The deadline to submit your 2018 health, dental and flexible spending claims for reimbursement is March 31, 2019. Claims must be received by Sun Life by this date. If submitting claims by mail, please allow a minimum of 5-7 business days. If you miss this deadline, you will not be reimbursed for your claims incurred in 2018.
Sun Life Financial is our benefits plan provider and who your claims for health, dental and the flexible spending program will be submitted to for reimbursement. There are a variety of ways to submit an expense: online, through the mobile app, or via mail on a paper claim form. In addition, some medical offices, such as dentists, are able to direct bill Sun Life so no payment is needed at the time of service.
Remember to keep a copy of your receipts (and claim form if using one) for your records.
For your reference:
- Policy Number for health, dental and HSA plan: 150798
- Policy Number for PSA plan: 151798
- Member ID: same as your employee ID (can be found on your pay statements in PAWS)
Claims must be submitted and received by Sun Life within 90 days of the end of the calendar year in which you incurred the expense. This means claims incurred in one calendar year must be submitted by March 31 in the following year (or March 30 in a leap year).
Claims incurred prior to the termination of employment must be submitted and received by Sun Life within 90 days of the date of termination.
Claims for the Tuition Spending Account must be received by ConnectionPoint within 30 days of the end of the benefit year or within 30 days of termination.
Failure to submit claims following these guidelines will result in declined reimbursement.
Health and Dental Claims
There are various ways for you to submit a claim:
1. Pay-Direct Drug card
If your plan includes a pay-direct drug card, this is the best way to submit claims for prescription drugs. Present your drug card to the pharmacist prior to filling a prescription anywhere within Canada. The pharmacist will submit your claim directly to Sun Life on your behalf. If the drug cost is higher than the amount eligible under your plan, you will be responsible to pay the balance to the pharmacy at the point of sale. Learn more about the Drug Card.
2. Direct Billing
Most dentists, some vision care providers and some paramedical providers are able to submit claims directly to Sun Life on behalf of their patients, with the reimbursement being paid directly to the provider. You will be asked for your policy number and member ID in order for the claim to be processed (you may present your drug card which has this information on it).
If the amount charged by the provider exceeds the reasonable and customary fee or benefit maximum for that benefit, you will be required to pay the difference.
3. Online or Mobile App (see instructions below.)
4. Mail (see instructions below.)
Flexible Spending Claims
Health Spending Account (HSA)
Submit eligible claims to your Sun Life Health and Dental plans first, with any unpaid portion then being submitted to your Health Spending Account (HSA). Claims to your HSA can be submitted online or by mailing in a paper form (instructions below). If you are covered under another plan (ie. as a dependent under your spouses’ plan), you may wish to complete a coordination of benefits claim prior to submitting your claim to the HSA.
Personal Spending Account (PSA)
Claims to your Personal Spending Account can only be submitted by downloading and mailing in paper form. Form and mail submissions instructions available below.
Tuition Spending Account (TSA)
Claims for the TSA are processed by ConnectionPoint. Claims must be submitted to ConnectionPoint and must include a completed Tuition Spending Account Claim Form and the original receipt or a copy of the student fees page from PAWS, in you or your immediate family member’s name. If the expense is for an eligible employee, the reimbursement is paid out on their regular paycheque. Claims must be submitted by the 10th of the month in order to be included on that month’s salary payment. If the expense is for a family member, the reimbursement will be applied against the student’s account.
ConnectionPoint will assist you or your beneficiary or executor in submitting a claim for Basic Life Insurance, Optional Life Insurance, Optional AD&D Insurance or Business Travel Accident Insurance.
View the process for submitting a claim for Disability Benefits which includes short-term disabilities (continuance of salary) and long-term disabilites.
Online or App Submission
You can submit a claim through your mysunlife.ca account or on the Sun Life mobile app.
