Status message

Key:
value:
Plan Group: {"77":"830","95618":"999","131111":"840","137028":"843","138470":"550","142424":"150","144474":"250","155750":"810","178065":"597","204029":"350","204889":"450","227815":"450","227855":"450","227970":"450","228143":"450","228302":"450","228322":"450","229066":"450","229591":"150","229805":"150","229826":"150","235857":"350","241651":"090","257980":"845","266676":"247","268636":"123","270425":"919","271952":"919","273323":"350","273408":"350","273451":"350","273497":"350","276508":"562","307658":"562","307699":"562","307845":"561","314587":"060","315235":"450","330087":"850","331592":"450","445728":"844"}
The optgroup_plan_select says:41

StudentBenefits

Basic Information

Identity

Logo:

Primary Plan Colour:

Secondary Plan Colour:

Plan Association:

PBAS

Plan Assocations Letter:

Union Name:

PBAS Group

Member Union Name:

PBAS Group

Plan:

999

Postal Code:

N6A 3K7

Affiliate Logo:

Claim Administration

Provider Name:

The PBAS Group

Provider Telephone:

1-800-563-1930

PBAS Claims Officer

Claims Officer:

Owen Ralph

Contact Notification Email:

owen_ralph@pbas.ca

Claims Officer Phone:

(709) 754-6633

Claims Officer Address:

20 Crosbie Place St. John's, Newfoundland, A1B 3Y8

Show Member Admin:

yes

Student Union Administrator

Claims Administrator:

Nathanial King

Claims Admin Email:

ask.nl@pbas.ca

Claims Admin Address:

20 Crosbie Place St. John's, Newfoundland

Claims Admin Phone:

(709) 754-6633

Website Forms

Email Header Image:

Claims Form Items

Claim Message:

To be considered an eligible expense, claims must be received within 6 months from the date expense was incurred or the date coverage terminated using the date of service or the date supplies were purchased.

Please click through all tabs on the left menu to view entire form. Your claim form must be completed in full.

Claims Form Message:

Toronto Regional Office 1-416-674-2407 or 1-888-404-6623 ask.on@pbas.ca

studentbenefits.ca

Claim Email Notification:

AnswerFirstName,

This will confirm that we are in receipt of your Online Claim Submission form, submission ID: SubmissionID. Your claim will be processed within 1 to 2 business days.

If you have not registered for Direct Deposit, and wish to do so; please visit www.studentbenefits.ca and update your profile.

Please do not reply to this message. It has been sent by an automated program.

Sincerely, Your Student Benefits Administrator

Opt Out Messages

Opt Out Message:

If you have equivalent extended health and dental coverage (ie. under your own plan or through your parent or spouse's employee benefit plan), you can opt out of the Health and/or Dental plan.At any time during the following 6 months, you may be required to submit proof of your alternative coverage.

To exclude yourself from the Plan you must complete the opt out process by OptOutEnd.

Opt Out Example:

Upload Proof Options:

proof not required

Opt Out Waiver Message:

<h5> </h5><h5> </h5><p><strong>I wish to waive my right to participate in the SGA Health and/or Dental Plan as I am covered elsewhere.</strong><br><br>Upon submitting this waiver, I acknowledge that I may only enroll in the current Health and/or Dental Plan by submitting a written request, accompanied by Alternate Plan termination documentation no later than 30 days following the loss of this existing coverage. I wish to waive my right to participate in the SGA Health and/or Dental Plan. <span style="line-height: 1.5;"> I acknowledge that I am still obligated to pay the fee assessed for this academic year.</span></p><p>I further acknowledge that I will receive reimbursement by cheque or direct deposit (depending on opt out) to reimburse my fees, if my opt out application is accepted.</p>

Opt Out Proof Provided:

Thank you for using the USC Opt-out System.

You have been approved to opt out of the Plan.

A credit for the health and/or dental plan fees will appear on your account near the end of September when the list confirming those students who have opted out is sent to Student Accounts. At any time during the following 6 months, you may be required to submit physical proof of your alternate coverage.

Opt Out Proof Not Provided:

YOU HAVE NOT SUBMITTED ACCEPTABLE PROOF OF COVERAGE TO OPT OUT OF THE HEALTH PLAN

However, to opt out of the Dental Plan Acceptable Proof of Coverage is not required. If you are opting out of the Dental Plan only, no further action is required.

In order to be removed from the Health Plan, you must submit your Acceptable Proof of Coverage by Opt Out Date. If you do not submit Acceptable Proof of Coverage by the opt out date, you have not completed the process and will remain enrolled in the Health Plan.

Opt Out Email Notification:

AnswerFirstName AnswerLastName,

Thank you for using The Campus Trust Opt-out System.

We have reviewed your application #SubmissionID.

Your application has been approved.

Your reimbursement will be available in mid-October, by cheque or direct deposit, please check with the SGA office if you do not receive your reimbursement.

The opt out process must be completed each year you are enrolled as a student.

Sincerely,
AdminName,
UnionName
AdminAddress

Opt Out Email Status:

AnswerFirstName AnswerLastName,

Thank you for using The Campus Trust Opt-out System.

We have reviewed your application #SubmissionID.

Your application has been approved.

