CAAT Support Joint Insurance Committee (JIC)
The CAAT Support Joint Insurance Committee (JIC) is established under Article 4.9 and Appendix A of the CAAT Support Collective Agreement. Its main purpose is to facilitate communications between the Council and OPSEU on the subject of group insurance applicable to the Support Staff Bargaining Unit.
The CAAT Support Joint Insurance Committee (JIC) helps overturn decisions made by Sun Life on claim denials of the Extended Health, Dental, Long Term Disability, Life Insurance (including Basic, Supplementary, Supplementary Spousal and Dependent) and Critical Illness plans.
The JIC meets monthly to review claim problems and attempts to resolve them. OPSEU, as your advocate, takes an active role in Committee meetings.
Why would I want to appeal a claim that has been denied?
- Your claim may have been improperly denied (it happens more often than you think).
- Claims that are denied today may highlight important future bargaining demands.
How can I appeal claims for denied Insured Benefits?
You can appeal the denial through the Union members of the Joint Insurance Committee (JIC). The JIC is composed of OPSEU representatives and the College Council. Sun Life representatives also attend.
Who are my JIC Union representatives?
Janice Hagan, Union Co-Chair, Local 561, Seneca College, Email: firstname.lastname@example.org
Dan Brisson, Vice-Chair, Local 672, College Boreal, Email: email@example.com
Paul Lahaise, Member, Local 416, Algonquin College, Email: firstname.lastname@example.org
Kathy Hokum, Member, Local 351, Fleming College, Email: email@example.com
Kim Macpherson, OPSEU Benefits Counsellor, Email: firstname.lastname@example.org
How do I commence an appeal to the Joint Insurance Committee?
First, make certain (through phone call, email or discussion) to note your complaint with Sun Life, the College Benefit Administrator at your College and your Local Union, when you become aware of the denial of benefits by Sun Life. Sometimes submitting additional information directly to Sun Life will resolve the problem.
If the complaint is not satisfactorily resolved, contact one of the members of the Joint Insurance Committee so that they can advocate for you. It is essential that you provide your contact information and any written documentation about what you want to appeal, such as a copy of the denial from Sun Life and the signed CAAT Support JIC Authorization and any notes or reports from your dentist or doctor.
Complete the authorization and send it, along with your documentation to your JIC advocate or to Kim Macpherson, Benefits Officer, Pension & Benefits Unit, OPSEU - 5757 Coopers Avenue, Mississauga, Ontario L4Z 1R9 Fax: (905)712-3009. You may also reach Kim at 416-443-8888 or toll free at 1-800-268-7376 x5564.
All information submitted to the JIC is treated as confidential and will not be disclosed to anyone outside of the insurer, your treating health providers and the committee.