Making sure your family has coverage

March 6, 2020

Your family members, also known as dependants, include your spouse* and/or child(ren)** who may be eligible for benefits coverage under the OSSTF ELHT Benefits Plan.

You must have life, health and/or dental coverage for yourself, in order for your family members to be eligible for coverage. They become eligible on the day you become eligible, or the day they become eligible for coverage (e.g. marriage, birth/adoption of a child, etc.).

If you are adding a new family member for life, health and/or dental coverage:

You have 31 days from the corresponding event (e.g. wedding day, day child is born or adopted, date spouse loses coverage) to add your spouse or child to the OSSTF ELHT Benefits Plan.

To add Child Optional Life, you must do this within 31 days of the birth or adoption of your child. This benefit cannot be added after the 31 days, even with proof of good health (evidence of insurability).

If you add your spouse or child 31 days after the event, they are considered a late entrant.

• If you have Single coverage, proof of good health will be required for your spouse or child. Based on medical evidence, their coverage may be denied. If coverage is approved, the new family member is covered as of the date coverage was approved (NOT the life event date). For dental coverage, late entrants are subject to a $200 maximum during their first 12 months of coverage.
• If you have Family coverage, proof of good health is not required for your spouse or child. They will have access to their benefits coverage as soon as you add them. Also, their dental coverage is not subject to the $200 maximum during the first 12 months.

If you are actively at work, you can add Spousal Optional Life at any time. Proof of good health will be required.

• Learn how to add a family member or add Spousal Optional Life to your plan.

Eligible dependants

Let’s look more closely at each family member or dependant.

As per your benefits booklet, here is the definition of a Dependant:

Each year, OTIP will send you a notice to confirm your overage child’s eligibility to maintain their coverage under your plan.

• Learn more about how to make sure your overage child is covered under your plan.
• Learn more about coverage for your child who is attending school outside of Canada.

If you have a disabled child:

A child, who is incapacitated or disabled on the date he or she reaches the maximum age (21 or 25) when coverage would normally end, will continue to be eligible for coverage. However, the child must have been covered under the OSSTF ELHT Benefits Plan before that date.

OTIP may request written proof of the child’s condition as often as reasonably necessary.

• Learn more about coverage for your disabled overage child.

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If you have questions about qualifying life events that make your dependants eligible for coverage, or how to make changes to your benefits coverage, please contact OTIP Benefits Services at 1‑866‑783‑6847.

Related links:

• You called, we answered
• My family status has changed. How do I add a dependant to my plan? How do I change my coverage?
• Benefit reminders for end of school year
• What do I do if I forgot to send in my overage dependant verification form for the current school year?
• Life events – What they mean to you and your benefits coverage
• Avoid being a late entrant
• Taking stock of your benefits coverage

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The information in this document is provided by OSSTF Benefits for general information only. OSSTF Benefits endeavours to have all information current and accurate. We make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, or suitability of the information included. All information is subject to change without notice.

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