Skip to content

Your Questions

The following Frequently Asked Questions (FAQs) are based on the general guidelines of the OSSTF Benefits Plan. Keep in mind there may be some variances for members due to red circling or the benefits effective date, for example. For specific member inquiries, please contact OTIP Benefits Services at 1‑866‑783‑6847 for information to your specific situation.

Note: These FAQs will be updated on a regular basis.

Please refer to our glossary of terms for reference.

Glossary of Terms

AD&D – Accidental Death and Dismemberment is provided to eligible members in an amount equaling Basic Life Insurance and Optional Member and Spousal Life Insurance Benefits. This means that if an insured member or covered spouse dies due to an accident, both the Life Insurance Benefits and AD&D benefits would be paid to the beneficiary.

ADP – Assistive Devices Program. The Assistive Devices Program (ADP) is a government sponsored plan that contributes towards the cost of customized equipment for people with long-term physical disabilities, like wheelchairs and hearing aids and specialized supplies, such as those used with ostomies.

Where an expense is ADP eligible, ADP is the first payer. Typically, the service provider will submit to ADP directly for their contribution and bill the member the balance. This allows the member to submit the portion of the cost not being reimbursed by ADP to the OSSTF Benefits Plan for consideration.

Beneficiary – The person that you name to receive a payment from your insurance policy. If you do not name a life insurance beneficiary, the payment goes to your estate.

Benefit Year – For the OSSTF Benefits Plan, a benefit year is defined as September 1st to August 31st.

Contingent Beneficiary – You can name a secondary or contingent beneficiary who would receive the benefit if there is no primary beneficiary alive when the benefit is paid.

Coordination of benefits (COB) – It’s common to have access to more than one health and dental plan in families with two working adults. The two plans may have slightly different levels of coverage and provide different service options. Under COB, insurance companies share the responsibility of paying for eligible health and dental expenses by determining which of these plans is primary and which is secondary. The primary plan considers the claim first and the unpaid balance is then considered by the secondary plan. Benefits are coordinated between the two plans to ensure that you receive reimbursement for up to 100 % of your eligible expenses. The details of the COB provisions are included in your benefits booklet on the OTIP secure member site.

Delisted Providers – Manulife is committed to protecting their clients and their members from benefits fraud and abuse. As part of this ongoing commitment, reviews of service providers are routinely conducted. If a review reveals concerns surrounding business practices and/or potential fraud, claims will no longer be processed or reimbursed for services from these providers. This is referred to as delisting. Manulife has conducted an extensive review into the business practices of the service providers listed below. As a result, they have been delisted and claims from these service providers are no longer eligible for reimbursement, effective the date indicated. You can view a detailed list of providers under My Claims on your OTIP member site.

ELHT – Employee Life and Health Trust

FTE – Full Time Equivalent, e.g. a full-time member has a 1.0 FTE, while a 2/3 member would have a .667 FTE.

Life Change Event – A change in your personal situation and/or in your coverage status.

Examples:

  • Marriage/common law
  • Divorce or legal separation
  • Birth or adoptions
  • Your spouse’s loss or gain of health and/or dental benefit coverage

If a life change event occurs, you will be able to enrol in the OSSTF Benefits Plan or elect benefit selections to ensure that the plan continues to meet you and your family’s needs. You need to complete your enrolment or make changes to your benefits coverage within 31 days from the date of change. Be sure to reference the FAQ section – Change in Status for more information.

Manulife Audits – Manulife regularly audits members and providers. This is part of the claims adjudication process and ensures that expenses being claimed are eligible. From time to time members will be asked to provide further back-up or additional information after submitting a claim. This is a standard part of the audit process and is in place as one of the tools to contribute towards the long-term sustainability of the OSSTF Benefits Plan. Member compliance with these requests is a required. For specific inquiries in this regard, please contact OTIP Benefits Services at 1-866-783-6847.

Paramedical Practitioners – For a complete list of eligible paramedical practitioners, please refer to your benefits booklet on the OTIP secure member site. Eligible expenses are for the actual services of an eligible licensed paramedical practitioner and not for items dispensed and/or additional testing completed.

