The purpose of the Extended Health Benefits (EHB) Fund is to support members with health care costs that would cause an undue financial burden and that are not covered by the Sun Life Insurance plan provided by our collective bargaining agreement. Please note these funds are not administered by the Sun Life Insurance Plan, rather they are administered by the Extended Health Benefits Committee.
The Committee meets approximately on a monthly basis to adjudicate funds. Please allow for a possible 4-6 weeks to receive a decision from the committee, in the event that you submit your application just after the committee has met for that month.
Email: ehb3903@gmail.com
Who is eligible for the Extended Health Benefits?
CUPE 3903 members (including international students) in good standing potentially qualify for the EHB fund. This fund does not cover dependents of said members. The only exception is for reproductive technologies, as members and their partners are eligible for reimbursement.
What is covered under EHB?
- Non-MD Psychotherapy
- Travel Health Insurance
- Acupuncture
- Orthotics
- Additional health funds in the event that you exceed your Sun Life coverage; proof of exhaustion of core benefits plan coverage is required
- Parking costs related to a hospital or a doctor’s visit
- Over the counter supplements that are prescribed by a physician, i.e. Iron supplements. You must provide the prescription and the prescription must be from a medical doctor
- Osteopathy
- Other services de-listed from OHIP
How do I apply?
To apply, fill out the Extended Health Benefits Fund form online, linked here. If you need a paper copy, drop by the office or contact a Vice-President.
If you are applying for a service for which you have already paid, receipts are required. If you are applying for a foreseeable expense, estimates are required from the health care practitioner. Receipts and estimates for travel health insurance must clearly indicate that baggage and cancellation insurance is not included or must separately indicate the cost of those items. Additionally, referral notes are required for orthotics. If you are applying to EHB for any service also covered by Sun Life, proof of exhaustion of Sun Life coverage must be provided. The proof of Sun Life coverage exhaustion can be obtained from the Sun Life website, which usually consists of the following message:
R15 We are not able to pay this expense because this claimant has already reached the annual maximum amount covered under the plan for this type of expense.
Appeals
When a member notifies the committee that they wish to appeal a decision on the application, the member’s application will be reviewed by one committee member, one designated executive member and the Equity Officer (ex-officio). To be considered, the appeal must be submitted within one month of the member’s receipt of the committee’s original decision.