Health & Dental Plan
The Students’ General Association Benefit Plan covers all full-time SGA/AGÉ students attending Laurentian University. These benefits were specifically designed with students in mind. Campus Trust has worked with the SGA/AGÉ in order to create a plan that meets and exceeds your needs. The SGA Benefit Plan provides coverage for many important services. Get to know your benefits so you are able to get the most out of them.
For the 2023-2024 academic year the health plan fee is $299.99 for full-time students and $400.00 for online and part-time students who chose to opt-in.
*Please note that the opt-out and opt-in period for the 2023-2024 academic year has now ended.*
Health Benefits Overview
80%, up to $1,000 per student year, Max dispensing fee of $6.99 per visit
Coverage is limited to the cost of the lowest priced equivalent item in the applicable generic category that can be legally used to fill your prescription. Our plan covers up to a 34-day supply of therapeutic (acute) drugs, and up to a 100-day supply for maintenance drugs unless prior approval is obtained from The Campus Trust.
100% up to $100 every 24 months.
One eye examination, by an ophthalmologist or optometrist, registered and legally practicing within the scope of their license is covered. No amount will be paid for contact lens fitting fee.
100% up to $500 per student year, combined. Max of 50$ per visit.
Acupuncturist, Chiropractor, Counselling by a Psychologist or Registered Social Worker, Dietitian/Nutritionist,
Osteopath, Occupational Therapist, Physiotherapist, Podiatrist/Chiropodist, Speech Therapist
$15 per hour, up to $1, 000 per disability
If you become disabled while covered and are confined at home or in a hospital for a minimum of 15 consecutive school days, you are eligible for the private tutorial services by a qualified teacher, up to the benefit maximum. The teacher must be approved, in advance.
100% up to $1,000 per injury
Charges for dental services by a licensed dentist for the repair of sound natural teeth (healthy, non-diseased and not heavily restored) are covered when required for a non-occupational accidental injury, external to the mouth, which occurs while the person is covered. No amount will be payable for injury caused by an object placed in or on the mouth, self-inflicted or to existing dentures, crowns, or bridgework.
50%, up to $200 per student year (Referral Required)
Charges for custom-made orthopaedic shoes (including repairs), arch supports, moulds and orthotics, which have been specially designed and moulded for the covered person, are covered when required to correct a diagnosed physical impairment and when recommended by a licensed doctor.
100% up to $200 every 24 months
Lenses and frames or contact lenses, when prescribed by an ophthalmologist or optometrist, are covered. Laser eye surgery; in lieu of lenses and frames, will also be covered, up to the benefit maximum. No amount will be paid for non-prescription glasses, such as safety or sunglasses, or features sue as anti-reflective coatings or tints.
Charges for licensed ambulance service are covered in excess of the amount payable under the covered person’s Provincial Health Care Plan. The coverage includes the transport of the covered person from the place of debilitation to the nearest hospital where treatment is available, or from the first hospital to another for specialized treatment not available at the first hospital, or to a convalescent/rehabilitation hospital.
100% up to $800 per student year
100% up to $3,000 per student year
Dental Care Benefits Overview
*Percentages are only covered until the total claims reach $1,000 per student year in total dental claims.*
Exams, X-Rays, Polishing, Scaling, Fluoride, Oral Hygiene Instruction, Space Maintainers
Procedures include root canals, root planing and management of oral disease.
Erupted teeth/Surgical, Residual Root Removal, Fractures, Surgical Excision/Incision
Includes General Anesthesia, Deep Sedation, Inhalation Technique, Intravenous Sedation
NO AMOUNT WILL BE REIMBURSED FOR THE FOLLOWING EXPENSES:
any anesthesia administered in a hospital
dental charges that could be claimed under Workers’ Compensation
dental charges not included in the current provincial Fee Guide
cosmetic procedures, experimental treatment or testing
charges for appointments that are not kept
charges for the completion of claim forms
treatment to correct temporomandibular joint dysfunction (Jaw)
endodontic treatment that started before the effective date of coverage dental appliances
any orthognathic surgery (remodeling or reconstruction of your jaw)
procedures or supplies used in vertical dimension corrections (changing the height of the teeth) or to correct attrition problems (worn down teeth)
implanting fabricated teeth or any major surgery resulting from implanting fabricated teeth.
If you wish to add dependents to your plan there is a fee associated with each dependent you add.
Please note that adding dependents can only be done during during the change of coverage period.
1st Dependent Added
2nd Dependent Added
Any Further Dependents
Additional $75.00 per dependent
Example as to how your total fee would be calculated if you are a full time student who wishes to add 2 dependents:
$299.99 (full time student fee) + $225.00 (1st dependent) + $150.00 (2nd dependent) = $674.99
How To Claim
How long do I have to make a claim?
Claims must be submitted within 6 months of the date of loss. If the Plan terminates, claims must be submitted within 3 months from the termination date. Legal action to recover benefits must begin within 2 years of the date of loss.
Where do I get my benefits cards?
Your personalized benefits cards can be printed from www.studentbenefits.ca under the Download Centre, once you have completed the online registration. The appropriate card should be presented to your health provider (dental office, pharmacist, etc.) in order to access the Pay-direct system when available. This way your claim is processed immediately without the need for you to make a claim online. Remember that all benefits have limits and some pharmacists and dental offices do not submit claims electronically.
How do I make a claim online?
Online Claim Submission is an easy and practical way to submit for reimbursement. You must log in to Member Registration in order to access the Online Claim Submission form. For more details, visit www.studentbenefits.ca.
Can I assign my benefits to a provider?
Your plan allows you to assign your benefits to a provider. When you assign your benefits, the Explanation of Benefits (EOB) is mailed to the provider only. When a provider is submitting a claim on your behalf, the claim must include an Assignment of Benefits form, found on studentbenefits.ca under the Download Centre, an invoice, and a Doctor’s referral (if applicable). You must review and sign the Assignment of Benefits form to ensure accuracy before the claim is submitted, on your behalf, by your service provider.
What if I have more than one plan?
In the case of a claim for you, the student, this plan is the first payer and the dependent coverage available through your other plan is the second payer. In the case of your spouse’s claim, our plan is the second payer if they have their own plan.
For dependent children, claims are submitted first to the benefit plan for the parent whose birthday (month and day) occurs earlier in the calendar year, regardless of age.
Following the reimbursement from the first payer, copies of the receipts and the Explanation of Benefits must be submitted to the other plan so that the balance can be considered for payment.
What if my practitioner does not accept my benefits card?
If your health care practitioner does not accept your benefits card (does not offer a pay-direct service) you are required to pay upfront and submit your receipt for reimbursement at studentbenefits.ca.