About Your Benefits Plan

Who Owns and Controls the OSSTF Benefits Plan

As negotiated in the 2015 Central Agreement, on October 6, 2016, an Agreement and Declaration of Trust (PDF) was signed between Her Majesty the Queen in Right of Ontario as represented by the Minister of Education (Crown), Ontario Public School Boards’ Association and OSSTF. Learn more about Our Governance.

Who Owns and Controls the OSSTF Benefits Plan
(Scroll bar at bottom of table.)
Plan Role Authority
Plan sponsor

OSSTF Benefits is made up of a Board of Trustees. The Trustees manage and govern the OSSTF Benefits Plan in the best interests of the members. The Trustees will also make a range of plan design, funding, administrative and investment decisions on their behalf.

Plan administrator OTIP (Ontario Teachers Insurance Plan) is the third-party administrator (TPA) for the OSSTF Benefits Plan.

If you have questions about enrolment, eligibility, life coverage, premium costs, benefits coverage or claims, call OTIP Benefits Services at 1-866-783-6847, Monday to Friday from 8 a.m. to 7 p.m.

Health & Dental Claims Payer & Life Insurance Benefits Insurer Manulife is the health and dental claims payer for the OSSTF Benefits Plan as well as the insurer of the Life Insurance benefits.

If you have questions about your benefits coverage or claims, call OTIP Benefits Services at 1-866-783-6847

Accidental death and dismemberment (AD&D) Teachers Life is the AD&D claims payer and insurer for the OSSTF Benefits Plan.

If you have questions about your AD&D coverage, please call OTIP Benefits Services.

How is the OSSTF Benefits Plan funded?

Negotiated FTE (Full Time Equivalent) funding is used to fund the Basic Life and AD&D (Accidental Death and Dismemberment) premiums for eligible active members and the majority of the funding for health and dental benefits. Eligible members on a non-statutory approved leave may elect to continue to participate in the benefits plan on a 100% member-paid basis.

Basic Life and AD&D benefits are 100% funded by the OSSTF ELHT and mandatory for all eligible active members regardless of their FTE level. The plan also includes Voluntary Life Insurance and Accidental Death and Dismemberment Benefits for members and their spouses as well as child optional life benefits on a voluntary 100% member paid basis.

Participation in the health and dental benefits is voluntary. The negotiated FTE funding pays 94% of the premium for 1.0 FTE active members with the member responsible for 6% of the premium. There is an additional pro-rating of member contributions for members with a less than 1.0 FTE.

Premium Coverage
(Scroll bar at bottom of table.)
Benefit Eligible Active Member/
Eligible Member on Statutory leave
Eligible Member on non-Statutory leave
Member Pays Trust Pays Mandatory/ Voluntary Member Pays Trust Pays Mandatory/ Voluntary
Basic Life and Accidental Death and Dismemberment (AD&D) 0% 100% Mandatory for all eligible active members regardless of their FTE level. 100% 0% Voluntary
Optional Member and Spousal Life and AD&D 100% 0% Voluntary 100% 0% Voluntary
Optional Child Life 100% 0% Voluntary 100% 0% Voluntary
Health and Dental 6% for 1.0 FTE eligible members. Pro-Rated for less than 1.0 FTE eligible members. 94% for 1.0 FTE eligible members. Pro-Rated for less than 1.0 FTE eligible members. Voluntary 100% 0% Voluntary

The chart below provides a summary of estimated costs for full and part-time participating members based on the rates at inception of the plan:

Monthly Premium Share
(Scroll bar at bottom of table.)
1.0 FTE 0.667 FTE 0.5 FTE 0.333 FTE
Health Single $7.61 $47.32 $67.24 $87.16
Family $19.03 $118.31 $168.10 $217.89
Dental Single $4.01 $24.91 $35.39 $45.87
Family $10.02 $62.27 $88.48 $114.68

During the enrolment process, members can see the cost of their benefit selections, which will help them make informed decisions on their coverage.

If the Board does not have my email address, how will OTIP and the OSSTF Benefits communicate with me?

If OTIP does not have your current email information on file, they will mail communications to your home address on file. Be sure to update your email address when you enrol to ensure efficient ongoing plan communications.

To view your current home and email address:

  1. Go to www.otip.com and click Log in.
  2. Select Health and Dental from the drop-down menu and log in.
  3. After you have logged in, click My Claims.
  4. My profile tab and click Update in the Address heading or Email field.

