ARM Health Insurance – Frequently Asked Questions

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If you don't see the answer to your question, please contact an OTIP life and living benefits sales representative at 1-800-267-6847.

Enrolment and Eligibility Questions

Who is eligible for plan enrolment?

All retired education employees in Ontario, their survivors, and others who are covered by the provincial health insurance plan, are eligible to enrol for coverage under an ARM health plan.

 

All unmarried, unemployed children under the age of 21, or 31 if attending school full-time, are eligible for dependant coverage under an ARM health plan.

 

There is no age limit for unmarried, dependant children who are incapable of self-sustaining support due to a mental or physical disability, which occurred prior to age 21.


When should I apply for coverage?

It's best to apply for coverage early, at least 30 days before you want your coverage to start. Applying before your current coverage ends gives you the peace of mind that your coverage will be ready for you when you need it.

 

If you're nearing retirement, please call OTIP life and living benefits toll-free at 1-800-267-6847 to discuss your needs.


When is medical evidence required to apply for coverage?

Medical evidence is required if you apply for any of the ARM health plans (except dental) more than 60 days after leaving any group health benefits plan. Medical evidence is also required if you are leaving a retiree group health benefits plan. Submitting a late entrant medical application does not guarantee approval.

 

Medical evidence is also required if you:

  • apply to increase your coverage by more than one level of extended health care coverage.
  • apply to add a spouse or dependant to your coverage and he or she has not had group health. benefits coverage within the last 60 days.

Medical Evidence is not required if you:

  • apply to increase extended health care coverage annually by one level.*
  • decrease coverage.*
  • apply to add dependants to any family status extended health care coverage.

*These changes take effect January 1 of the following year.

Download a medical evidence of insurability form.


As of what date is my age calculated?

Your age is calculated as of the plan renewal, January 1 of each year. When you turn 65, your policy is re-rated at the following renewal.


Should I stay with my board plan?

Many boards no longer have a retiree plan. For the boards that do, many plans have become very expensive due to their unlimited drug coverage feature. In addition, board plans rarely have rates for couples, making it even more expensive for a couple to stay with the board as they are forced to choose the more expensive family coverage rates.

 

If staying with a board plan is an option for you, please call OTIP life and living benefits at 1-800-267-6847 for assistance comparing coverage options and making your decision.


When will my coverage start?

Coverage under any of the ARM health plans starts on the first day of the month.  You must be in your province of residence on the effective date in order for your travel benefit to be covered.


There is only myself and one dependant to insure. Do I have to choose family rates?

No, you can choose the more affordable couple rates. Any two family members can qualify for couple coverage, which means you and your dependant child can qualify for couple rates if you do not have an eligible spouse.

 

 

 

OSSTF   60 Mobile Drive, Toronto, ON   M4A 2P3   1-800-267-7867  |  www.osstf.on.ca
OTIP   125 Northfield Drive West, Waterloo, ON   N2L 6K4   1-800-267-6847  |  www.otip.com