FAQs

1. How do I become eligible for my dental benefits?

Full-time Employees must:

  • (i) be classified for full-time employment under the terms of the Collective Agreement pertaining to their employment;
  • (ii) have been employed for ninety (90) consecutive days commencing from, or after, the date at which their employer became a Participating Employer; and,
  • (iii) have had Contributions made, continuously on their behalf, for all of their employment time on, and after, the date at which their employer became a Participating Employer.
  • Part-time Employees must:
  • (i) be classified for part-time employment under the terms of the Collective Agreement pertaining to their employment;
  • (ii) have been employed for one-hundred and eighty (180) consecutive days from, or after, the date at which their employer became a Participating Employer; and,
  • (iii) have had Contributions made, continuously, on their behalf, for all of their employment time on, or after, the date at which their employer became a Participating Employer.

    Exception: Coverage, for both Full-time and Part-time Employees, begins on the date at which their employer becomes a Participating Employer if, immediately prior to that date, they had comparable dental-care coverage sponsored by that employer. However, Employees of the same organization, hired after the date at which their employer became a Participating Employer, must fulfill the ninety (90) and one-hundred and eighty (180) consecutive days requirements, noted above.

    You must have completed a Registration Form and submitted it to the Administrator. (Registration Forms are available from the Administrator, the Participating Employer, or the Union office.) Regardless of the other Requirements for Eligibility, no Benefits will be paid until the Registration Form is received and accepted by the Administrator.

2. How do I add my dependant spouse or child?

There is space provided on the Registration Form for the addition of your dependants. This should be done when you first send a Registration Form to the office of the Administrator. To add dependants after you join the Plan you must complete and remit a second Registration Form. (Registration Forms are available from the Administrator, the Participating Employer, or the Union office.) Note, part-time members must qualify annually for dependent coverage.

3. What does my Dental Plan cover?

Please refer to the Plan booklet and insert on the main page of this website.

4. How do I complete a claim form?

Contact your Plan Administrator for assistance at:
(416) 674-3350 (in Toronto) or 1-800-461-4361

5. What is my Group Plan Number and ID number?

Your Plan Group Plan Number is 1000 and your ID Number is your 9 digit Social Insurance Number.

6. Can I send my claim form by fax?

Yes, your claims can be sent by facsimile message, provided they are properly completed and signed.

7. Does my plan have other electronic claims submission?

Currently the Plan provides for paper and fax submission of claims.

8. How long does it take to process and pay my claim?

Short of any complications and assuming the claim form is properly completed, it will be paid within 3 business days following receipt by the Administrator.

9. What is a dental fee guide? When does it change and how?

Each year the Dental Associations in most Provinces publish a Fee Guide of dental services and supplies. The related fees for each service and supply can change from year-to-year. The Board of Trustees of your Plan decide, each year, whether or not to adopt a more recent version of fee guide. This decision is based on whether or not the Plan has the financial resources to do so.

10. Why does the Fund not provide for assignment (direct payment to dentist)?

Some plans facilitate payment directly to dentists, many do not. The philosophy behind your Plan’s decision to ensure all payments go to you (the Plan Member) is so that you are aware of what your dentist is charging for your visit. That way you can verify that the services listed on your claim are accurate. Not doing so could open the door for inaccurate billing or worse, fraud. These expenses ultimately erode the assets of your Plan, thereby leaving less money for benefits.

11. Why are certain deductions made to my payment what do they mean?

(We again recommend using an animated Explanation Of Benefits illustration, which will include the deduction codes, that accompany each cheque)

12. If my dependant child is over 18 years of age, can I still receive payment for their expenses?

Yes, if your Dependant Child is over age 18 they are still covered if they are attending full-time studies at a School. School means an institution that provides education, at the secondary or post-secondary level, of the types approved for general, public application within the jurisdiction of the Government authority responsible for the particular school and/or school district.

13. What type of proof is required that my dependant child is in full-time School.

Your Plan will accept:

  • (i) a letter from a Registrar’s office, noting the dates of enrolment;
  • (ii) confirmation of payment of tuition, including dates of attendance; or,
  • (iii) if your request for coverage is made retroactively, a copy of your dependant Child’s school transcripts or report card, evidencing the dates of attendance.

14. What does the Plan require as proof of my common-law relationship?

Your Plan will accept:

  • (i) Government issued identification that includes the same address information and issued at least one year prior to your request to add a common-law Spouse; or,
  • (ii) a utility bill (telephone, hydro, gas, cable) that names your common-law spouse and is dated at least one year prior to your request to add you common-law Spouse.

15. Where can I get a Plan Registration Form?

Registration Forms are available from the Administrator, your Union office, or your Employer. Please ensure that the registration Form is completed in full and signed and dated in ink.

16. Can I make a self-Payment?

Self-payments are voluntary and can be made:

  • i) following the first 12 months of disability leave, for up to an additional 36 months; and,
  • ii) during any Approved Leave of Absence or Temporary Lay-off, for up to 36 months.

Failure to remit Self-payments during the above leaves will result in suspension of your Eligibility for benefit reimbursement.

17. How do I make a self-payment? Can it be deducted from my bank account or paid by Visa or Mastercard?

Self-payments are to be made to the Administrator, by cheque or money order made payable to the United Food and Commercial Workers Trusteed Dental Fund – Ontario. We are unable at this time to accept payment by Visa and Mastercard.

The amount of the Self-payment changes from time to time, based on the operating costs of the Trust Fund and the Plan.

©2012-2015 United Food and Commercial Workers Trusteed Dental Plan - Ontario
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