Note: If your home mailing address is incorrect, please contact your school board.

If I am not in a 1.0 FTE assignment, what are the costs of monthly pro-rated premiums?

You can log into OTIP’s secure member site to review and validate your coverage information. Any required member contributions will also be displayed.

Note: The amounts displayed are monthly premium amounts and will apply from the eligibility date go forward. This could result in retroactive premium being owed by the member from the eligibility date go forward. You will find a breakdown of your View the illustration (PDF).

Plan Coverage

Do members receive a drug card?

Yes, all eligible OSSTF Benefits Plan members who participate in the health benefits will receive a new pay-direct benefits card. Members who elect single coverage will be provided with one card and members who elect family coverage will be provided with two cards. Additional benefits cards can be printed online at www.otip.com.

Are paramedical claims fully covered under the OSSTF Benefits Plan?

For a list of types of eligible paramedical practitioners, please refer to your benefits booklet on the OTIP secure member site. Eligible expenses are for the actual services of an eligible licensed paramedical practitioner and not for items dispensed and/or additional testing completed.

Paramedical claims for the eligible practitioners are covered up to reasonable and customary (R&C) limits and up to the specified maximums indicated in the benefit booklet per benefit year (September 1st to August 31st). R&C refers to the maximum allowable amount that an insurer will reimburse on a particular service or item. This is an approach by insurers to limit allowable costs for some services within a plan without providing a fixed hard cap.

For example, if the reasonable and customary cost for a service is $100 per visit and the provider bills $120 per visit, only $100 will be reimbursed. For more information, read our newsletter on Understanding Reasonable and Customary limits.

Are my diabetic supplies covered?

Largely, diabetic supplies and equipment are eligible under the OSSTF Benefits Plan. Some supplies require a doctor’s recommendation. It is recommended that you contact OTIP Benefits Services at 1-866-783-6847 to inquire about eligibility in advance of making a purchase.

Submitting a claim

How do I submit a claim?

Claims can be submitted by:

I’m worried that my expensive medications will not be covered. Will prior authorization of drugs be required?

Most drugs that are not “over the counter” are covered under the OSSTF Benefits Plan. Some drugs may require completion of a Manulife prior authorization form (PDF) by a physician to determine eligibility under the drug plan. NOTE: Completion of this form is not a guarantee of approval.

By logging into My Claims members have access to My drug plan where the name of the drug and/or DIN (Drug Identification Number) can be input to inquire about eligibility and whether a pre-authorization is required.

Do I have to provide a doctor’s note for massage therapy?

A doctor’s note is required for massage therapy each 12 months. When you submit your massage claim online via My Claims, you will be required to check a box stating that you have obtained a doctor’s note for massage therapy. You are required to keep the doctor’s note in your personal files, in case your claim is subject to an audit by Manulife.

When should I submit a pre-determination of a claim?

To avoid large out-of-pocket expenses that may not be covered by the OSSTF Benefits Plan, we recommend that you submit a pre-determination to OTIP prior to the expenses being incurred. Please contact OTIP Benefits Services at 1‑866‑783‑6847 for more details.

What if I cannot take a generic form of a particular drug for medical reasons?

The OSSTF Benefits Plan has a mandatory generic requirement.

If you or your dependant cannot take a generic drug because of an adverse reaction or therapeutic failure, you can request your physician to complete the Request for Approval of Brand-Name Drug Form (PDF) and submit it to OTIP Health Claims for review.

This form is also available at wwww.otip.com/forms.

NOTE: Completion of this form is not a guarantee of approval.

Eligibility

Who is eligible for participation in the OSSTF Benefits Plan?

  • Contract teachers and support staff
  • Eligible long term occasional (LTO) teachers
  • Eligible retirees

LTO Teachers: If an LTO Teacher bargaining unit previously had eligibility for coverage under their collective agreement, eligible LTO members are eligible for participation in the OSSTF ELHT.

Note: If participation in the benefits for eligible LTO’s was on a 100% member paid basis under previous collective agreements, this arrangement continues under the OSSTF Benefits Plan.

Retirees: Eligible retirees will be eligible to participate in the OSSTF Benefits Plan if they are were covered in a board-owned retiree plan at the transition date for active members of their bargaining unit into the OSSTF Benefits Plan and still have coverage in a board-owned retiree plan.

