Benefits FAQ

Eligible drug expenses are shared between the plan and the employee. The plan covers 80% of the eligible expenses until the employee’s 20% cost reaches the out-of-packet cap, after which point the plan covers 100% of eligible expenses, subject to the benefit maxima. Until you have reached the out-of-pocket maximum, you will have to pay a portion of the costs. For more information, please visit the Extended Health Care Benefit page.

Please visit the Benefit Eligibility and Eligible Dependents page.

When two or more plans are involved, one plan is considered to be the primary plan. The primary carrier pays its eligible amount first. The secondary carrier then reduces its payment by the amount in which total payments would exceed eligible expenses available through both plans. Eligible expenses are as defined in each carrier's contract before limitations like deductibles, co-insurance, fee guides, and maximums are applied.

As a plan member, your claims should be processed through your benefit plan first. Claims for your spouse must be processed through your spouse's plan first. Any remaining balance can then be processed through the other insurance plan.

When a child is covered under both parents' plans, the plan of the parent whose birthday (month and day) falls earlier in the calendar year is billed first.

Our chiropractic coverage includes 80% of $12.00 for the first 15 visits within the year. After 15 visits, 80% of reasonable and customary per visit charges (100% if out-of-pocket limit is reached) applies. All chiropractor expenses apply to the 2021 annual maximum of $743 per covered person per calendar year.

For more information, please refer to Annual Benefit Maximums.

Our plan includes a dispensing fee cap for prescription drugs, which is currently $7.00. If this fee (charged by the pharmacy) exceeds the dispensing fee cap, the difference is the responsibility of the employee and the fee is not applied to the employee’s out-of-pocket amount.

• Active employees can access their records within Workday to confirm their dependents, personal information, or address. Add or update any missing information. This information is shared/updated with GSC weekly.
  
  • If the information cannot be updated by you, such as a birthday or misspelling, please contact hrhelp@uwaterloo.ca and advise them of this needed change, and we will update your records.
  • Middle names are not included on your benefit ID card.
  • If the information is correct on Workday, you will need to contact GSC’s customer support line directly and have them update your information.
• For retirees, you can contact our office with your new address information to hrhelp@uwaterloo.ca. We will update your address on the University systems.

• Visit greenshield.ca and print your GSC benefit ID card yourself from GSC everywhere
• If you have a smartphone or tablet, your card is available electronically on GSC’s app, GSC everywhere. If you have questions about the app, please call GSC
• Contact GSC’s Customer Contact Centre toll-free at 1-888-711-1119, and they will mail an additional card to you

Cards are issued only under the name of the plan member and spouse. The pharmacy will ask your dependent to confirm his/her relationship to you to verify that he/she is an eligible dependent.

An important and valued feature of the extended health benefit is the Green Shield Canada out of country travel benefit, which covers 100% of medically necessary services, or supplies required, as a result of a medical emergency, up to $5,000,000 (Canadian) per lifetime per covered person. Please visit the Out-Of-Country Benefit page for more information.

The plan does not cover transportation costs if you are unable to leave home at the start of a trip due to emergencies. This type of coverage is provided by flight cancellation insurance.

If you miss prearranged and prepaid return transportation to Canada because you are in a hospital, the assistance company will arrange and pay the cost of comparable return transportation for you.

Currently, the only country that requires proof of coverage is Cuba. Employees who will be travelling to Cuba are advised to contact hrhelp@uwaterloo.ca for a letter indicating the type of coverage and any covered dependents.

The toll-free out-of-country/travel contact information for GSC is 1-800-936-6226 (also, collect with operator assistance at 519-742-3556). GSC Travel Assistance is available 24/7/365 (including holidays). When contacting GSC Travel Assistance, quote your ID number on your GSC card.

If you require a travel coverage letter, employees can contact GSC directly with this request.