Policy Administration
The TMU Retiree Extended Health Care (EHC) Plan and Dental Plan are designed to help you pay for many routine and unexpected medical and dental expenses for yourself, your spouse and your dependents.
The cost of the plan is fully paid for by the participating members.
While your provincial health insurance (e.g. OHIP) provides basic coverage, a number of services and supplies are not covered.
Insurer, policy and certificate numbers
The insurer is Sun Life Financial. The EHC and dental policy number is 25180. Your Sun Life certificate number is the same as your TMU employee identification number.
How do the EHC and dental plan work?
The cost of the plan is fully paid for by the participating members. Premiums are adjusted annually on May 1st.
Extended health care premium
Monthly premiums as of May 1, 2024 are $80.04 for single coverage and $160.79 for family coverage.
Dental plan premiums
Monthly premiums as of May 1, 2024 are $94.40 for single coverage and $203.93 for family coverage.
Deductible and coverage amount
The extended health care plan reimburses 80% of eligible expenses, unless otherwise stated, and has a $25 annual deductible. The deductible is automatically deducted from the first claim you submit each year and does not apply to hospital expenses.
The dental plan reimburses 90% of eligible routine dental expenses, and 50% of major restorative services to a maximum benefit of $2000.00 per covered individual per calendar year. There are no deductibles for the dental plan.
Explore coverage with other providers
To explore alternative coverage options with other providers, please review the Retiree 65+ Health and Dental Benefit Comparison (external link) .
Claims submission
You can submit claims for covered expenses in three ways:
- online claim submission
- My Sun Life mobile application
- hard copy claim submission
Additionally, some providers may submit claims for direct-pay, removing the need for you to pay out-of-pocket.
For more detailed information on submitting EHC and dental claims, visit the information on making a medical or dental care claim.
Anything else I should know?
TMU is proud to offer a comprehensive and robust benefit plan, but some expenses have limits and some are not eligible.
This site describes limits on covered expenses and lists excluded expenses. To find out if a specific service or item is covered, you can call Sun Life at 1-800-361-6212.
TMU reserves the right, at any time, to amend, change or discontinue any benefit coverage. If there is a question about coverage referred to in any portion of this benefits communication, the master contract from the insurer is the governing document.