The transition of the coverage for eligible retirees into the OSSTF Benefits Plan is being worked on. All involved parties are evaluating current arrangements in board plans and details will be shared once further information is available.

Who are eligible dependants under the OSSTF Benefits Plan?

Your legal spouse, or a person continuously living with you in a role like that of a marriage partner for at least 12 months, is eligible.

Your natural or adopted child, stepchild, or foster child, who is:

  • Unmarried;
  • Under age 21, or under age 25 if a full-time student;
  • Not employed on a full-time basis; and
  • Not eligible for coverage as a member under this or any other Group Benefit Program.

A step child must be living with you to be eligible. A child who is incapacitated due to a mental or physical disability on the date they reach the age when they would otherwise cease to be an eligible dependant will continue to be eligible.

Life events such as the birth of a child, marriage and common law must be reported within 31 days of the event, otherwise may be subject to late applicant restrictions. Please refer to the FAQ section – Change in Status for more information.

Are Daily Occasional Teachers or Temporary Support Staff eligible for benefits in the Plan?

Daily Occasional Teachers or Temporary Support Staff are not eligible to participate in the OSSTF Benefits Plan. OTIP currently provides an OCM (Occasional Casual Member) plan which provides optional benefits plan that Daily Occasional Teachers and Temporary Support Staff may be eligible to elect to pay and participate in if they wish. For more information, please contact OTIP Benefits Services at 1-866-783-6847.

Can a teacher in a .5 permanent contract and a .5 eligible LTO position (same person) get full benefits coverage?

If a .5 permanent teacher also has an eligible 0.5 LTO teaching assignment, the member may combine eligibility and premium share to receive full benefits coverage with a 6% member contribution towards health and dental benefits for the duration of their LTO assignment.

After the LTO assignment is complete, the permanent member can continue to participate in the health and dental benefits. The member will be responsible for paying the pro-rated premium share (i.e. 50% + 6% of the premiums for health and dental) as required by the eligibility rules for contract employees.

When will my eligibility for coverage start?

Eligible members are eligible immediately upon their start of an active eligible assignment. There is no waiting period.

Note: The duration of eligible assignments differs for eligible LTO teachers based on their previous collective agreement wording.

Do I need to provide evidence of insurability to be eligible for the OSSTF Benefits Plan?

All eligible OSSTF members and their eligible dependants were invited to enrol in the OSSTF Benefits Plan without medical evidence of insurability for Basic Life & AD&D, Optional Dependent Life, and Health and Dental benefits provided the enrolment process was completed within 31 days from the date that they receive the invitation to enrol.

For member Optional Life the first $10,000 of coverage is available without medical evidence of insurability if applied for within the first 31 days of eligibility. Enrolment in all other member and spousal optional life is subject to approval of evidence of insurability before going into effect.

When will eligible members receive their invitation to enrol?

The Boards are responsible for providing Human Resource Information System (HRIS) data to OTIP on a regular basis that will identify when a member is eligible to enrol in the plan or if there are eligibility changes. Once the Board provides this information to OTIP, eligible members will be notified by OTIP when they are eligible to enrol for benefits coverage in the OSSTF Benefits Plan. OTIP will send an email to the member’s Board email address and the member will be required to log in to the OTIP’s secure website to complete their enrolment online within 31 days of the date that they received the invite. If the member does not complete their enrolment within the specified time, new health care coverage and/or coverage changes will be subject to approval by the insurer along with any required new proof of good health and dental coverage would be subject to a $200 maximum in the first 12 months of coverage.

What if I was eligible but did not receive my invite until a later date?

OTIP is working with the Boards to get the member data on a regular basis. Once the member data has been received by OTIP, an invitation to enrol will be sent to eligible members as soon as possible.

You will always have 31 days from the date that you receive your invitation to complete your enrolment.

The effective date of the coverage will always be the same as the eligibility date. Therefore, eligible claims incurred on or after the eligibility date will be honoured once the enrolment is complete. It also means that you will be responsible for any member portion of the health and dental premium retroactive to the eligibility/effective date.

When will New Members receive their enrolment invite?

