Eligibility & Enrolment for Medical & Dental

MAC retirees 65+ are eligible for coverage as long as you:

• are in receipt of the TMU Pension Plan;
• retired from active service (i.e. no break between being an active employee and a retiree);
• enrolled in the group benefits plan(s) when you were first eligible to; and,
• you are a permanent resident in Canada and are covered by provincial insurance (e.g. OHIP).

When will my coverage begin?

This coverage begins the day that your retirement begins, if you are age 65 or older.

Can my family be insured for some benefits?

Yes, your spouse and eligible children (dependents) can be insured under the Extended Health Care and Dental Plans.

In order to be eligible, dependents must:

• be a permanent resident in Canada and be covered by provincial health insurance (e.g. OHIP).

Dependents are eligible:

• as soon as your enrolment in the plan is effective or the date they become your dependents (if that date is later).

If a dependent is confined in a hospital on the date coverage would commence, coverage will commence on the day following the last day of confinement. This does not apply to a newborn child.

Anything else I should know?

Enrolment information for your family must be submitted to HR within 30 days of your spouse/dependents becoming eligible. 

If your dependant is hospitalized when his or her coverage is scheduled to begin, the coverage will not start until he or she recovers.

How do I enrol?

Once you notify HR of your intention to retire, you will receive information regarding the election of retiree benefits. 

Anything else I should know?

It’s your responsibility to complete your Sun Life enrolment form and to ensure that your dependants are enrolled properly. The next section provides some tips on the process.

If you have any questions, please submit a request to HR.

Your TMU paid employee benefits cease effective your retirement date. You have 90 days from your retirement date to submit claims to Sun Life for any outstanding eligible health and dental expenses incurred prior to your retirement date.

For retirees 65+, the plan includes health and dental benefits.

You are responsible for the benefit insurance premiums, which will be deducted monthly from your TMU pension.

Participation in the TMU Retiree Benefit Plan is a one-time only offer. If you decline the option to participate at your retirement, the plan allows a retiree to re-elect coverage only in such circumstances whereby coverage was waived in writing as a result of being covered under a spousal or other insurance plan and such plan ceases.

There must be no lapse in insurance coverage. Your Sun Life member ID and policy number remain the same.

If you elect to participate in the early retiree benefit plan, unless you advise us otherwise in writing, upon attaining age 65, you will automatically be enrolled in the retiree benefit plan for retirees age 65 and older. This plan is a modified benefit plan that does not include prescription drug coverage.

When does my coverage end?

Your coverage under the retiree benefits program will end on the earliest of the following dates:

• the date you turn 65, unless you enrol in the Retiree 65+ plan;
  • If you do not enrol in the 65+ plan, you have 90 days from your 65th birthday date to submit claims to Sun Life for any outstanding eligible health and dental expenses incurred prior to your 65th birthday.
• the date the relevant plan policy ends; and
• in the event of your death, your surviving spouse and/or eligible dependent children will be offered health and dental plan coverage for a period of six months following the date of your death.

Coverage for your dependants stops when they no longer qualify as dependants or when your own coverage ends.