You will be reimbursed for 100% of the costs you and/or your eligible spouse paid on behalf of your surrogate for the surrogacy non-medical expenses noted in the following section up to a lifetime maximum of $2,000 per family.

THE PLAN COVERS SERVICES THAT INCLUDE:

Expenses reimbursed for surrogacy are considered a taxable benefit (subject to Canada Pension Plan and Income tax deductions) and will be included on your paycheck and on your annual T4.

How do I make a claim?

After you’ve paid an expense, submit your receipts, along with a completed Supplemental Surrogacy claim form to Sun Life (all forms can be found on Benefits forms). The receipt must show you paid for the expense(s), and list the surrogate as the patient. The Supplemental Surrogacy Benefit contract number is 150520.

Your claims can be submitted via the following options:

• Digitally using the my Sun Life mobile app or members website. To submit digitally, follow these steps: 

You can also submit by regular mail to the claims office noted on the claim form.

For more information

The outline above is a descriptive summary of the plan and is not a contract. All terms and conditions are governed by Contract Number 150520 with Sun Life Assurance Company of Canada. In the event of a discrepancy, benefits will be paid according to the official document and applicable legislation.

For complete details about your Surrogacy Benefit, refer to the Sun Life benefits booklet for your employee group.

​​​​​​

Surrogacy medical expenses are covered under the extended health benefits plan.​​​​​

You will be reimbursed for 100% of the costs you and/or your eligible spouse paid for expenses related to the adoption process and noted in the following section up to a lifetime maximum of $50,000 per family.

THE PLAN COVERS SERVICES THAT INCLUDE:

Expenses reimbursed for adoption are considered a taxable benefit (subject to Canada Pension Plan and Income tax deductions) and will be included on your paycheck and annual T4. 

How do I make a claim?

After you’ve paid an expense, submit your receipts, along with a completed Adoption Benefit claim form to Sun Life (all forms can be found on Benefits forms). The Adoption Benefit contract number is 150520. 

Your claims can be submitted digitally using the my Sun Life mobile app or members website. To submit digitally, follow these steps: 

• my Sun Life Mobile App:

  1. On the mobile app, tap Documents at the bottom of the app (next to “Notifications”).
  2. After selecting “Benefits” please select “Medical or dental plans”
  3. Select “Client Care Centre requests”
  4. Select “Medical/dental” then “Medical”
  5. Enter FBPADOPTION when asked for document or claim number
  6. Add photos of the completed surrogacy enrolment form and submit

  my Sun Life members website

  1. Log into mysunlife
  2. Click on “Submit a claim” or "Benefits centre"
  3. Click on Claims” at the top of the page
  4. Select “Submit documents”
  5. Select “Client Care Centre requests”
  6. Select “medical”
  7. Enter FBPADOPTION when asked for document or claim number
  8. Upload the completed surrogacy enrolment form and “Submit”

You can also submit by regular mail to the claims office noted on the claim form.​​​​​​

For more information

The outline above is a descriptive summary of the plan and is not a contract. All terms and conditions are governed by Contract Number 150520 with Sun Life Assurance Company of Canada. In the event of a discrepancy, benefits will be paid according to the official document and applicable legislation.

For complete details about your Adoption Benefit, refer to the Sun Life benefits booklet for your employee group.

​​​​​​

Procedures for the treatment of fertility and fertility drugs for you and your eligible spouse are covered under UBC’s Extended Health Benefits Plan.

From February 1, 2024, The Lifetime maximum for fertility treatment procedures and services is increasing up to a lifetime maximum of $50,000 per family.

​​​​​​

You will be reimbursed based on the reasonable and customary charge for the item or service at the following levels, up to a lifetime maximum of $2,000,000 per person:

Prescription Drugs 

Paramedical Services 

• Counselling services: 100%
• All other paramedical services: 80%*

Vision Care: 100%

Medical Services & Equipment (including Fertility services): 80%*

Emergency Out-Of-Province Medical Care: 100% 

In-Province Hospital: 80%* 

* You will be reimbursed based on the above reimbursement levels for the eligible expenses of each person enrolled in your plan until that person has reached $1,000 in reimbursable expenses for prescription drugs, paramedical services, medical services and equipment, and in-province hospital costs combined. After this, you will then be reimbursed for 100% of that person’s eligible expenses for the remainder of the benefit year.