OTIP is working with the Boards/School Authorities to obtain data on new hires as soon as their employment status is known. Once OTIP receives the data, they will load the data into the OSSTF Benefits Administration System which will prompt an enrolment invite being sent to the member. Members will have 31 days from the date of this enrolment event email being sent to make their coverage elections.

How is this process communicated to new hires?

Boards and School Authorities have been provided with a OSSTF New Hire Letter (PDF) and the OSSTF 2018-19 At a glance benefits that they are encouraged to pass on to new hires. New members are encouraged to access these documents for their enrolment questions, or to call OTIP Benefits Services at 1-877-783-6847 if they do not receive their enrolment invite or if they need assistance in the enrolment process.

Disabled members: What you should know

What is a waiver of life insurance premium?

The waiver of life insurance premium is provided to ensure that the amount of life coverage you had when you became disabled can be maintained (even if there are changes in your plan), at no cost to you. Essentially, the insurance company will “lock-in” your life coverage and forgo future premiums while you are disabled–even if the policy is terminated or a change in insurance carrier takes place. The disability waiver feature differs from company to company, but typically expires at the earlier of recovery or age 65. The waiver of life insurance premium terminates when you no longer meet the terms of the contract including the definition of disability, termination age, etc.

I recently joined the OSSTF Benefits Plan and was receiving LTD benefits at the time. What happens to my life insurance?

If you filed a claim and were approved for a waiver of life insurance premium under your previous plan, your life insurance will continue to be provided by your previous plan at no cost to you, as long as you continue to be eligible based on the terms of the previous contract. As life insurance is being maintained under the previous plan, you will see that both your salary and your life insurance amounts under the provincial plan are set at zero (0) dollars.

What if the previous life contract that I was covered under did not include waiver of life insurance premium provision? What if I missed the deadline to make application for the waiver of life insurance premium benefit? What if I was not approved for a waiver of life insurance premium under my previous plan?

The OSSTF Benefits Life Insurance Contract requires that you must be actively at work for benefits coverage to become effective. If you were not actively at work on the date your coverage would normally become effective, your coverage will take effect the day you are actively at work.

However, if you were not approved for a waiver of life insurance premium under your previous plan, and you or your Board maintained your life insurance coverage while you were disabled on a premium-paying basis, the amount of life coverage that you had with the previous carrier will be provided under the OSSTF Benefits Plan.

I was going on LTD just prior to the transition. What do I do?

If your date of disability is prior to the transition date, we encourage you to apply for a waiver of life insurance premium under your previous plan. There may be a deadline to apply for this benefit and we recommend that you contact your previous carrier as soon as possible to ensure your life coverage can be maintained at no cost to you.

When will I receive the amount of life coverage available through the OSSTF Benefits Plan?

Once you have actively returned to work, you will be eligible for the amount of coverage available under the OSSTF Benefits Plan.

If I was disabled as of the transition date, am I eligible for health and dental benefits through the OSSTF Benefits Plan?

If you were participating in the health and/or dental benefits as of the transition date, you are eligible for the continuation of benefits. Standard eligibility rules in the OSSTF Benefits Plan for the first 24 months of an LTD claim includes:

  • Members are eligible for the same level of benefits funding as an active member (i.e. a 1.0 FTE disabled member would be responsible for 6% of the health and dental premium).
  • Member contribution for disabled members with less than 1.0 FTE is pro-rated.
  • After the first 24 months, eligible members can choose to continue benefits coverage (premiums are 100% member-paid).
  • Standard termination rules apply (i.e. benefits would terminate at retirement).

If you are a disabled member who did not participate in the health and/or dental benefits prior to the start date of your LTD claim, you will not be eligible for enrolment in these benefits until you have actively returned to work.

When will my information be updated?

OTIP continues to validate information and process updates for all members on LTD. While we update your information should you have any questions, please email OTIP at OTIP_onLeave_Contact@otip.com or contact OTIP Benefits Services at 1‑866‑783‑6847.

If you have questions with your life coverage provided under the waiver of life insurance premium provision with the previous carrier, please contact them directly or your benefits administrator.

Change in Status

When will I be eligible to make changes to my coverage?

If you experience a life change event, you may enrol in the health and dental benefits or make changes without evidence of medical insurability. These life change events may include:

  • increase in FTE
  • birth/adoption of a child
  • marriage/common law qualification
  • loss of spousal benefits

You will need to complete your enrolment or make changes within 31 days of the life change event.

