OTSU - Opt-Out Form

Student Health & Wellness!mystudentplan is a benefits plan for students and can provide coverage for prescription drugs, vision care, dental care, mental health counseling, and more. The plan is designed to supplement provincial health insurance and provide additional access to medical services.

Online Forms

Are you covered by a comparable plan? Do you wish to cover your dependents? Or have you opted out of the plan and wish to be re-enrolled? Eligible Students may submit their online forms.

Health and Dental Opt-Out Application

Deadline to Opt Out of your Student Benefits Plan

Spring-Summer term - May 30^th, 2024

After the deadline, the online form will not be available.

Opt-Out Eligibility

There are 3 circumstances in which students enrolled in the Student Health and Dental Plan may opt out: (1) when they are starting the fall term, (2) when they are new students in winter term or (3) when they are new students in spring-summer term.

Out-Out Eligibility

How to Opt Out

To Opt Out, you must be enrolled in the Student Beneftis Plan, meet the Opt-Out eligibility criteria, and complete the online form before the applicable term deadline.

Steps to Opt-Out

Things to consider:

A parents' insurance plan ceases coverage until you turn either 18 or 21, or up to 25 if you are studying full-time at a recognized education institution.
You can combine two benefit plans to maximize your coverage, potentially reaching up to 100% coverage! Find out more Coordination of Benefits.
Students with comparable coverage can choose to opt out of the health, dental, or both plans.
Approval of the Student Benefits Plan Opt-Out application will result in the plan fee being refunded according to the school's policy.
NO EXCEPTIONS will be made if the deadline is missed. It is the student's responsibility to pay the plan's mandatory fees, should they miss the applicable opt-out deadline.

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

The winter opt-out deadline is closed.

The winter deadline to apply was January 30^th, 2024. The online Opt-Out Form is not available at this time. The online form was open from December 1^st, 2023, until January 30^th, 2024.

NO EXCEPTIONS will be made if the deadline is missed. It is the student's responsibility to pay the plan's mandatory fees, should they miss the applicable opt-out deadline.

If you were eligible for the plan for the first time in the fall or winter term and missed the deadline, your next opportunity to submit applications would be the fall 2024 and winter 2025 term respectively.

The online form will be open for all eligible spring-summer students on April 1^st, 2024, and the deadline to apply is May 30^th, 2024.

Health and Dental Opt-Out Form

Please complete all information on the opt out form and we will process your application as soon as we can.

Student Information

Student ID Number

Email Address

Confirm Email Address

First Name

Last Name

Date of Birth

Date Month Field Date Day Field Date Year Field

Mailing Address

City

Province

Postal Code

Phone Number

Phone Area Number Phone Local Number Phone Digits

Program Name

Program Start Date

Date Month Field Date Day Field Date Year Field

Spring-Summer Deadline
Submit your online Family Add-On, Opt-Out, or Opt-In applications by May 30^th, 2024

Plan Card Generator
Generate your Plan Card and use it where direct billing to Canada Life is available.

Prescription Search Tool
Find out if your prescription drugs are covered by the student plan.

Plan Claims
Learn more about submitting online or manual claims to Canada Life to get your refund.

OTSU Benefits Plan Office

Email: ontariotech@mystudentplan.ca
Phone: 905-721-8668 Extension 6345
Address: 40 Founders Drive, Lower Level SHA 023.
Oshawa, Ontario.
L1H 7K4

General Inquiries Line

Monday to Friday from 8:00am to 7:00pm EST

Phone: 1-877-746-5566 Ext. 7249

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Online Forms

Health and Dental Opt-Out Application

Deadline to Opt Out of your Student Benefits Plan

Opt-Out Eligibility

How to Opt Out

The winter opt-out deadline is closed.

Eligibility Confirmation

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

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

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

Have you ever opted out of the Student Benefits Plan during your program?

Are you covered by a comparable Health and Dental Plan from parents, spouse, work, government, or band?

Health and Dental Opt-Out Form

Student Information

OTSU Benefits Plan Office

General Inquiries Line

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