University Health Insurance Plan
December 2010
Employees and visitors working and/or studying at the University of Guelph must have insurance to pay for health care services and medical treatments for themselves and family members who come with them. Enrollment in the University Health Insurance Plan (UHIP) is mandatory for anyone that is not enrolled in a provincial health plan such as the Ontario Health Insurance Plan (OHIP). UHIP benefits are underwritten by the Sun Life Assurance Company of Canada.
How do I enroll in UHIP?
Upon arriving on campus, contact the Administrative Assistant/Secretary in your department at the University of Guelph and you will be provided with an Employee Identification Number. Also please contact a Human Resources department Service Associate to obtain enrolment and complete insurance information. To book an appointment with Human Resources, call 519-824-4120 extension 53374 or e-mail hr@uoguelph.ca .
What if I become eligible for OHIP while I am covered by UHIP?
Once you are covered by OHIP (the Ontario Health Insurance Plan) you no longer need to have UHIP coverage. Please note that requirements for OHIP eligibility are different for employees than for employee dependents. For more information about OHIP, such as eligibility and waiting periods, please visit the Ministry of Health and Long-Term Care website at www.health.gov.on.ca . To visit the Guelph OHIP office, located at 1 Stone Road West (OMAFRA building), first call 1-888-376-5197 to book an appointment.
What happens if I enroll late?
If you enroll late, you must pay premiums retroactive to your employment start date. If you enroll your family members more than 30 days after they arrive in Canada, you must pay a late application fee of $500 plus retroactive premiums to your employment start date.
What does UHIP cover?
In general, UHIP covers medical emergencies, hospital services, doctors’ services, laboratory and x-ray services in Ontario only and within the limitations of the plan. For a comprehensive look at what UHIP covers, please visit the www.uhip.ca website.
What happens when I visit a health care provider?
When you visit a health care provider, you should bring proof of coverage and a claim form (available on the UHIP website). Even if your medical service providers do not directly bill to UHIP, they need to complete sections of the claim form.
What type of information can I find on the UHIP website www.uhip.ca ?
- UHIP Booklet
- How much UHIP will cost (monthly premium tables)
- What UHIP pays for
- Current forms (eg. claim form)
- Links to OHIP information (OHIP - Ontario Health Insurance Plan)
- UHIP Preferred Hospital Network
- How to get an exemption from UHIP coverage
- Plans that have been evaluated and are NOT considered equivalent to UHIP
How do I find a family doctor?
The college of Physicians and Surgeons of Ontario keeps a list of available doctors on their website. Go to www.cpso.on.ca and choose ‘Doctor Search’ from the left-hand menu. Then choose ‘Easy Search’ to determine if a family physician is accepting new patients in your area.
Will UHIP cover the cost of a missed appointment?
UHIP will not cover the cost for missing an appointment. If you inform the health provider in advance that you will be missing the appointment, they might not charge you for missing the appointment.
Why did I get a bill? I thought I wouldn't have to pay anything!
In Guelph, there are some locations that bill UHIP directly such as Guelph General Hospital and the Homewood Health Centre. However, depending on where you go, you may have to pay the health care provider directly and seek reimbursement through UHIP. In some cases, the reimbursement may not cover the full cost of the medical service. For example, a walk-in clinic may charge $75.00 - $100.00 for a visit, but UHIP may reimburse you $42.00. The maximum UHIP will reimburse is 125% of the Ontario Health Insurance Plan (OHIP) fee schedule. As well, there are some health service costs, or portions of health service costs, that UHIP does not cover. Check UHIP's web site to find out which services are covered.
Do any Guelph hospitals charge at UHIP reimbursement levels?
Yes, Guelph General Hospital and Homewood Health Centre (which provides specialized psychiatric services) are members of the UHIP preferred hospital network (PHN). UHIP and its service providers have worked closely with hospitals in Ontario to establish their preferred hospitals network. These hospitals have agreed that UHIP members will not incur any out-of-pocket charges for standard ward accommodations. You can visit the UHIP website or call the UHIP insurer, in advance (toll-free at 1-866-500-8447, you will need your UHIP identification numbers), to verify whether the hospital you intend to visit has an agreement with Sun Life. All medically necessary emergency room visits and the first 4 days of an emergency admission are reimbursed by UHIP at 100% regardless of whether or not the hospital is a member of the PHN.
What is Telehealth Ontario?
For health advice or information from a nurse, you may wish to contact Telehealth Ontario, a free and confidential telephone service available 24 hours a day, seven days a week. The nursing staff speaks English and French, have translation support for other languages, and a TTY for those with hearing and speech difficulties. To contact an English-speaking nurse, call 1-866-797-0000. For TTY, call 1-866-797-0007. A call to Telehealth Ontario does not replace 911 — that is always the first number you should call in emergency situations.
Can I be covered by another health plan instead of UHIP?
Yes, it is possible to be covered by another plan instead of UHIP. The current list of pre-approved plans is available on the UHIP website (in the section on exemptions). In order to be exempt from UHIP, you must complete a UHIP Application Form in full and sign it, and provide proof of coverage under one of the pre-approved plans. Not all pre-approved plans offer dependent coverage. If you are covered under a plan other than a pre-approved plan, you must join UHIP and pay the required UHIP premium, and may then apply for an exemption. In the unlikely event that your plan is subsequently recognized, you may apply for a refund of the premium. The UHIP website maintains a list of plans that have been evaluated and are NOT considered equivalent to UHIP.
Does UHIP provide enough insurance coverage?
The answer to that question will depend on your individual risk tolerance, your personal financial situation and your ability to use medical services providers that bill at the UHIP reimbursement level. UHIP does not provide full coverage against all medical expenses. If you are not comfortable with the level of coverage provided by UHIP, you can purchase additional private health coverage.
Local Providers of Medical Services in Guelph
Emergency
Dial 9-1-1 on your telephone. To report any life-threatening emergency situation requiring Ambulance, Police or Fire DepartmentHospital
Guelph General Hospital 115 Delhi St. Guelph, Ontario Open 24 hours / 7 days a week519-837-6440 UHIP Preferred Hospital Network member
Guelph Walk-In Medical Clinics
Surrey Street After Hours Clinic
21 Surrey Street West - Behind McDonalds at Gordon and Wellington Streets
519-763-3344
Campus Estates Walk-In Clinic
Clinic is Closed
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