The Extended Health Benefits (EHB) Fund (officially called the CUPE 3903 Benefits Fund in our collective agreements) is funded by annual contributions from the Employer and administered by the Union. It is available to all CUPE 3903 members who hold a contract during the funding year (September 1–August 31) in which eligible health-related expenses are incurred and submitted.
The EHB Fund supports members with health care costs that would cause an undue financial burden and that are not covered by the Sun Life Insurance plan, whether due to lack of coverage by the plan or exhaustion of benefits.
Applications are adjudicated by the EHB Committee, comprising four members and the EHB Coordinator who are elected at our Annual General Membership Meeting (AGM) in March.
What does the EHB Fund Cover?
Members may submit claims for most medically necessary healthcare related expenses that our Employer-provided drug, paramedical, vision, and dental plans do not cover. For information on our Sun Life Benefits plan coverage, please see our website: https://cupe3903.org/benefits/benefits-plan/. This includes both services explicitly not covered under our the plan and costs of covered services that exceed the annual maximums. (Note that each year of Sun Life coverage runs from January 1 to December 31.)
Members may submit claims for both foreseeable and paid expenses. In either case, members are required to submit receipts (preferably PDFs) verifying they have paid for services out of pocket. (See the Submitting Foreseeable Expenses section below.)
Expenses the EHB Fund will reimburse include:
- paramedical or dental services provided by licensed practioners not covered by Sun Life (e.g., osteopathy, accupunture, orthodontics)
- individual paramedical services (e.g., pyschotherapy, massage therapy) covered by Sun Life but for which the member has incurred expenses exceeding the annual per-service maximum ($2000) or total paramedical services maximum ($3000)
- dental expenses that exceed the Sun Life maximums
- the portion of major dental expenses not covered by Sun Life (which covers only 85% of such work)
- medically necessary equipment (e.g., wheelchairs, canes, leg braces) not covered by Sun Life or government programs
- travel health insurance (not not baggage or cancellation insurance)
What does the EHB Fund NOT cover?
The EHB Fund does NOT cover any of the following:
- any paid expenses that fall outside of the current funding year (Sept-Aug 31)
- any foreseeable expenses that fall outside of the current funding year (e.g., pyschotherapy estimates summitted in the spring or summer for for fall appointments)
- Cosmetics or other OTC (over-the-counter) products, drugs, or supplements
- Any cosmetic or non-medically necessary treatments or procedures, including botox and hair transplants
- furniture (e.g., desk chairs, sit-stand desks)
- computer hardware or accessories (e.g., ergonomic keyboards or mice)
- gym memberships or fitness equipment, including smart watches or other electronic devices used to monitor fitness
- Any health expense incurred by members' dependents and/or spouses (exception: IVF treatments for members' partners)
- baggage or trip cancellation insurance
- other health insurance premiums, including UHIP
Please do not submit claims/receipts for any of the above; doing so takes up the committee's time and delays the processing of eligible applications.
Can I submit multiple receipts in a single application?
Yes, but there are limits. When you begin your application, you must chose between submitting applications for expenses you have already incurred (i.e., you have receipts for) or for foreseeable expenses. You cannot submit both paid and foreseeable expenses in the same application.
Additionally, the form also allows you to submit a maximum of three expenses and/or receipts at one time. To make it easier for the EHB Committee to adjudicate your application, you must submit each receipt or estimate (and any supporting documentation) as a separate expense rather than (as in the old application) grouping them together. However, if multiple expenses appear on a single receipt (e.g., several psychotherapy sessions), you may submit them as one expense.
If you have more than 3 receipts/expenses to submit, you will need to submit more than one application. But don't worry, when you submit an application, you will see a button labelled "Submit another application." If you click on that button, you will be taken to a new application with the first section prefilled from your original application. So you only need to fill out the expense portion and attach receipts. (Limiting the number of expenses allows for quicker adjudication and avoids delaying your claims for multiple receipts if the EHB Committee needs further information or documents related to a single expense.)
What documents must I submit with my initial application?
If you are applying to EHB for a service covered by Sun Life, you must submit a Sun Life Claim Statement showing that you have exhausted your coverage. When you have exhausted a Sun Life benefit, you statement will include the following note:
R15 We are not able to pay this expense because this claimant has already reached the annual maximum amount covered under the plan for this type of expense.
