Glossary of Terms
Authorization Document
A study or work permit, or other documentation providing temporary status to live, work, or study in Ontario and has been issued by Citizenship and Immigration Canada.
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Child/children
The member’s natural or legally adopted children, or stepchildren, or children for whom the member has been appointed legal guardian, who accompany the member, are unmarried, dependent on the member for support, and are:
- under age 22
- under age 25, if studying full-time at an accredited educational institution (annual proof of attendance may be required by the UHIP insurer)
- any age, if mentally or physically disabled and not capable of self-sustaining employment, provided that the disability began:
- while the child was covered under the plan, or
- before the member applied for UHIP coverage, only if the child was disabled before age 22 or 25 if a full-time student (proof of disability and its continuation may be required by the UHIP insurer)
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Eligibility of Disabled Child/Children
| Child, age 28, full-time student and disabled before age 25, before member applies |
Eligible for UHIP coverage |
| Child, age 28, disabled after age 25, before member applies |
Not eligible for UHIP coverage |
| Child, age 18, covered by UHIP, becomes disabled |
Eligible for continued UHIP coverage |
| Child, age 20, covered by UHIP, not a full-time student, turns 21, and becomes disabled at age 22 |
Not eligible for UHIP coverage |
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Fraud
The intentional deception or misrepresentation that an individual knows to be false or does not believe to be true and makes, knowing that the deception could result in some unauthorized benefit to himself/herself or some other person.
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Full-time student
A full-time regular and term student who:
- holds a valid study permit issued by Citizenship and Immigration Canada
- is registered in any given semester in an approved degree program, as defined by the Ministry of Training, Colleges, and Universities,
- has paid a required tuition fee for the program
- is in regular attendance, as defined by regulations of the participating university, and
- is actively pursuing an undergraduate, graduate, or post-graduate degree
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Member
Any undergraduate, graduate, or post graduate student, a short-term university visitor, or an employee who must join UHIP
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Non-resident
A person who does not normally live in Ontario
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OHIP
The provincial health care plan provided to Ontario residents by the Ontario Ministry of Health and Long-Term Care
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Out of Country
Outside of the 10 provinces and 3 territories of Canada.
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Out-of-Pocket Expense
The portion or entirety of an expense for services that is not eligible for reimbursement and is the financial responsibility of the member or patient. An out of pocket expense may result from a fee for service that exceeds the maximum eligible reimbursement amount or for a service that is not a covered benefit in accordance with the provisions of the UHIP Policy.
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Out of Province
Outside of Ontario but within one of the other 9 provinces or 3 territories of Canada
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Participating University
All universities in Ontario, with the exception of the University of Windsor, and colleges affiliated with those universities, whose non-resident students must enrol in UHIP.
| Algoma University College |
Saint Paul University |
| Brock University |
Trent University |
| Carleton University |
University of Guelph |
| Lakehead University |
University of Ontario Institute of Technology |
| Laurentian University |
University of Ottawa |
| McMaster University |
University of Toronto |
| Nipissing University |
University of Waterloo |
| Ontario College of Art and Design |
University of Western Ontario |
| Queen's University |
Wilfrid Laurier University |
| Royal Military College of Canada |
York University |
| Ryerson University |
|
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Part-time student
A student who was previously enrolled as a full-time student who:
- has been approved by a participating university to continue studies on a part-time basis
- holds a valid study permit issued by Citizenship and Immigration Canada
- is registered in an approved degree program, as defined by the Ministry of Training, Colleges and Universities
- has paid the required tuition fee for the program
- is in attendance as defined by regulations of the participating university for a part-time student, and
- is actively pursuing an undergraduate, graduate, or post-graduate degree that the student will be able to complete within the generally established timeframe for the program, as established by the participating university
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Pre-approved plans
(Plans that allow a person not to participate in UHIP*)
- Canadian International Development Agency Health Care Plan
- Canadian Bureau for International Education Health Care Plan
- Canadian Commonwealth Scholarship and Fellowship Plan
- International Council for Canadian Studies Plan
- The National Insurance Office for Social Insurance Abroad (Norway)
- World University Service of Canada Plan
- OHIP coverage
- Embassy of Kuwait
- Libyan Scholarship Program
- The Schlumberger International Health care Plan for Mobile Employees
- Interim Federal Health Plan
*This list is subject to change without notice.
