Eligibility & Enrolment for Medical & Dental

TFA retirees under age 65 are eligible for coverage as long as you:

• are in receipt of the TMU Pension Plan or the Ontario Teachers’ 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 health care (e.g. OHIP).

When will my coverage begin?

This coverage begins the date you retire from TMU as long as you are under age 65. If you are over age 65 at the time of retirement, please refer to the TFA Retiree 65+ benefit information.

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?

On the date of your retirement you and your eligible dependents will be moved into the TFA Retiree under 65 benefit plan automatically.

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.

The retiree plan for TFA retirees under age 65 includes health and dental benefits and reduced life insurance.

Your Sun Life member ID and policy number remain the same.

When does my coverage end?

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

• The TMU TFA Early Retiree paid benefits plan ceases effective your 65th birthday, unless you enrol in the TFA 65+ Retiree 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;
• 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.