Do not submit an application for services covered by Sun Life without including a claim statement. If you do, the Committee will reject your application or ask you to edit it to include the required document(s).
If you are applying for a service you have already paid for, you must submit your receipts as part of your application.
If you are applying for a foreseeable expense, you must submit an estimate from your health care practitioner.
For services like custom orthotics, you must submit a prescription from a medical practitioner (e.g., doctor, podiatrist).
Receipts and estimates for travel health insurance must clearly indicate that baggage and cancellation insurance is not included or must separately indicate the cost of those items.
Please ensure that your initial application includes ALL required documents, including estimates and receipts. Missing documents will delay processing your application, and the time required to follow up with a few members by email also means delays in processing other members applications.
Per-Year Maximum
Members may submit more than one application per funding year (Sept 1–Aug 31). and receive reimbursements totalling up to a maximum of $2,500 per funding year.
In any funding year, members may receive no more than $1000 at a time for foreseeable expenses. A member who has reached this limit may submit additional applications for foreseeable expense only after they have submitted the required receipts to verify that they used their advance from the fund to pay for the services covered in their application. (See the foreseeable expenses section below.)
During years of high demand, the committee may impose a lesser maximum and/or pay out only a portion of amounts requested to ensure that as many members as possible benefit from the fund.
Once you have reached the annual limit, please do not submit additional expenses.
Is there an Application Deadline?
Yes. Because of the limited funds available and the high (and rising) volume of applications each year, the EHB Fund only reimburses expenses submitted during the (current) funding year (Sept 1–Aug 31) in which they are incurred.
All expenses incurred during each fuding year must be submitted for reimbursement by August 31. Expenses submitted after this deadline (i.e., during the next funding year) will be rejected because they are outside of the relevant funding year.
For example, expenses incurred during July or August must be submitted before August 31 to be covered. Expenses falling outside of the funding year will be rejected.
When will I get a response to my application?
When you submit an application, you will receive an email immediately confirming your application. The Committee recognizes the importance of this fund in supporting members facing urgent needs and strives to review applications on a regular basis; however, due to the high volume of requests, please allow up to 8 weeks for processing your application.
Can I edit my application after submitting it?
Yes. The confirmation email includes an "Edit Your Application" link, in case you need to edit or update your application.
In some cases, the EHB Committee may contact you to request additional or missing information or documentation (e.g., receipts). You can use the edit link to add requested documents to the "Submit Requested Additional Documentation and/or Information" section of your application. (Please leave this section blank when you first submit your application.)
If you receive money for foreseeable expenses, you must later use the Edit Your Application link to upload your payment receipts to verify you have purchased/paid for the services.
How do I submit receipts for foreseeable expenses?
All members who have received funds to cover foreseeable expenses are required to submit receipts for those expenses no later than the end of the following academic term. The submission deadlines are as follows:
- Apr 30 for applications approved in the fall (Sep–Dec)
- Aug 31 for applications approved in the winter term (Jan–Apr)
- Dec 31 for those approved in summer (May–Aug).
Members who "owe" the EHB Committee receipts for foreseeable expenses may continue to submit and receive reimbursement for other expenses (including foreseeable, if they haven't reached the $1000 foreseeable maximum) up to the yearly overall maximum.
However, if a member doesn't submit the required receipts by the deadline above, the Committee will not adjudicate any further applications, including in following funding years, until the receipts. For example, if a member receives $1000 for foreseeable expenses in November 2026, they must submit payment receipts for the services by April 30, 2027. If they don't, they will not be able to make further EHB claims until they do.
How will I receive my money from the EHB Fund?
By email transfer. CUPE 3903 uses Plooto to facilitate electronic fund transfers. When the fund requisition for your claim is completed, you will receive an email (to the address you submit as part of their application) from the Union via Plooto. Click on the link to access/deposit your funds.
If you experience a problem with your payment or have questions about how to accept your tranfer , please contact the Treasurer (treasurer@cupe3903.org) or the Financial Coordinator (finance@cupe3903.org).
How do I get in touch with the EHB Committee?
To contact the EHB Coordinator, email ehb@cupe3903.org. Please allow up to 15 business days for a response, as the email is not monitored daily.