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Proof-of-coverage card
The wallet-size plastic card issued by the UHIP insurer and used by UHIP members when visiting a health care provider to prove coverage under UHIP.
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Repatriation
Terminal Illness: If a UHIP member or a member of his/her family is diagnosed as terminally ill (with 12 months or less to live) and the medical condition is stable, either the UHIP insurer or the member may request repatriation to the person’s home country.
When the UHIP insurer and the member mutually agree to repatriation, the UHIP insurer will pay up to $20,000 or the actual cost, whichever is less, for returning the covered person by the most direct route to the air terminal nearest the covered person’s residence in his home country.
If Sun Life or the covered person refuse the request for repatriation, UHIP coverage will continue for as long as the covered person meets the eligibility requirements of UHIP. Until a terminally ill covered person has been repatriated or no longer meets the eligibility requirements of UHIP, Sun Life , in consultation with the attending physician, reserves the right to determine the level of care required in the circumstances, including the right to transfer the person to another hospital or medical facility. In addition, Sun Life may consider alternative procedures, services, and personnel, and to provide benefits on the least costly basis that will result in adequate care, consistent with accepted standards of medical practice.
If a member requests repatriation, and the UHIP insurer does not agree that the member meets the criteria for repatriation, an independent medical opinion will be obtained.
Death: If a member dies, the UHIP insurer will pay up to $20,000, or the actual cost, whichever is less, of returning the person’s remains by the most direct route to the air terminal nearest the person’s residence in the home country. Eligible expenses within the $20,000 limit will include the reasonable and customary costs for preparation of the body, transportation of the remains, documentation, and shipment container(s): limited to those required by provincial, federal, international or transportation legislation.
The UHIP insurer must be notified as soon as is reasonably possible regarding any request for repatriation.
The list is subject to change at any time without notice.
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Short-term university visitors
Individuals who are at a participating university for a brief, defined period of time, not necessarily related to an academic term, that is:
- visiting scholars
- post-physicianal students
- international researchers
- conference participants
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Spouse
The person who accompanies the member, and
- to whom the member is legally married, or
- of the same or opposite sex, with whom the student/employee declares on the Application Form that he/she has been living in a relationship resembling marriage for at least 12 months
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Treatment Consent Form
When you visit a health care provider in Ontario, he/she may ask you to sign a consent form, agreeing that the laws of Ontario will govern the relationship between you and your health care provider in any dispute that may arise between you and him/her. What this means is that, if you get into legal proceedings against the physician, these proceedings will be heard in Ontario courts, not the courts in your home country. Health care providers outside Ontario may also ask you to sign a similar form.
UHIP cannot advise you to sign or not to sign the consent form, nor is it responsible for any liability/costs associated with this form or with any dispute between you and your health care provider. The decision to sign the form is yours.
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University Health Insurance Plan—university plan administrator (UHIP-UPA)
The person or persons designated by each university to enrol eligible participants in the plan and perform related administrative duties.
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UHIP Insurers
Sun Life Assurance Company of Canada (Sun Life) insures combined claims up to $100,000 each policy year under Group Policy 50150 and American Home Assurance Company insures combined claims above $100,000 and up to $1,000,000 each policy year under Policy number SRG 9114277, All claims inquiries and all claims adjudication will be administered by Sun Life, regardless of the amount. Inquiries should be directed to Sun Life at :
Members and health service providers can contact the insurer at:
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Who May Not Join UHIP
The following people may not join UHIP:
- individuals other than short-term university visitors and members' families who are in Canada with temporary resident status recognized by Citizenship and Immigration Canada
- family members of UHIP members who have been refused OHIP coverage or whose status is that of visitor under a Minister’s permit, or medical Minister’s permit correspondence students
- those individuals who were not eligible for OHIP coverage before July 1, 1994, or who would not have been eligible had the government not changed eligibility rules
- children who become disabled after they are no longer eligible for coverage or who were over age 22 (or age 25 if a full-time student) when the member applied for coverage
- students and employees registered at an Ontario university not participating in UHIP For those not eligible to join UHIP, health care coverage for visitors to Canada is available from several Canadian insurers.
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