year and why is it important?

The benefit year is January 1 to December 31. Your HCSA allows you to carry forward any unused credits for one benefit year. After that, it is forfeited.  For example, your remaining 2023 HCSA balance will be forfeited on December 31, 2024.  You will have until March 31, 2024 for Sun Life Financial to receive any 2023 claims of which can be applied against your 2023 balance prior to it being forfeited. No cash outs of HCSA funds are permitted.

How important is the effective date of a medical or dental expense in relation to the year in which the claim is made?

This is very important. You may not use this year’s funds to pay last year’s expenses. For example, in January 2024, you cannot claim reimbursement for 2023 expenses from your 2024 allotment. Those 2023 expenses however, can be claimed from any 2022 carryover that was brought into 2023.

Any unused amounts from 2023 will be carried forward and available to you until December 31, 2024.

What dollar amount do I have available in my HCSA?

On your benefit enrollment form you would have indicated Single or Family. The HCSA is $2,000 for family coverage and $1,000 for single coverage per a calendar year.

What happens if I change my family status throughout the year? Does my allotment increase from $1,000 to $2,000?

No. The annual allotment is based on the single or family status as of January 1 each year, there is no adjustment.

When can I change my HCSA participation?

Each November, you can change your HCSA for the upcoming calendar year to one of the following: Waive Participation, Single Coverage or Family Coverage. If you would like your HCSA participation to remain unchanged from your current participation, there is no action required.

I am a new Member hired on or after January 1, of a given year, what level of HCSA do I receive?

New members receive the full HCSA allotment ($1,000 for single and $2,000 for family) based on single or family status on the date of hire.

Can I enhance my HCSA by adding additional funds from elsewhere?

No, you cannot add any additional funds to your HCSA.

If my spouse is also a Clinical Faculty member, can we each have an HCSA?

Yes, both can elect to have a HCSA.

My niece who lives with me and is dependent on me for support has a bill for new prescription glasses. I suppose the only thing I can do is claim it on my income tax to see if she is eligible?

If your niece qualifies as your dependent under the Income Tax Act you can submit the expense to your HCSA.

When I retire how long do I have to claim expenses that were incurred up to my retirement date?

You would have up to 90 days after your retirement date to claim for reimbursement.

Will the Disability Insurance through Western offset disability benefits payable through other policies I may be covered under, for example OMA Group Disability Insurance?

This will depend on the policies of those other plans. The details of the various OMA Disability Insurance plans can be found on the OMA website. Please contact the OMA, and/or the policy holder(s) of your other disability plan to determine the impact of the Disability Insurance through Western on your other coverage. The total disability benefits payable from all individual or group plans cannot exceed your earned income prior to the disability.

What benefits are included under Statutory and Other Benefits?

How do I claim for Dependent Tuition Scholarship plan?

To make application for the Dependent Tuition Scholarship plan, please visit the Office of the Registrar webpage for Employee Group Scholarships.

Am I eligible for post retirement benefits when I retire from Western?

For participating members as of June 30, 2009 and those who joined as a new faculty member after July 1, 2009 are eligible to accrue entitlements to post retirement health, dental, vision and life insurance programs for yourself and your family. For Clinical Faculty who previously waived enrolment in the benefit program but have now elected to participate in various other elements of the program effective January 1, 2010, are not able to accrue rights to post retirement benefits.

How do I qualify for Post Retirement Benefits?

You must be a member of the benefit plan for at least 10 years (including years of employment as a faculty member before July 1, 1999), retire from the University no earlier than the 1st of July following your 55th birthday, provide written notice of retirement within the time frame specified under your clinical faculty contract, and either be a member of the Benefit Plan prior to January 1, 2010 or commence a regular full time position in the Schulich School of Medicine and Dentistry on or after January 1, 2010.

What is included in the Post Retirement Benefits?

The Post Retirement Benefits include: drug, hospital, paramedical, supplies, out of country emergency, dental and vision care for you and your spouse and eligible dependent children. Some expenses are subject to an annual dollar or per incident maximum. 85% of each claim (that do not have a dollar maximum already defined) is payable under the plan and the member is responsible for 15% of these claims costs. Once a member with single coverage has paid $450 in a calendar year ($900 for family coverage), then the plan provides for 100% reimbursement of eligible expenses without dollar maximums for the remainder of that calendar year. Expenses incurred for out of province and out of country emergencies that occur within the first 60 days per trip will be eligible. Out of country eligible expenses are subject to a maximum of $200,000 per person per trip. In addition, a life insurance benefit of $15,000 is payable to your designated beneficiary upon your death in retirement.

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