Note: Eligibility requirements are based on the member being actively at work or while on a qualifying statutory leave.

Newsletter – Life events and your benefits coverage

What if I want to make a change to my coverage that does not coincide with a life change event?

As Basic Life Insurance and Accidental Death and Dismemberment coverage is mandatory for all eligible members this coverage is automatically in place effective the date of member eligibility once OTIP receives the HRIS data from the employer.

As participation in the health and dental benefits is voluntary, if a member does not elect to participate in the plan within 31 days of receiving their initial invite but wishes to join the plan at a later date without a life change event taking place, they will be considered a late applicant. This means that dental benefits will be subject to a $200 maximum in the first 12 months of coverage, and that Extended Health Care benefit would have to be applied for with evidence of insurability. The Health Care coverage will not be in place until the evidence of insurability is approved, and the coverage could be denied.

Note: These “late applicant” rules also apply to eligible dependants if application is not made within 31 days of initial eligibility or an eligible life change event.

Am I able to continue benefits plan coverage if I am on an approved LTD claim?

Yes, eligible permanent members who are a currently approved LTD claimant or a new LTD claimant who is approved for LTD benefits after transition into the ELHT program who were participating in health and/or dental benefits prior to becoming disabled are eligible to continue their coverage. For eligible permanent members on an approved LTD leave, the ELHT will cover the cost of benefits premiums at the same level of premium that the member was paying as an active member (i.e. 6% for a 1.0 FTE member, and pro-rated for less than 1.0 FTE members) for the earlier of the first 24 months of the claim or until the member’s LTD claim is closed. If the LTD leave continues beyond 24 months, a member may continue coverage on a 100% member paid basis.

I am a permanent member and participate in the OSSTF Benefits Plan. If I retire in February or June 2019, when will my OSSTF Benefits Plan end?

Benefits terminate at 11:59 p.m. the day an eligible member retires or resigns.

For example, if you retire or resign on February 1st, your benefits would terminate at 11:59 p.m. on February 1. If a you retire or resign on June 28, your benefits would terminate at 11:59 p.m. on June 28. If you retire or resign on August 31, your benefits would terminate at 11:59 p.m. on August 31, etc.

If I am approved for an unpaid leave of absence – am I eligible to continue in the OSSTF Benefits Plan while I am on leave?

Permanent members may continue coverage that is in force prior to the leave of absence.

During a statutory leave such as maternity/parental leave, members will pay for health and dental benefits on the same basis as they did as active, i.e. FTE pro-rated basis (e.g. if a member is 1.0 FTE the member will pay 6% of the health and dental premium; if a member is 0.5 FTE the member will pay 50% + 6% of the health and dental premium).

During a non-statutory leave (e.g. unpaid medical leave, extended parental leave) a member must pay 100% of the premium for a full time leave, or a pro-rated member contribution during a part time leave.

If I am approved for an unpaid leave of absence but have waived my benefits while on leave. When can I opt back into the benefits plan?

If an eligible member is currently on a leave of absence and has waived their benefits for the duration of their leave, they will be eligible to enrol when they actively return to work. You will have 31 days after your return date to reinstate your benefits without medical evidence of insurability.

Where premium deductions apply, are premiums being deducted from payroll? What if I’m on an unpaid leave?

Premium contributions for active members are standardly calculated by OTIP and provided to your employer/board for payroll deductions. View the illustration (PDF).

Members who are in a 0.3 FTE position or less and who are enrolled in the OSSTF Benefits Plan will be billed directly by OTIP.

Members on a leave who elect to continue participation in the OSSTF Benefits Plan will be required to provide pre-authorized debit information and will be billed directly.

For newly eligible bargaining units whose members became eligible after the initial transition into the plan (i.e. benefits for the members of the newly eligible bargaining units after June 1, 2017) will be required to provide pre-authorized debit information and will be billed directly for the member portion of the premium.

How will it work if my schedule differs by semester?

As per the eligibility rules for the OSSTF Benefits Plan, if a member has different work schedules by semester, employers have been advised to report the members eligibility and salary on an annualized basis to ensure that the member has full access to the benefits throughout the year.