Your reimbursement will be available in mid-October, by cheque or direct deposit, please check with the SGA office if you do not receive your reimbursement.

The opt out process must be completed each year you are enrolled as a student.

Sincerely,
Your Campus Trust Administrator
AdminName,
UnionName
AdminAddress

Add Dependants Form

Manage Dependants Dates:

Manage Dependants Dates 1

Manage Dependants Message:

To enroll your family in this plan you must complete the process by RequestCoverageEnd.

The additional fee will be applied to your student account.

Who Qualifies:

In order to be eligible, your dependants must be covered under a Provincial Health Care Plan and you must pay the applicable fee before the deadline. Your spouse and dependant children become eligible when you become eligible.

Spouse - a person, either opposite or same sex, to whom you are legally married or whom you have cohabited with for; at least, one continuous year.

Dependant Children – include children either natural, legally adopted, stepchildren or other children that live with you on a full-time basis, who are under the age of 21 and depend on you for support while living in a parent-child relationship.

Children, under the age of 25 who are in full-time attendance at an accredited educational institution or unmarried dependant children over the age of 21 who have been identified as disabled, are also eligible for coverage. Documentation will be required each student year.

Dependant Pricing Chart:

For Undergraduate

Rates for student year 2014-2015:

Add your family to the Health Plan for an additional: $ 121.01 Add your family to the Dental Plan for an additional: $180.47

For MBA

Rates for student year 2014-2015

Add your family to the Health Plan for an additional: $ 121.01 Add your family to the Dental Plan for additional: $180.47

Manage Dependants Email:

Thank you for using The Campus Trust Request for Coverage System.

It should be noted that the corresponding fee will be applied to your student account.

Opt In Form

Opt In Dates:

Opt In Dates 1

Opt In Message:

This form allows part-time students who were not automatically assessed the fee to opt in to the benefit plan. This is a two step process:

Fill out the following form below before OptInEnd.
In order add yourself to your plan, you must provide payment before OptInDate to the Finance Office, AdminAddress

Pricing Chart:

AnswerFirstName AnswerLastName,

Thank you for using The Campus Trust Opt-out System.

We have reviewed your application #SubmissionID.

Your application has been AnswerStatus.

A credit for the health and/or dental plan fees will appear on your account near the end of September when the list confirming those students who have opted out is sent to Student Accounts.

The opt out process must be completed each year you are enrolled as a student.

Sincerely,
Your Campus Trust Administrator
AdminName,
UnionName
AdminAddress

Who Qualifies Opt In:

All Part-time Students are eligible for benefits if you are covered under a Provincial Health Insurance Plan and you have paid the applicable fee.

You must complete this form and make the payment before OptInEnd.

Opt In Email Message:

OptInMessage

Submission ID: SubmissionID

School	AnswerSchool
Student Number	AnswerSIN
First Name	AnswerFirstName
Last Name	AnswerLastName
WaiverMessage

Student Benefits
Calgary Regional Office	1-403-769-9877 or 1-866-391-7526	ask.ab@pbas.ca
Toronto Regional Office	1-416-674-2600 or 1-888-404-6623	askl.on@pbas.ca
St. John's Regional Office	1-709-754-6633 or 1-800-563-1930	ask.nl@pbas.ca

www.sbta.ca

Opt In Waiver:

Although, I am registering online, I am aware that this is a request only and understand that without payment my request is void. I must complete this process by OptInEnd in order to be added to the plan.

Activate Benefits Messages

Activate Benefits Message:

This form allows you to gain access to your benefits during The Blackout Period.

PLEASE NOTE THAT WHEN YOU APPLY TO AVOID THE BLACKOUT IT IS NOT INSTANTANEOUS~~IT WILL REQUIRE A MINIMUM OF 48 HOURS TO PROCESS.

At the beginning of each enrolment period your pay direct card does not work until the eligibility list of who’s covered is completed. We have worked with the Administrator to allow all eligible members to activate their card and avoid this Blackout Period.

You will receive confirmation by email, when you have been approved.

Should you need to purchase prescription drugs, or incur other health/dental claims expenses during this time you should submit the claim to Campus Trust.

If you need help, please contact the On Campus Administrator.

Activate Benefits Dates:

Activate Benefits Dates 1

Activate Benefits Waiver:

I certify that if I do not meet the definition of an eligible student, any charges that are incurred will be my sole responsibility. If I am reimbursed for medical expenses that I was not eligible for, I will reimburse the Campus Trust for any amount that I may have received.

Activate Benefits Email:

Thank you for using The Campus Trust System.

We are currently reviewing your submission and will notify you, by email, the status of your request. The verification process should take no more than 1-2 business days.

ATTENTION: The verification process takes 1-2 business days. You will receive confirmation by email, when your pay direct access has been granted. Should you need to purchase prescription drugs, or incur other claims expenses during this time you should submit the claim to Campus Trust.

Activate Benefits Email Status:

AnswerFirstName AnswerLastName,

Thank you for using this service..

We have reviewed your application #SubmissionID.

Your application has been AnswerStatus.

This process must be completed each year you are enrolled as a student.

Sincerely,
Your Campus Trust Administrator
AdminName,
UnionName
AdminAddress