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Benefit appeals
- Members
- Benefit appeals
The benefit appeals process
The benefit appeals process gives you the opportunity to address disagreements with a decision made by Member Services regarding your benefit entitlement. This process is intended to provide you with a timely, accessible, and confidential dispute resolution forum.
Decision review process
At UPP we are responsible for administering the plan in line with applicable legislation and its provisions. We act with good faith, fairness, honesty and in the best interests of all our plan members.
One of our responsibilities as the administrator of UPP is to ensure our members receive relevant information about up-to-date plan terms and legislative requirements in a clear and concise manner.
Our Member Services team is available for any questions or concerns you may have and will treat all requests in a fair, timely, transparent and effective manner. In most cases, a resolution will be reached during the initial review with Member Services. However, if you wish to appeal the decision made, you may follow the benefit appeals process.
Member Services review
The first step to resolve your concern is to contact our Member Services team via phone or secure message. Whether you have questions about your pension benefit, how the plan works, forms you received, or other pension-related questions, our team of pension experts are available to assist you every step of the way.
Our Member Services team will work with you to ensure they understand the nature of your concern, identify next steps, and keep you informed.The management team will be engaged as needed. The timing will vary depending on the type of request. Once a decision has been made, it will be communicated to you in writing, unless the matter was resolved in your initial communication with Member Services.
The timing will vary depending on the type of request, but rest assured, we will keep you informed every step of the way and provide you with regular updates.
Benefit appeals process
In most cases, a mutual resolution will be reached at the previous stage. However, if you are not satisfied with the decision provided and your concern is specific to your benefit entitlement, or claim to a benefit entitlement, you can request a formal review by our Pension Services Committee through the benefit appeal process described below.
The benefit appeals process gives you the opportunity to address disagreements with a decision made about your benefit entitlement or claim to a benefit entitlement under UPP. This process is intended to provide you with a timely, accessible, and confidential dispute resolution forum.
Who can submit an appeal?
Any member, spouse, or beneficiary may submit an application for an appeal to request a review of a decision regarding their benefit entitlement or claim to a benefit entitlement under UPP. You may choose to be represented by legal counsel or another representative, but it is not a requirement.
Who reviews the appeal?
The Pension Services Committee is a sub-committee of UPP’s Board of Trustees that oversees member and employer benefit related matters, as well as the Plan Text interpretation.
The Pension Services Committee has the authority to change a decision made by our Member Services team, based on the interpretation or application of the Plan Text or UPP policies.
The Pension Services Committee does not have the ability to pay damages or award benefits that aren’t allowed in the Plan Text.
What should you expect in the appeals process?
The review of an appeal will generally include the following steps:
- Initiation: You can start an appeal by submitting a UPP Benefit Appeal Form to UPP’s Board Secretary.
- Prehearing conference: The Board Secretary may schedule a prehearing conference to clarify the issue being appealed and discuss procedural matters, such as sharing any documents and scheduling the hearing date.
If you decide to proceed with an appeal hearing, the Board Secretary will provide you with the details including the date, time, and location or virtual platform for the meeting. A copy of the Benefits Adjudication Policy and Benefits Appeal Procedures will also be provided.
If additional information or documentation is required, all parties will make a preliminary agreement on the timeline and content for exchange, and this will be communicated to you in writing.
- Hearing: At this hearing, you present your concerns to the Pension Services Committee. The hearing can be conducted either in person, in writing, or via video conference.
- Decision: The Pension Services Committee will provide a written decision to all parties involved.
What is the appeal process timeline?
The table below provides a snapshot of the key timelines for the appeal process.
Appeal process timeline
After receiving a decision from our Member Services team
Complete and submit the UPP Benefit Appeal Form to the Board Secretary. Note: The recommended timeframe is within 60 days of receiving a decision from our Member Services team. However, appeals submitted outside of this window will still be reviewed.
After receiving your UPP Benefit Appeal Form
The Board Secretary will acknowledge receiving the form and provide you with a status update within 60 days.
Within a reasonable period of time
The Board Secretary will identify dates for the prehearing conference, if applicable or the hearing.
At least 2 weeks prior to the hearing
Submit any additional information or documentation to the Board Secretary.
You can request additional time to prepare for the meeting within ten business days of receiving the notification, outlining the reasons and the proposed extension. You will be notified of the outcome, including a revised schedule for the hearing, where applicable.
Once a decision is made, it will be communicated to you in writing within a reasonable time.
Submit an appeal
To request an appeal, you may complete and submit the Benefit Appeal Form to the via email to [email protected].
Alternatively, you can mail us at the address below:
Attn: Board Secretary
University Pension Plan
PO Box 70, Toronto ON M5C 2H8
You are encouraged to submit additional documentation in support of your appeal. If you are submitting documents digitally, they should be in a format that cannot be altered such as PDF or image files (e.g. JPEG, PNG).
If you need special formats or assistance for accessibility during the appeals process, please mention your requirements when you submit your appeal request.
If you have any concerns about your appeal, contact us at [email protected] or 1-833-877-3088.
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