For an overview of all the kinds of benefits, funds and leaves, click here
This information is not about the standard Benefits Plan (through Sun Life, covering vision care, dental, prescription drugs and paramedical services: click here for that information). It is, however, important! The purpose of the Extended Health Benefits 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.
There are two fund types:
Option A: extended health care needs that are unexpected and urgent, which present an undue financial burden. These are adjudicated monthly. For the application form click here
Option B: extended health care needs that are foreseeable or planned, which present an undue financial burden. These are made on a “going forward” basis and adjudicated three times a year, with application deadlines of September 10, January 10 and May 10. For the application form click here
These funds are not administered through Sun Life (the provider of the Benefits Plan aaacovering vision care, dental care, prescription drugs and paramedical services). It is administered through an elected committee of members (the Extended Health Benefits Committee: three CUPE 3903 members—currently with representation from each of the three bargaining units—who are elected by the general membership in April of each year, and the Equity Officer, who serves on the committee ex officio)
Who is eligible (or not) for EHBF assistance?
- 3903 members only (expenses associated with your dependents are not covered)
- Members who have coverage under other benefits (e.g. through spousal coverage) are also ineligible. The only exception is for reproductive technologies, as members and their partners are eligible for reimbursement
- International students: If you have a contract and are a member of CUPE 3903 then you are eligible to apply for these funds. This plan is not a replacement for UHIP
- Option B applicants have the opportunity to identify in an equity statement any form of social marginalization they experience (for example, as a result of race, ethnicity, class, sexual orientation, ability, etc.) and how this affects the needs they are trying to meet with the application
How much is given?
There is no guarantee of a fixed amount or percentage of costs. Rather, the amounts reimbursed to members vary depending on the total requested of the fund. Approved applicants will generally receive between 25% and 50% of the costs for which they apply. Further, because this is a financial needs based fund, the committee may follow up with members whose net income appears large in comparison to the EHB amount being requested.
Application limits
- Health care expenses made during a Collective Agreement year will only be reimbursed during that year
- EHBF member eligibility follows Sun Life insurance plan eligibility. Thus members may make claims for four months after the date of their last contract, as long as the expense made or proposed is in the Collective Agreement year in which the member applies
- Generally, Option A expenses will only be considered in the funding period in which they are incurred
- Members may apply as many times as they wish in a year but funds are allocated according to consideration going to first time applicants (after the first adjudication of the year), to members who have international student status and/or who are single people with dependents
Eligible Expenses
Support from this fund might range from the one time purchase of an assistive device to an ongoing regiment of therapy or to unexpected health needs resulting from a sudden accident or injury. This includes assistance with costs associated with longer-term disabilities and/or care needs that are not otherwise covered by under other health insurance plans. Cosmetic procedures are not covered. The following is covered:
- Non-MD psychotherapy
- Travel health insurance (does not include baggage or cancellation insurance)
- Acupuncture
- Orthotics (with a doctor’s note)
- With proof of exhaustion of the BENEFITS PLAN (as described here) coverage
--- Vision care expenses
--- Emergency dental work
--- Prescription drugs
--- Naturopathy, Chiropractic, Physiotherapy, Psychologist, Podiatry and Massage Therapy (the latter with a doctor’s note within the last year)
- Incidental health expenses (e.g. hospital parking, emergency taxis, crutches/canes, etc.)
- Other services de-listed from OHIP
How to apply
Application forms are at the bottom of this page. Only complete applications will be considered. Receipts are required for all Option A applications and written estimates are required from the health care practitioner for all Option B applications. 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 massage therapy and 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.
Please send applications to in an envelope marked personal and confidential
Extended Health Benefits Fund CUPE 3903
104 East Office Building
York University
4700 Keele St.
Toronto, Ontario M3J 1P3
Fax: 416-736-5480
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.
For more information
For more information on the Extended Health Benefits Fund, do not contact Sun Life or Human Resources. They do not administer this funding.Contact the Extended Health Benefits Fund Committee at 416-736-5154 x1 or 416-736-2100 x66314
In setting up the policy, guidelines and allocation process for this fund, CUPE 3903 recognizes that there is a strong relationship between a range of social factors and a person’s health and well-being. Such social determinants of health include, but are not limited to: income, social support, education and literacy, employment and working conditions, housing, health services, nutrition and coping skills. The union also recognizes that inequitable access to resources and supports may be specific and/or systemic. People may have a lack of access due to poverty and they may be denied access due to one or more forms of social exclusion (such as racism, sexism, ableism heterosexism and transphobia). Health issues and health inequities are thus often deeply intertwined. This understanding also incorporates the fact that there is a finite amount of money in the Fund for a growing union membership of approximately 3400. Ongoing collective bargaining is critical to continuing to improve member access to funds to support them with health care expenses.