Medical services providers and suppliers charge a range of fees for certain services, including paramedical services and eye exams.

Sun Life will determine “reasonable and customary” charges as the basis for reimbursing your paramedical, eye exam and other services which are also subject to the reimbursement level and maximum amounts specified under the Extended Health Plan. Sun Life outlines the reasonable and customary charges where applicable in each province on their mobile app and through the online Sun Life account (www.mysunlife.ca). For example, when searching for a paramedical practitioner, reasonable and customary charge limitations are indicated by a dollar ($) sign. One or two dollar signs indicates the practitioner is charging within the reasonable and customary charge limit. Three or more dollar signs means they are charging over the reasonable and customary rate and you will be responsible for the extra cost.

To ensure your prescription drug costs are covered, please confirm that you are registered with Fair PharmaCare. Learn more about Fair PharmaCare.

Depending on your UBC employee group, you will be reimbursed 70% to 85% of the costs of eligible prescription drugs that are prescribed by a physician or dentist and obtained from a pharmacist. Refer to the table above for the reimbursement level for your employee group.

You are also covered for both prescribed and over-the-counter smoking cessation drugs to a maximum of $300 per person per benefit year and vaccinations to a maximum of $300 per person per benefit year.

Sun Life will cover the cost of prescription drugs up to the cost of the lowest-priced generic equivalent, unless your doctor specifies in writing that no substitution for the prescribed drug may be made.

If you are prescribed a drug under the provincial specialty drug program, Sun Life may require you to complete and send them the Provincial Drug Integration Form to be eligible for reimbursement under the Extended Health Plan. The completed form can be submitted to Sun Life through your online Sun Life account (www.mysunlife.ca), the Sun Life mobile app or by mail.

What the plan does not cover

The plan does not cover all drugs or medicines, even when they are prescribed. Some examples of what is not covered include over-the-counter drugs, preventive drugs, the cost of giving injections, vitamins, natural health products, treatments for weight loss unless prior authorization is obtained, hair growth stimulants and erectile dysfunction drugs.

For more information on prescription drug coverage and what is excluded, please refer to your Sun Life Booklet. 

FACET prior authorization drug program

Specialty drugs that are used to treat specific health conditions and/or cost more than $5,000 per person, per calendar year will require pre-approval (“Prior Authorization”). This means that if your physician prescribes such a specialty drug for you or your covered dependents, you and your physician must submit evidence that supports the need for the drug in order to obtain coverage for it under the extended health benefit plan.

To find out if prior authorization applies to you, please visit our FACET webpage.

para You will be reimbursed for 80% or 100% of the reasonable and customary charge for the services of some paramedical practitioners. There is a maximum annual amount that you can be reimbursed for each type of service.

The practitioners covered under the plan are:

• 100% for licensed psychologists, social workers or registered clinical counsellors (up to a maximum of $3,000 for each person per benefit year and includes counselling services and psychological testing);
• 80% for licensed speech therapists, acupuncturists, chiropractors, naturopaths, homeopaths, podiatrist, chiropodists, osteopaths, dietitians, audiologists or occupational therapists up to a combined maximum of $500 (for CUPE 2950) or $600 (for all other UBC employee groups) for each person per benefit year; and
• 80% for licensed physiotherapists (no doctor referral required) or massage therapists (no doctor referral required), up to a combined maximum of $1,000 (effective January 1, 2024) for each person per benefit year.

Paramedical practitioner qualifications

The cost of paramedical services will only be covered if the paramedical practitioner meets specific qualifications/designations for their profession and they are licensed/registered with an appropriate regulatory body or society where the service is received (in Canada or the United States only). 

