OTSU - Family Add-On Form

Plan Number: 175208
Certificate Number: Student ID
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Student Health and Wellness! mystudentplan provides health, prescriptions, dental, mental health care plus additional benefits for eligible students.

Family Add-On Applications

Submit your health and/or dental family add-on application before the deadline.

Fall Application Period

August 1^st, 2024 to September 30^th, 2024

Make sure to submit your form by September 30^th as the online form will be accessible only to eligible students who have lifestyle changes.

Your student account fees only cover you. If you wish the same coverage for your dependents, you can purchase additional coverage using a credit card.

Family Add-On Eligibility

There are 3 circumstances in which students enrolled in the Student Health and Dental Plan may add dependents to their plan: (1) when they are starting the fall term, (2) when they are new students, or (3) when they have a lifestyle change.

Family Add-On Eligibility

All eligible domestic and international students enrolled in eligible studies programs (9 or more credits) as having full-time status at the Ontario Tech University are automatically enrolled in the Student Health and Dental plans . Students get one opportunity per academic year to add dependents to their plans and must meet the following criteria in order to have their application approved:

1 Fall Academic Enrollment

All eligible students attending the fall term; and
Assessed the Health Plan Fee and Dental Plan Fee on their student account; and
Must be covered by alternate comparable Health and dental coverage from their parents, spouse, job, government or band; and
Must submit their family add-on application before the applicable fall deadline.

Eligible students who miss the fall deadline would be able to add dependents the following fall term if they are fall-enrolled students. Students will not be able to add dependents in the winter term.

2 Winter Academic Enrollment

New eligible winter students; or
Returning students who did not attend fall term or attend a co-op or internship program; and
Assessed the health Plan fee and dental Plan fee on their student account; and
Must be covered by alternate comparable Health and dental coverage from their parents, spouse, job, government or band; and
Must submit their family add-on application before the applicable winter deadline.

New eligible winter students who miss the winter deadline would be able to add dependents the following fall term if they are fall-enrolled students.

3 Spring-Summer Academic Enrollment

New eligible spring-summer students; or
Returning students who did not attend fall/winter term or attend a co-op or internship program; and
Assessed the health Plan fee and dental Plan fee on their student account; and
Must be covered by alternate comparable Health and dental coverage from their parents, spouse, job, government or band; and
Must submit their family add-on application before the applicable spring-summer deadline.

New eligible spring-summer students who miss the spring-summer deadline would be able to add dependents the following fall term if they are fall-enrolled students.

4 Lifestyle Change

Assessed the Health Insurance Fee and Dental Insurance Fee on their student account; and
had a lifestyle change such as getting married, meeting the co-habitation requirement for common law status, or birth/adoption of a child; and
Must submit their family add-on application within 30 days of the lifestyle change; and
Must pay the family add-on fees by the assigned deadline.

You must provide documentation such as a marriage certificate, birth certificate, or adoption documents by emailing ontariotech@mystudentplan.ca. You have 10 business days to email the proper documentation or your application will be denied.

Eligible students who miss the 30 days deadline would be able to add dependents the following fall term if they are fall-enrolled students.

How to Add Family

To add dependents, you must be enrolled in the Student Benefits Plan, meet the Family Add-On eligibility criteria, and complete the online form before the applicable term deadline.

Steps to Add Dependents

Family Add-On Fees:

These are the fees to purchase family coverage, you must pay using a credit card (Visa® or MasterCard®) before the applicable payment deadline.

One dependent		Two or more dependents
Health	$180.00	Health	$180.00
Dental	$140.00	Dental	$280.00
Health and Dental	$320.00	Health and Dental	$460.00

These are the current family Add-on fees. However, the fees are subject to change without notice.
The Family Add-on fees are non-refundable and are not automatically renewed.
The Family add-on fees cover your dependents until August 31^st. If you wish to keep your family covered, you must submit a new application before the applicable fall deadline.
The family Add-On fees are not assessed as part of your term fees. If your application is approved, the Benefits Plan Office emails you a link, the payment deadline, and instructions to pay online using a credit card.

Things to consider:

You can only add as a dependent to your Student Benefits Plan your spouse or common-law partner and your children. Parents, grandparents, and siblings do not qualify as dependents.
Your dependents would be covered under your Student Benefits Plan, which means they would be entitled to the benefits you have through your plan.
Each dependent added uses the same Benefits Card that the student has. The Benefits Card must have the student's information (Full name and student ID).
Family Add-On fees are not automatically renewed every fall term. If students wish to keep the dependents covered, they must re-apply every fall.
NO EXCEPTIONS will be made if the application or payment is missed. It is the student's responsibility to check their emails regarding the status of the application or deadlines.

Add donotreply@gallivan.ca to your address book. Please do not reply to this email.

Questions? Please contact your Benefit Plan Office: ontariotech@mystudentplan.ca

Family Add-On Applications

Fall Application Period

Family Add-On Eligibility

How to Add Family

Family Add-On Fees:

The spring-summer Family Add-On deadline is closed.

Eligibility Confirmation

Have you been assessed the Health and Dental Plan fee on your student account?

Are you a new winter student who has been assessed the Health and Dental Plan fee on your student account?

Are you a new spring-summer student who has been assessed the Health and Dental Plan fee on your student account?

Are you a returning student who has not attended the previous term and has been assessed the Health Insurance Fee and the Dental Insurance Fee on your student account?

Are you a student enrolled in the Student Benefits Plan and have a lifestyle change such as getting married, common-law status, or birth/adopting a child?

Are your family members eligible to be added to your Student Benefits Plan?

Health and Dental Family Add-On Form

Student Information

Benefits Plan Office

General Inquiries Line

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