For example, a teacher who is hired into a .5 FTE position and works .333 first semester and .667 second semester will be reported as a .5 FTE for the entire school year. They will have Basic Life Insurance and accidental death and dismemberment (AD&D) benefits for the entire school year based on 2 times the .5 annual salary. If they elect to participate in the health and dental benefits, the member premium share will be based on the .5 FTE.

There is the understanding that this is being handled differently for some boards/school authorities who are reporting salary and FTE by semester. OSSTF Benefits is working with OTIP and the boards/school authorities to have this reported on an annual basis in the future.

If you have any questions, please contact Donna Morrison at donna.morrison@osstfbenefits.ca.

What if I was hired as a .5 FTE member working .667 first semester and .333 second semester and then my contract changes to .667 commencing second semester?

Once your FTE status has been updated by your employer/board, it will be reported to OTIP as .667 retroactive to the first working day in September. Your payroll deductions for the entire year will be adjusted resulting in a refund for overpaid contributions being made to you by OTIP.

There is the understanding that this is being handled differently for some boards/school authorities who are reporting salary and FTE by semester. OSSTF Benefits is working with OTIP and the boards/school authorities to have this reported on an annual basis in the future.

If you have any questions, please contact Donna Morrison at donna.morrison@osstfbenefits.ca.

Summer Months

Teachers and LTOs

  • For LTO members who are eligible for participation in the OSSTF Benefits Plan, their coverage will terminate at the end of their LTO assignment. LTO members are not eligible for coverage over the summer months.
  • For permanent teachers, as long as their employment status does not change, they are eligible for continued coverage over the summer months, with no change to the member contribution for July and August.
  • For permanent teachers who are laid off at the end of this school year, benefit eligibility and funding continue for July and August. Commencing at the beginning of the new school year, members on a recall list are eligible to continue to participate in the plan on a 100% member paid basis for up to 24 months. Members on permanent lay off are eligible to continue to participate in the plan on a 100% member paid basis for up to 6 months.
  • For members who retire or terminate their employment, coverage will cease at the date of their retirement or resignation. For example, if the retirement or resignation date is June 28th, coverage will cease as of midnight on this date and will not continue over the summer months.

Support Staff

  • Permanent support staff members during temporary summer lay off are eligible for continued coverage over the summer months, with no change to the amount of the member contribution. For 10-month employees at work, the summer contributions will be collected through payroll deduction either before or after the summer months.
  • For permanent support staff who are laid off at the end of this school year (i.e. after summer lay off) benefit eligibility and funding continues until August 31. Commencing September 1, members on a recall list are eligible to continue to participate in the plan on a 100% member paid basis for up to 24 months. Members on permanent lay off are eligible to continue to participate in the plan on a 100% member paid basis for up to 6 months.
  • For members who retire or terminate their employment, coverage will cease at the date of their retirement or resignation. For example, if the retirement or resignation date is June 28th, coverage will cease as of midnight on this date and will not continue over the summer months.

Summer Deductions for Members on a 10-month payroll schedule

As group insurance rates are payable monthly, it is necessary for members on less than a 12 month pay schedule to have double payroll deductions made for the payment of the member contribution towards the premium for the summer months.

Is summer coverage available during the summer break?

Permanent members not working during the summer continue to be eligible for coverage and are responsible for the same level of member contribution that they paid in June.

This does not apply to Long Term Occasional Teachers or members who are retiring or terminating their employment prior to the summer break.

Coordination of Benefits

My partner and I are both OSSTF members in the same board. Can we both enrol in the OSSTF Benefits Plan and coordinate benefits between the plans?

Yes, under the OSSTF Benefits Plan, you are both eligible to enrol and list each other as dependants; thereby, you will have the ability to coordinate claims between both plans.

NOTE: Since health and dental is voluntary coverage, members can choose to opt out of the plan. If you opt out of the coverage, the only way to be eligible for re-enrolment without restrictions is to do so within 31 days of a life change event (e.g. increase in FTE, birth/adoption of a child, marriage/common law qualification, loss of spousal benefits).

For Your Reference

Be sure to visit the Resources page of this website to learn more about the OSSTF Benefits Plan. Our newsletters include information on reasonable and customary limits, beneficiary designations, travel coverage, benefits fraud and much more.

Still searching for an answer?

Submit your question and we will do our best to provide you with an answer.