For a complete list of the acceptable qualifications/designations and regulatory bodies and societies for all paramedical practitioners in British Columbia, please review the BC Practitioner Qualifications table. 

What the plan does not cover

The plan does not cover the services of a religious or spiritual healer, kinotherapist, reflexologist, sexologist, sex therapist or shiatsu specialist.

For more information on paramedical coverage and what is excluded, please refer to the Sun Life Booklet. 

You will be reimbursed for 100% of the cost of the reasonable and customary vision care expenses up to a maximum of $600 (for IUOE 115) or $400 (for all other UBC employee groups) in a 24-month period for:

• contact lenses or eyeglasses prescribed by a licensed optometrist or ophthalmologist,
• contact lenses prescribed for the treatment of severe corneal astigmatism, severe corneal scarring, keratoconus or aphakia,
• prescription sunglasses, and
• laser eye correction surgery, when performed by an ophthalmologist.

You can claim the maximum of $600 (for IUOE 115) or $400 (for all other UBC employee groups), less the amount of any benefit that has been paid to you during the previous 24 months.

Eye exams

Effective January 1, 2024, eye exams are covered separately from other vision care benefits, with a limit of $130 over a 24-month period. This is in addition to the vision care maximum and is available for both you and your covered dependents.

If you have been reimbursed for an eye exam within the past 24 months, the new eye exam maximum will be reduced by that amount. For example, if you received an eye exam in October 2024, costing $80, your eye exam maximum will now be $50. Your eye exam maximum would reset to $130 in October of 2026. The separate vision care maximum is not affected. 

Please check the date of your next eligible eye exam and the amount available under your Sun Life account (the amount can found under Optometrist in the Medical Coverage section on the members portal) before incurring any eye exam costs.

What the plan does not cover

The plan does not cover the cost of magnifying glasses or safety glasses.

For more information on vision care coverage and what is excluded, please refer to the Sun Life booklet. 

You will be reimbursed for 80% of the reasonable and customary costs of a wide variety of medical services and equipment when ordered by a doctor, dentist or nurse practitioner (if applicable provincial law permits nurse practitioners to prescribe or order certain supplies or services).

The plan covers services that include:

• private duty nursing care in-hospital or out-of-hospital if medically necessary,
• transportation in a licensed ambulance or air ambulance,
• custom-made orthopedic shoes (doctor’s or nurse practitioner's (if permitted by provincial law) referral required every 5 years for those with chronic foot conditions) up to a maximum of $400 per benefit year for adults (maximum is $200 per benefit year for dependent children under age 19),
• custom-made orthotic inserts (doctor’s or nurse practitioner's (if permitted by provincial law) referral required every 5 years for those with chronic foot conditions) up to a maximum of $400 per benefit year for adults (maximum is $200 per benefit year for dependent children under age 19). Custom-made orthotics must be dispensed by a podiatrist, chiropodist, orthotist or chiropractor,
• knee braces made of metal or rigid/semi-rigid plastic when prescribed by a doctor,
• accidental dental services,
• equipment recommended for therapeutic use, such as wheelchairs, hearing aids, insulin pumps, blood transfusions and dialysis machines,
• equipment for speech difficulties such as bliss boards and communication aids up to a combined maximum of $300 per person per benefit year,
• one pair of contact lenses or intraocular lenses following cataract surgery, if this is not covered by MSP. This is not counted towards your vision care maximum.
• Continuous Glucose Monitor (CGM) receivers, transmitters or sensors, for those diagnosed with Type 1 or Type 2 diabetes requiring insulin use (doctor’s note confirming both the diagnosis and insulin use is required) up to a combined maximum of $4,000 per person per benefit year.
• Hearing aids or hearing assisted devices and batteries (including replacements), prescribed by an ear, nose and throat specialist, up to a maximum of $2,000 per person over a period of five benefit years. Repairs are included in this maximum.

