Student Health Plan
Available to Full-Time Domestic and International Students.
STUDENT HEALTH PLAN
Recorded Webinar
Our Health Plan Account Manager provides a walk through of the Loyalist Student Health Plan website to help you submit your prescription drug and accident claims.
Coverage Period
Fall: September 1 - December 31
Winter: January 1 - April 30
Spring: May 1 - August 31
Please note: Although coverage begins at the start of the semester, there is a blackout period at the beginning of each semester. During this time, the student health plan contractor is not able to confirm coverage and will not process or reimburse claims. Please note that pharmacies cannot accept your Student ID Card for the Pay Direct Prescription Drug Service during the blackout period.. Please keep receipts from prescription drug purchases or accident claims to make a manual claim once the blackout period ends.
Eligibility
Only full-time students at the Belleville, Bancroft, Port Hope and Tyendinaga Campuses are eligible to receive coverage based on the terms of the Health Plan.
Dropping a course may affect your status as a full-time student and, consequently, may impact your eligibility. To qualify as a full-time student, your course load must represent at least 70% of the hours of two-thirds of the courses required for the semester of the program in which you are enrolled.
Belleville Campus students with documented permanent disabilities who are registered with AccessAbility Services or verified through the Financial Aid Office (OSAP) are considered full-time students when registered in a minimum of a 40% course load but will only be charged part-time Student Ancillary Fees. These students have the option to receive coverage if they choose to self-declare and pay all the same Ancillary Fees as full-time students, such as the Student Health Plan.
Health Plan Details
This is a brief outline of the benefits available to you under your Group Insurance Plan and does not create or confer any contractual or other rights. It is not an insurance policy, but an informal explanation of benefits provided by the plan. All rights with respect to the benefits of an Insured will be governed solely by the Group Master Policy issued by SSQ Financial Group. Terms and conditions subject to change.
OUTLINE
Group Name: Loyalist College Student Insurance Plan
Policy Number: 100011687
Group Number: 513979
Certificate Number:
Your Student ID #
_ _ _ _ _ _ _ _ _ G
(10 digit alpha numeric number: your 9 digit student number plus the letter G) i.e. If your student ID # is 9 digits, the correct ID # would be 987654321G
All Drug & Accident Benefits Underwritten By: SSQ, Life Insurance Company Inc. (SSQ Financial Group)
Drug Claims Paid By: ClaimSecure
Prescription Drug & Accident Questions & Plan Consultants:
ACL Student Benefits
tel 1-800-315-1108
fax 416-216-1179
IMPORTANT INFORMATION
Students should be aware of this information prior to processing any claims. Loyalist College staff will refer to the Student Insurance Plan Booklet when assisting students and replicating information and as such, will not be held responsible for any allegations of misinformation provided on their part.
Freedom of Information & Protection of Privacy Act In accordance with Loyalist College’s commitment to privacy and security of your personal information, please be advised that your personal information will be used to collect, use and disclose information for the purposes of underwriting, administration, audit, paying claims and patient safety including: Loyalist College, Loyalist College Student Health Centre, Loyalist Student Government, ACL Student Benefits, SSQ Life Insurance Company Inc. (SSQ Financial Group), ClaimSecure, the pharmacies through which the Pay Direct Prescription Drug service is used, health-care practitioners, institutions, investigative agencies and insurers, and any person performing services for ACL Student Benefits, SSQ Life Insurance Company Inc. (SSQ Financial Group) and/or ClaimSecure.
Additional Information
Additional coverage such as dental, vision and family would increase the Health Plan ancillary fee for all full-time students and there would be no option to pick and choose between additional offerings. As a result, there has not been enough support from full-time students to include additional coverage with the Loyalist Health Plan.
Dropping a course may affect your status as a full-time student and, consequently, may impact your eligibility using the Student Health Plan (including Prescription Drug Plan and Accident Insurance). To qualify as a full-time student, your course load must represent at least 70% of the hours of two-thirds of the courses required for the semester of the program in which you are enrolled.
