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ETFO Employee Life and Health Trust (ELHT) Benefits Plan

Frequently Asked Questions

The following Frequently Asked Questions (FAQs) highlight some of the questions that members have asked regarding the new ETFO ELHT Benefits Plan. Please note that these FAQs will be updated on a regular basis as required.

Updated May 1, 2017

Answer
expand Title : Am I able to continue benefits plan coverage if I am on an approved LTD claim? ‎(1)
expand Title : Are Daily Occasional Teachers eligible for benefits in the Plan? ‎(1)
expand Title : Are retirees eligible to participate in the Plan? ‎(1)
expand Title : Can a teacher in a 0.5 permanent contract and a 0.5 LTO (same person) get full benefits coverage? ‎(1)
expand Title : Can temporary or occasional DECE/ESP/PSP members pay into the Plan? ‎(1)
expand Title : Do I need to provide evidence of insurability to be eligible for the Plan? ‎(1)
expand Title : How does a Plan member get coverage confirmation for a dependant student who requires proof of coverage for their post-secondary institution including waiving coverage by that institution? ‎(1)
expand Title : How does eligibility work for Long Term Occasional (LTO) teachers? ‎(1)
expand Title : How does OTIP know when a member is eligible to enrol or if their employment status changes? ‎(1)
expand Title : I am a permanent member and am in the ETFO ELHT plan. If I retire on June 30, 2017, when will my ETFO ELHT benefits end? ‎(1)
expand Title : If I am approved for an unpaid leave of absence but have waived my benefits while on leave... ‎(1)
expand Title : If I am approved for an unpaid leave of absence, am I eligible to continue in the Plan? ‎(1)
expand Title : If I am not eligible for enrolment at the time of my local’s transition into the Plan, how will I be notified if I become eligible after the transition date? ‎(1)
expand Title : If the board doesn’t have my email address, how will OTIP and the ETFO ELHT communicate with me?    ‎(1)
expand Title : Is the new ELHT plan mandatory for 1.0 Teachers, DECEs, PSPs, ESPs and eligible 1.0 Long Term Occasional Teachers? ‎(1)
expand Title : What about members who are on leave and unreachable during transition into the ETFO Benefits Plan? ‎(1)
expand Title : Who is an eligible dependant? ‎(1)
expand Title : Will a child who is covered under my current plan as an overage dependant student be transferred into the new Plan? ‎(1)
Answer
expand Title : Does the ELHT Plan have an impact on employee assistance programs? ‎(1)
expand Title : I had heard that members would retain individual components of their current board plan design as superior entitlements under the new Plan. Is that true? ‎(1)
expand Title : If I am not in a 1.0 FTE assignment, what are the costs of monthly pro-rated premiums? ‎(1)
expand Title : In comparing my current plan to the new Plan, some coverages are decreased while others are increased. How was this plan design determined? ‎(1)
expand Title : Is there open enrolment for optional life insurance? Will there be additional health requirements when choosing levels of optional coverage?  ‎(1)
expand Title : My partner and I are both ETFO members in the same board. In the past we have not both been able to hold our own family benefits. Under the new Plan, can we each enrol and coordinate benefits between the plans? ‎(1)
expand Title : What happens to my life insurance? I used to have more than 1x salary life insurance. ‎(1)
expand Title : When will locals transition into the plan? ‎(1)
expand Title : Where premium deductions apply, will premiums be deducted from payroll? What if I’m on an unpaid leave? ‎(1)
expand Title : Will claims activity under a member’s previous plan have an impact on eligibility for claims under the new Plan (e.g. Will the new Orthodontic or Vision Care maximum benefit automatically apply to all?) ‎(1)
expand Title : Will I still have to pay a premium share under the new plan if I am an eligible 1.0 member? ‎(1)
expand Title : Will members get a new drug card? ‎(1)
expand Title : Will my personal information be carried over to the new Plan? ‎(1)
Answer
expand Title : Are all paramedical claims fully covered under the new Plan? ‎(1)
expand Title : Are my diabetic supplies covered? ‎(1)
expand Title : Do I have to provide a doctor’s note for massage therapy? ‎(1)
expand Title : I’m worried that my expensive medications will not be covered. Will prior approved exceptions for a specialized prescription drug be transitioned into the new Plan? ‎(1)
expand Title : Is there an appeal process for the new Plan? ‎(1)
expand Title : What if I cannot take a generic form of a particular drug for medical reasons? ‎(1)
expand Title : Will pre-approved expenses for members with ongoing treatments be recognized under the Plan once a member has been transitioned into the new Plan? ‎(1)