💬 TBT — Part 5: Coverage Caps, Rising Costs & Common Questions Explained
We’re back with another instalment of our Demystifying Benefits series — your guide to navigating the maze of coverage, insurance, and pension with clarity.
In our last post, we tackled digital fatigue and organization.
Now, we’re answering the questions members ask most often — from coverage caps and rising costs to confusion around sick leave.
If you’ve ever looked at your benefits statement and thought, “Why does my coverage stop at 80%?” — you’re not alone.
Let’s unpack it together.
Coverage Caps & Rising Costs
Common question:
“If costs for dental or physio are going up, why doesn’t our coverage rise too?”
Fair question.
UA Local 787 renegotiates the Collective Agreement every three years, while healthcare costs fluctuate constantly.
Prices often rise faster than contract updates — meaning reimbursements may cover less over time.
Your voice matters: attending union meetings is your best chance to raise these concerns for future negotiations.
You can find meeting details in the Members Portal.
Dental Benefits
Your dental coverage automatically includes your spouse and dependents — at no extra cost.
Our plan follows the Ontario Dental Association (ODA) fee guide, meaning if your dentist charges above that, you pay the difference.
Our Coverage includes:
100% for basic services
80% for major services (up to $2,500/year combined)
60% for orthodontics (children under 21)
$2,000 lifetime orthodontic max
If you’re looking for support beyond your current benefits, don’t panic — the path to peace of mind has many routes.
Want more support options? Explore our Ontario Resources page — a hub of free and subsidized programs for housing, healthcare (including dental), and more.
Sick Day Confusion
Another common question:
“Why don’t we get paid sick days?”
While your plan includes Short-Term Disability (STD) and Long-Term Disability (LTD) for qualifying illnesses or injuries, paid sick days aren’t a standard benefit under the UA Local 787 plan.
Under Ontario’s Employment Standards Act (ESA), all workers — union or non-union — are guaranteed at least three unpaid, job-protected sick days per year.
Any additional paid days would need to be negotiated into the Collective Agreement or arranged directly with your employer.
Quick Recap — Your Most Asked Questions
If you’ve been skimming the maze of benefits info and missed a few turns, we’ve got you covered — here’s a quick recap of the essentials.
“Why was my claim denied?”
There could be many reasons. However the most common reasons are usually due to missing documents or ineligibility. To avoid undue delays, confirm requirements with McAteer before submitting, and check your claim status anytime in MembersXG.
“Why do claims take so long?”
It depends on the specifics of your claim. Since multiple parties are involved — you, your healthcare, McAteer, your employer, etc, any delay in the chain can slow the process.
“What benefits are actually covered?”
Your Benefits Booklet in MemberXG lists all coverage. You can also run a mock claim in GreenShield+ to confirm.
“Why doesn’t coverage rise with costs?”
Healthcare costs often increase faster than contract renewals. The plan’s limits keep it sustainable while still offering strong family coverage. You can help protect and improve benefits by participating in union meetings. In the meantime, explore additional supports through the UA National Wellness Program, Union Savings, the Local 787 FaQ page and our Ontario Resources page.
Recap- Tips and Best Practices for Navigating the System
Think of this guide like a map through a winding maze: with the right tools, you won’t get stuck.
Use GreenShield+ for faster claim submissions.
Keep copies of pay stubs, hours, and claim confirmations.
Track your own eligibility (700-hour rule).
Log into MemberXG for pension status, booklets, and tutorials.
Call McAteer early for clarity on forms and timelines.
Bookmark 787benefits.ca — your hub for all benefits info.
In Summary
While not exhaustive, the above questions are our most common coverage and claim based inquiries.
Even with rising costs of living, your benefits remain a powerful safety net — protecting your health, your family, and your peace of mind.
We’ve shared many high-value resources in this series — but this time, we’re guiding you to one already on your map.
📥 Explore our “Ontario Resources Page” to find additional provincial supports for healthcare, housing, and wellness. It’s your one-stop waypoint — a hub of trusted programs and free services that support your mind, body, and wallet.
Next: Part 6 — Your Pension & Retirement Roadmap.