Students with Documented Permanent Disabilities
Belleville Campus students with documented permanent disabilities who are registered with the AccessAbility Services or verified through the Financial Aid Office (OSAP) are considered full-time students when they are registered in 40% of a full course load. Loyalist College’s registration process only assesses these students with part-time post-secondary day Student Ancillary Fees.
Students with documented permanent disabilities must complete the Students with Documented Permanent Disabilities Ancillary Fees Form to self-declare if they want to pay the same Ancillary Fees as full time post-secondary day students as an option to receive the same benefits as full time students, such as the Student Health Plan.
Prescription Drugs
Provides a prescription drug plan for students that offers 80% coverage through a pay direct system to a maximum of $3,000 per year
Includes various birth control options and methods
There are some exceptions
Find out more information on the prescription drugs coverage
International Students: Prescription drug coverage through Guard.me Health Insurance is for emergency medical conditions or injuries only and medication is limited to a 60-day supply. Prescription claims for pre-existing conditions, and those that are not related to emergency medical conditions or injuries should be submitted through the Student Health Plan instead of Guard.me.
Prescription Drugs Reimbursement Process
Please note:
Although coverage begins at the start of the semester, there is a blackout period at the beginning of each semester. During this time, the student health plan contractor is not able to confirm coverage and will not process or reimburse claims. Please note that pharmacies cannot accept your Student ID Card for the Pay Direct Prescription Drug Service during the blackout period.. Please keep receipts from prescription drug purchases or accident claims to make a manual claim once the blackout period ends.
Automatic:
Present a valid Loyalist Student ID Card at any pharmacy:
Fall 2023 Semester: Monday, October 2
Winter 2024 Semester: Monday, February 5
Spring 2024 Semester: Monday, May 27
Manual by submitting an online claim:
Click eProfile for Online Claim Submission.
Click Register and follow the prompts to create an account.
Once you have created an account, you will be able to submit your receipts electronically.
Manual by submitting a claim by mail:
Pay the cost of your prescription
Keep the official receipt(s) to complete a manual claim by mail
Download the prescription drugs claim form. Click Booklets & Forms.
Complete all sections of the form that apply to your claim and once you sign it you can mail it along with your original receipts directly to:
ClaimSecure
PO Box 6500, Station A
Sudbury, ON P3A 5N5
Accident Benefits
Coverage for expenses related to an accident, i.e. life insurance, medical and dental expenses, emergency taxi, etc.
Life insurance
Medical and dental expenses
Emergency taxi
Rehabilitation
Repatriation
Eyeglasses and contact lenses
Home and vehicle modification
Hearing aids
Family benefits
Tutorial services
Accident Benefits Reimbursement Process
Manual by submitting a claim by mail:
Download the accident benefits claim form. Click Booklets & Forms.
Complete all sections of the form that apply to your claim and sign it.
Please Note:
Students must have received treatment from a qualified physician/dentist within 30 days from the date of an accident.
Accident must be reported within 90 days.
Claim must be filed no later than one year.
The claim form must be signed by an authorized authority at Loyalist College. Please email this completed and signed claim form to the Registrar’s Office.
Mail your Accident Claim form along with your original receipts to:
Industrial Alliance Financial Group
Life and Health Claims Department Special Markets Solutions
2165 Broadway West
PO Box 5900
Vancouver, BC V6B 5H6
Health Plan Contacts
Prescription Drug Inquires:
(including the Pay Direct Prescription Drug Service)
ACL Student Benefits
tel 1-800-315-1108
fax (416) 216-1179
1 Yonge Street, Suite 1200
Toronto, ON M5E 1ES
If mailing your prescription drug claim, mail it directly to:
ClaimSecure
PO Box 6500, Station A
Sudbury, ON P3A 5N5
Accident Benefit Inquires:
SSQ, Life Insurance Company Inc.
tel 1-866-696-6001
Claims Department
110 Sheppard Avenue East, Suite 500
Toronto, ON M2N 6Y8
Student Health Plan Opt-Out
Domestic Students Only
Domestic students who can provide proof of pre-existing coverage may opt-out of the Prescription Drug Plan online during the following dates. Domestic students cannot opt-out of the Accident Benefits.
