Your New Health and Dental Plan Provider: Green Shield Canada

No. Your health and dental plan designs have not changed. The same benefit maximums and same deductibles still apply. The organizations who administer your benefits haven’t changed either (STF still administers the health plan, and the TSC still administers the dental plan).

It's important to note that each carrier applies its own administrative practices when processing claims and providing reimbursement.  

You will not receive a physical benefits card. GSC emailed you a digital Welcome Kit that contains your new digital GSC ID card and instructions for creating your GSC everywhere account. If you have not received your Welcome Kit, please call the GSC Customer Service Centre at 1-888-711-1119 (7:30 am – 7:30 pm CST).

GSC has sent Welcome Kits to the preferred email addresses of all eligible members. This is the same email address you use to log in to MySTF. In some instances, these emails end up in junk/spam folders. You can check there, or search “GSC” in your inbox.

If you’ve attempted the above and still can’t find the email, please call the GSC Customer Service Centre at 1-888-711-1119 (7:30 am – 7:30 pm CST). They will provide your GSC ID number over the phone, which is all you need to register for GSC everywhere and begin submitting claims.

Nope. As long as your health claim isn’t over 15 months old, you can submit your claim to GSC for a limited time.

Once you have registered your GSC everywhere account, you have three options for submitting claims to GSC:

Provider-submitted claims: Many health service providers will electronically submit claims on your behalf. Present your digital GSC ID card to your provider and ask them to submit your claims directly to GSC. All of the information they require for direct billing is on the card.

GSC is currently sending out targeted communications to health and dental care providers across the province to ensure they are aware of the change in coverage for teachers and providing them with the information they need to assist you in this transition.

Do-it-yourself online claims: Through this service, you pay for the medical product or service then submit your claim online through GSC everywhere. If you sign up for direct deposit, your claim payment is deposited into your bank account approximately two business days from the date your payment is processed.

Please note that online claim submission is not available after your contract termination date so you will need to submit a paper claim for expenses incurred while on contract.

Paper claims: For claims that are not submitted electronically, simply pay for your item or service and mail the paid receipt and claim form for reimbursement to GSC at the address indicated on the claim form. All GSC claim forms are available online through GSC everywhere. Be sure to include your unique GSC ID number (found on your digital ID card) and current mailing address on all claims you submit.

No. Your direct deposit information has not been transferred to GSC from the previous carrier (for privacy reasons). But it’s an easy process to set that up with GSC.

You will just need to sign up for direct deposit again via GSC everywhere. Once you’ve registered, all you have to do is select Direct Deposit from the left menu and provide your banking information. GSC will use your direct deposit information for payment of both health and dental benefits.

Drug and medical prior authorizations approved by your previous carrier will be honoured by GSC. Dental predeterminations will also be honoured, but you will need to submit a copy of your prior authorization with your claim.

While GSC is the new insurance provider, the STF and the TSC still maintain administrative oversight over their respective plans and plan designs. So: 

• If you have questions about registering for GSC everywhere, submitting claims or benefit details, please call GSC.
• For general questions regarding eligibility, or the effective date or termination of coverage, please contact the Members’ Health Plan.
• If you have questions about your dental benefits, please call the TSC.

While GSC has been reaching out to health care providers and dental offices across the province to let them know about the change to teachers’ insurance carrier, some providers may not yet be registered for GSC’s direct billing system.

If your provider is not set up with GSC (or if they require assistance submitting an online claim on your behalf), they should visit www.providerconnect.ca to register or call Provider Connect at 1-844-553-2522.

No, a referral is not required. When submitting your claim in GSC everywhere, there is a question that asks if you have a referral. Just answer “No” to that question and go ahead with your claim details. Your claim will be processed as usual.

Claims for visits with a registered Social Worker no longer need to be submitted manually, and can now be claimed online without a receipt. 

If you have electronically submitted a claim for a visit with a registered Social Worker who has a Bachelor of Social Work designation and the claim has been denied, you can resubmit the claim for payment using one of the following methods:

1. GSC everywhere (desktop)

• Log into GSC everywhere. The status of the claim will show “Denied”.
• Select “View Details” for the denied claim.
• Scroll down to where it notes “Upload.”
• You can add additional notes (optional). Click “Add document” and select the correct claims documentation (file must be an image, pdf or text file).
• Select “Attach to Claim.”

2. GSC everywhere (mobile app)

• Log into GSC everywhere on the mobile app.
• Click on the “Denied” claim.
• Scroll down to ”Add Documents.” Choose from Select Files, Take a Photo or Select Photos from Library.
• You can add notes (optional). Click “Submit Documents.”

3. Submit the claim by mail

• Obtain the General Claim Form using GSC everywhere.
• Select the button: “View Personalized Claim Forms.”
• When asked “What kind of claim form would you like to personalize?” select “General Claim Submission Form” and select the participant.
• This form is pre-populated with the participant’s information.
• Print, complete and send the claim form to GSC at the address shown on the form, along with your receipt.