What the plan does not cover

The cost of some services and equipment is not covered under the plan, even when a doctor prescribes them. These include:

• off-the-shelf non-custom-made orthopedic shoes and orthotic inserts,
• knee braces used for athletic purposes,
• experimental treatments,
• personal comfort items,
• services and supplies for cosmetic purposes, and
• the services of a licensed practical nurse.

If your medical services or equipment cost more than $5,000, you must obtain pre-authorization for these expenses from Sun Life. You may also require a doctor’s referral, and maximum amounts may apply. For more information on coverage and exclusions, please refer to the Sun Life booklet. 

Emergency out-of-province medical care

You will be reimbursed for 100% of the costs of out-of-province emergency doctor and hospital services required within 365 days of the date you leave BC. An emergency is an acute, unexpected condition, illness, disease or injury that requires immediate assistance.

Some of the emergency expenses covered in this category include:

• a semi-private hospital room,
• other hospital services provided outside of Canada,
• out-patient services in a hospital, and
• the services of a doctor.

If you or a dependent are hospitalized while travelling outside of BC, the cost of in-patient hospital services is covered for 90 days. This 90-day limit will be extended if transporting the patient back home would be a risk to their life.

In addition to emergency doctor and hospital services, emergency expenses for all other services or supplies eligible under this plan are also covered outside of BC (emergency and non-emergency basis) as if you had incurred the expense in BC. For example, emergency prescription drug expenses will be reimbursed as if you had made the drug purchase in BC.

You are also covered for other emergency travel assistance services through Medi-Passport, which is provided by Sun Life’s travel benefit provider, Global Excel Management. These services include:

• referrals to physicians, pharmacists and medical facilities,
• transportation home or to a different medical facility,
• travel expenses if stranded by a medical emergency,
• repatriation, and
• assistance with lost luggage or documents.

What the plan does not cover

The plan does not cover the cost of emergency medical services:

• obtained after 365 days have passed since you left BC;
• for pre-existing conditions that require continuous or routine medical care while outside your home province (unless the condition was stable and controlled at the time of departure from Canada and your doctor has stated you are cleared to travel);
• services that are not immediately required or that could reasonably be delayed until you return to BC, unless your medical condition reasonably prevents you from returning to BC before receiving the medical services;
• services relating to an illness or injury that caused the emergency, after such emergency ends;
• continuing services, arising directly or indirectly out of the original emergency or any recurrence of it, after the date that Sun Life or Global Excel Management, based on available medical evidence, determines that you can be returned to the province where you live and you refuse to return;
• services that are required for the same illness or injury for which you received emergency services, including any complications arising out of that illness or injury, if you had unreasonably refused or neglected to receive the recommended medical services;
• where the trip was taken to obtain medical services for an illness or injury, services related to that illness or injury, including any complications or any emergency arising directly or indirectly out of that illness or injury;
• illness resulting from the hostile action of any armed forces (military or police), insurrection, riot, civil commotion or terrorist activity that you participated in;
• any work for which you were compensated that was not done for the employer (UBC) as the provider of this plan; and
• services for an illness or injury caused by your participation in a criminal offence.

If you are on an unpaid leave and older than 65

If you are on an unpaid leave of absence and over the age of 65, you and your dependents will be reimbursed for the cost of emergency doctor and hospital services and travel assistance services through Medi-Passport obtained within 60 days (and not 365 days) of the date you leave your home province. All other coverage is as described above.

For complete information on your benefits while travelling outside of BC and Canada, visit our Travel benefits section and refer to the Sun Life booklet. 

You will be reimbursed for 80% of the cost for the fertility treatment procedures and services noted in the following section, up to a lifetime maximum of $50,000 per family (from February 1, 2024). Drugs to treat infertility are covered under the prescription drug benefit and are not included in the lifetime maximum. 

THE PLAN COVERS SERVICES THAT INCLUDE:

Physician and lab services

• Physician block fees and monitoring fees
• Medical imaging (including ultrasound/nuchal translucency ultrasound, Spindleview, embryo-scope, Matris test, non-invasive analysis of embryo culture media, Sonohystereogram)
• Fees for services related to donated reproductive materials from a Canadian fertility clinic or donor bank.
• Diagnostic lab tests and screening of the gestational carrier (including pre-natal screeening, Endometrial Receptivity Analysis, FSH, AMH)

      *Note: when submitting claims for diagnostic lab tests, please include the lab requisition form.