International students cannot opt-out of the Student Health Plan, including the Prescription Drug Plan and Accident Benefits, as your International Student Health Insurance does not provide adequate coverage.
Opt-Out Deadlines
For Fall 2023 students: September 6-25
For NEW Winter 2024 students only: January 10-29
For NEW Spring/Summer 2024 students only: May 1-20
How to Opt-Out
Visit wespeakstudent.com and click the “Opt Out” link
Please Note
OHIP + through the Ontario Government or UHIP coverage CANNOT be used as proof of alternative coverage to opt out of plan coverage.
This online opt-out is available to full-time Winter intake domestic students only. If you are not a Winter intake domestic student, please be aware that while the online opt-out will accept your request, you are not eligible to opt-out of the plan, even if your benefits were never used. You will not be issued an opt-out refund.
International students cannot opt-out of the Student Health Plan, including the Prescription Drug Plan and Accident Benefits, as your International Student Health Insurance does not provide adequate coverage.
The opt-out refund is $30 per semester. Please keep the receipt as your proof of completing the opt-out application. Please be aware that your deposit is not instant. Once the online opt-out period has ended it will take approximately 6 weeks for your direct deposit to be placed into your account. Should your direct deposit information not be accepted at your banking institution a refund cheque will be issued and mailed to the address you have supplied on your opt-opt application.
Loyalist College does not provide reimbursements for this ancillary fee. It is up to the Student Health Plan provider to determine if the pre-existing coverage is satisfactory and issue a refund.
Student Health Plan Opt-Out Frequently Asked Questions
Who is eligible for the Student Health Plan opt-out?
Full time domestic students who can provide proof of pre-existing coverage may opt-out of the Prescription Drug Plan. Domestic students cannot opt-out of the Accident Benefits. OHIP + through the Ontario Government or UHIP coverage CANNOT be used as proof of alternative coverage to opt-out of plan coverage.
International students cannot opt-out of the Student Health Plan, including the Prescription Drug Plan and Accident Benefits, as your International Student Health Insurance does not provide adequate coverage.
Can international students opt-out of the Student Health Plan fees?
International students cannot opt-out of the Student Health Plan, including the Prescription Drug Plan and Accident Benefits, as your International Student Health Insurance does not provide adequate coverage.
Can part-time day students also opt-out of the Student Health Plan?
Part-time day students are not charged any Student Health Plan fees, so opt-out is not applicable.
What if I am already covered?
Domestic students who can provide proof of pre-existing coverage may opt out of the Prescription Drug Plan prior to the opt-out deadline. Domestic students cannot opt-out of the Accident Benefits. Please opt-out online by going to wespeakstudent.com and complete the online opt-out form. You are only eligible to opt-out of the Prescription Drug Plan before the deadline date of the first semester you are registered in and you are required to opt-out of the Prescription Drug Plan each academic year.
International students cannot opt-out of the Student Health Plan, including the Prescription Drug Plan and Accident Benefits, as your International Student Health Insurance does not provide adequate coverage.
What are the Opt-Out Date deadlines?
Fall 2023 opt-out will run from September 6-25, 2023. For NEW Winter 2024 students only, opt-out will run from January 10 to 29, 2024. For NEW Spring/Summer 2024 students only, opt-out will run from May 1 to 20, 2024. Go to wespeakstudent.com and fill out the online opt-out form prior to the opt-out deadline date.
Please note: The above noted deadline dates will not be extended even if
You miss the deadline date no reimbursement will be issued. (i.e. If you are a September student you will not be able to opt-out of the plan in January even if your benefits were never used).
