August 2007 Focus Update #124

Time to update eligibility records for over-age students

With school enrolment near, we need current records for over-age student dependents eligible to receive benefits. We must receive any record changes as soon as possible in order to ensure we process claims correctly.

If we don’t receive over-age student information?

  • We will terminate coverage for dependents who reach the lower age limit under your plan (typically age 21) and have not been identified as full-time students on our system.
  • We will continue coverage for dependents who are currently identified as full-time over-age students on our system until they reach the upper age limit under the plan (typically age 25; 26 in Quebec), unless we are advised that the dependent is no longer a student.

Sending us over-age student information

You can send us over-age student information up to one year prior to the dependent child reaching the lower age limit under your plan. If you send us this information more than one year in advance, our claims system will automatically reject it (without notice to you) and you will need to resubmit it later.

If you aren’t sure whether you have already submitted over-age student information – or whether it was submitted too early and rejected - simply resend it and we will be glad to re-enter it. 

NOTE: If you use our web-based Member Enrolment Tool, you can’t update your records to show a dependent as an over-age student until they reach your plan’s lower age limit.

For Pay-Direct drug plans

If your plan has Pay-Direct drug and members need additional drug cards for students going away to school, you or they can print a personalized paper card directly from our website at www.sunlife.ca.  Our paper drug cards are accepted by all participating pharmacists.

Important reminders for your plan members

  • They need to annually update their dependent records, especially for those dependents that become over-age students or no longer qualify as one.
  • They must indicate the student’s status on claims for dependent children that are full-time post-secondary students.  
  • When a school needs confirmation of their child’s coverage, many universities have an online tool that allows students to enter their coverage information. All they need are their policy and certificate numbers.

Questions?

If you have any questions, please contact your Sun Life Financial group representative.