Expenses related to the egg, embryo and sperm

• Screening tests
• Cryopreservation
• Transfer fees
• Storage fees
• Thawing
• Egg retrieval
• Sperm retrieval (including PESA, MESA, TESE, Micro TESE)
• Sperm function test, and
• Sperm selection, wash, and preparation

Genetic testing

• Includes PGT-A, PGT-SR, PGT-M, products of conception analysis, sperm chromatin assay

Insemination and fertilization

• Invitro maturation
• Assisted hatching
• Intra-cytoplasmic sperm injection (ICSI)
• In-vitro fertilization (IVF) (including standard, natural, stimulated, antagonist, and reciprocal)
• Intrauterine insemination (IUI)
• Artificial insemination (AI)

In addition, donor expenses related to the fertility process are eligible if the donor is an eligible dependent of the extended health plan.

If your treatment services cost more than $5,000, you must obtain pre-authorization for the expenses from Sun Life.

You will be reimbursed for 80% of the cost difference between a room on a general hospital ward (covered by MSP) and a semi-private or private hospital room. Care in a hospice is reimbursed at 80% ($40/day for a maximum of 60 days).

What the plan does not cover

The plan does not cover:

• hospital outpatient fees and user fees,
• care in a nursing home or rest home, and
• care in an alcohol or drug abuse treatment centre, even if it is located in a hospital.

For more information on in-province hospital or hospice coverage and what is excluded, please refer to the Sun Life booklet. 

You will be reimbursed for 100% of the costs for the gender affirmation procedures noted in the following section up to a lifetime maximum of $50,000 per person, provided you meet the eligibility requirements set out below.

Eligibility Requirements / Application Form

You must be under the care of a doctor for gender affirming care and:

• You must be at least 18 years old, and have attained the age of majority in your province of residence,
• You must be diagnosed with gender dysphoria by a medical doctor,
• Prior approval from UBC’s insurance provider is required.  You and your doctor must complete the Gender affirmation application form, and submit it to Sun Life.
• All procedures must be performed in Canada, and
• Only expenses after your effective date for extended health coverage will be eligible for reimbursement.

THE PLAN COVERS SERVICES THAT INCLUDE:

Eligible procedures:

• breast augmentation/augmentation mammoplasty,
• thyroid chondroplasty,
• laryngoplasty,
• permanent hair removal (laser or electrolysis) for pre-surgical areas,
• hysterectomy,
• vaginectomy,
• salpingo-oophorectomy,
• chest contouring/chest masculinization, other than liposuction / lipofilling,
• implantation of penile and/or testicular prosthesis,
• permanent hair removal (laser or electrolysis) for excessive facial or body hair,
• brow bone reduction/construction,
• jawbone reduction/reshaping/contouring,
• rhinoplasty, blepharoplasty and rhytidectomy,
• liposuction of the waist,
• gluteal augmentation (lipofilling or implants),
• hairline reconstruction to correct receding hairline,
• chin and cheek augmentation,
• chest contouring, including liposuction/lipofilling done to provide additional contouring, and pectoral implants.

The above list of procedures may be modified if there are changes to the procedures that are covered by any of the gender affirmation programs in a province or territory.

Before incurring an expense, you must complete the Gender Affirmation application form and recieve prior approval from Sun Life.

WHAT THE PLAN DOES NOT COVER

The plan does not cover the cost of:

• procedures payable or available under the medicare plan in your place of residence, regardless of whether you have applied or been accepted into the gender affirmation program,
• travel or accommodation expenses,
• reversal of gender affirmation procedures,
• sperm preservation or cryopreservation of fertilized embryos (these may be covered under medical services and equipment, fertility treatment benefit), and
• procedures related to fertility problems caused by gender affirming treatment and/or surgical care.