You made errors while filling out the application when trying to opt-out of the student health plan.
The Prescription Drug Plan coverage was never used.
How do I opt-out of the Student Health Plan?
Go to wespeakstudent.com and click the opt-out form prior to the opt-out deadline date. There are no paper opt-out forms available. Opt-out is completed online.
When filling out the opt-out application form online:
You will need to register with your Loyalist College email address.
Make sure that you know the correct policy number and the name of your insurance provider. Failure to provide the correct policy number and the name of your insurance provider will result in the rejection of the opt-out application. For example, if you put “Local 92″ as your insurance company name; your application will be rejected, because this is not an insurance company name.
If you are covered as a dependent under another health insurance plan, the relationship between you and the primary insurance holder must be clearly stated. This means spouse, mother, father, etc. If you are the policy holder, please write in “myself” as the policy holder.
Once you have completed the online form:
Please be sure to print your on-line opt-out confirmation.
You will receive the opt-out confirmation email. Please keep this confirmation email for future reference for your opt-out application. The confirmation page has the application number, so you can use this number to follow up regarding your application if you do not receive the confirmation email. However, if you cannot find your confirmation email at all, please contact ACL Student Benefits (telephone 1-800-315-1108, email help@aclstudentbenefits.com) as soon as possible before the opt-out deadline.
Even though you completed the online opt-out process it could require verification or correction info and time allowed to receive reimbursement.
Do students opt-out of the Student Health Plan fees every semester?
Domestic students will only have to opt-out of the Prescription Drug Plan during their starting semester. Domestic students cannot opt-out of the Accident Benefits. For example, September start students would opt-out in September, January start students would opt-out in January and May start students would opt-out in May. Domestic students will not have to do any additional work after opting out the first semester. Domestic students will then have to opt-out again in September of the next academic year as the opt out is only for 2023-2024.
International students cannot opt-out of the Student Health Plan, including the Prescription Drug Plan and Accident Benefits, as your International Student Health Insurance does not provide adequate coverage.
What is the opt-out refund amount?
The opt-out refund is $30 per semester. This includes the Prescription Drug Plan. Students cannot opt-out of the Accident Benefits.
When will I receive my opt-out refund?
Please keep the receipt as your proof of completing the opt-out application. Please be aware that your deposit is not instant. Once the online opt-out period has ended it will take approximately 6 weeks for your direct deposit to be placed into your account. Should your direct deposit information not be accepted at your banking institution a refund cheque will be issued and mailed to the address you have supplied on your opt-opt application. The opt-out will be reimbursed to students each semester they pay the fees. Domestic students will not have to do any additional work after opting out the first semester. Loyalist College does not provide reimbursements for this ancillary fee. It is up to the Student Health Plan provider to determine if the pre-existing coverage is satisfactory and issue a refund.
International students cannot opt-out of the Student Health Plan, including the Prescription Drug Plan and Accident Benefits, as your International Student Health Insurance does not provide adequate coverage.
Is your parents’ health insurance enough? How do coordination of benefits for private and provincial plans work?
Most plans won’t cover all your health costs on their own, but you can combine your Student Health Plan with another plan for up to 100% coverage. Amounts payable under the policy shall only be for the excess of such expenses over any amounts available or collectible for the treatment or services which are insured services under the Provincial Medical or Hospital Care Plan of the province in which the Insured is resident, whether or not the Insured is covered hereunder.
If an Insured has coverage under another plan of insurance which provides similar benefits, the order of benefits determination is as follows:
The plan that does not include a Co-ordination of Benefits provision is considered to be the primary plan and pays benefits first before a plan which includes a Co-ordination of Benefits provision
The plans that include a Co-ordination of Benefits provision, priority payment is established as follows:
The plan where the Insured is covered as a student
The plan where the Insured is covered as a dependent
Can dependents be added on the Student Health Plan?
Dependents cannot be added on the Student Health Plan.