5979903560

UNI VERSI TY HEALTH INSURANCE PLAN UHIP RAMU To val>dat* th« aligibWity of tbej m*mb*r, pl*as* vi*t
Ur*v*r*«ty M«mb«< 10		Policy numb*r
Acc*it 10 Nam* of insured(l) (la»t rum*, fint nam*;		K*y: M-M*mb*r. S-Spoul*. C-OWd M
Eff*<tiv* dat* (ÓJrn/y) 01/09/2016	T*>m.r\abon dat* (diWy) 30/04/2017 NON TRANSFERABLE

COVERAGE

UH1PS provid*ł bapc KotpiUl. m*dical and tuppl*m*ntary msurane* compaiabl* to cov*rag* provxł*d through th* Ontano H*ałth Intujnc* Ptan (OHIP) for Ontano r*s*d«nts. S*nnc*s insid* and outsrd* Canada ar« cov*rcd to th* sam* famits and condibons as OMIP. For furthar Information about UHIP® COv*rag* go to wvru.uhgi.cj or contact 1 366 50O-UHJP (8447). This CJrd tS not transf*r*bl*. Lost or stoł«n cards shoutd b* r*po*t*d imm*d*at*ly.

Th i* p.oof-of-cov*iag* card >d*nt>f>*ł th* msur*d m*mb**. and d*p«nd*nts wh*r* appbcabł*. provtd*d pc*cn.ums hav* b**n paid and th* agr*«m*nt u in-forc*. Not<« to hospitah: pl*as* oontact th* company, at th* addr*ss and t*l*phon* numb*r b*iow. wsthin 48 hours of th* instawd** admnuon to hospital.

Sun Life Assurance Company ot Canada PO Box 2010 Stn Waterloo    Sun

Waterloo ON N2J 0A6    Life Financial

Toll free: 1 866 500 UHI P < 8447)

Fraudutont _us* ot tnts card will r*łolt n loss of cov*r»g* and potuOł* pros*cutlon.