- Sign in to your mysunlife account or Sunlife mobile app
- Under the "Benefits" section, select "Submit a claim" found on the right hand side of your screen
- Select "Claims" from the top menu bar, then choose the appropriate claim type (i.e., paramedical, vision) from options presented and follow the steps to submit
You will need to sign up for direct deposit with Sun Life in order to submit an online claim. This can be done in the benefits area of your mysunlife account. Once your claim has been submitted, your reimbursement is deposited directly into your bank account, usually within 24-48 hours from the time your claim has been processed. You will receive emails from Sun Life to notify you about the status of your claim.
You can also use photo submission on the mobile app for claims that require supporting documentation (i.e. doctor referrals)
Online Submission hours: Monday-Friday from 6:00 a.m. to 11:59 p.m. Saturday from 6:00 a.m. to Sunday 2:00 a.m. and Sunday from 8:00 a.m. to 11:59 p.m. (Eastern time)
Please note that there may be some expenses that require paper submission. Details can be found in your mysunlife account
Mail Submission and Forms
All eligible expenses can also be submitted by mail.
Download your personalized claim forms from Sun Life’s website:
- Sign in to your mysunlife account
- Under the "Benefits" section, select "Submit a claim"
- Select "claim form"
- Complete any additional information requested, print the form, enclose the original receipt and mail it to one of the addresses listed on the form. Be sure to keep a copy of the claim form and receipts for your records.
Personal information will automatically be populated into your form when you download them through your Sun Life account. However, if you don’t have access to your online Sun Life account you can download the following forms:
- Extended Health Care and Health Spending Account Claim Form for submitting Health Plan claims (or Health Spending Account claims related to health care expenses)
- Dental Care and Health Spending Account Claim Form for submitting Dental Plan claims or (Health Spending Account claims related to dental expenses)
- Personal Spending Account Claim Form
- Post-Retirement Spending Account Form
Coordination of Benefits
If you and your eligible dependents are covered for similar benefits under two plans, you can maximize the amount of money you get back by coordinating your benefits.
Claims for you
Any of your personal claims should first be claimed under any plan(s) where you are the plan member. Remember to make copies of the originals receipts if you are submitting a paper claim. When your claim is processed you will receive a claim statement which includes your explanation of benefits. You can then submit the remaining amount not covered by your plan to the second insurance company.
If you are the plan member in more than one group benefit plan, priority for payment is established based on the following order:
- First, the group plan where the you are an active full-time employee
- Next, the group plan where you are an active part-time employee
- Finally, the group plan where you are covered as a retiree
If you are covered under two plans with the same priority above, it is then based on which plan you have been covered under the longest.
Claims for your spouse
If your spouse has coverage under their own plan, they should submit their claims to that plan first. Any remaining amount not covered by their plan can then be submitted under your plan to Sun Life. Don’t forget to make copies of the receipts.
Claims for your children
Claims for children should be submitted to the plan of the parent whose birthday falls earlier in the calendar year. For example, if your birthday is in March and the other parent’s birthday is in August, submit your children’s claims to your plan(s) first and then any remaining amounts to your spouses’ plan. Students and eligible dependents may have coverage through work or school. Their claims should be submitted to any plan where they are the plan member prior to being sent to a plan where they are covered as a dependent.
In a single custody situation, the plan of the parent with whom the child resides pays first, the plan of the spouse of that parent pays second, and the plan of the parent not having custody pays third.
In a joint custody situation, when both parents have plans and their children are covered under both as dependents, the plan of the parent with the earlier birthdate in the calendar year pays first.
For all cases, if both insurance plans are with Sun Life, any unpaid balances can be processed at the same time if you provide the plan and member information for the second plan when asked on the e-claim or paper claim form.
Sun Life Customer Call Centre
Sun Life has a Customer Call Centre that provides information directly related to your benefits, claims submitted and status of your claim. Other questions or scenarios that Sun Life can assist with are:
- How do I update or change my dependents?
- My child is attending University. How do keep them on my plan as an overage dependent?
- What is the status of my claim?
- What is my maximum for a specific service? How do I know if I have reached my benefit maximum?
- What am I or my dependents covered for under a certain plan?
- I am locked out of MySunLife account. How do I reset my password?
- Why was my claim denied?
1-800-361-6212 during the work week from 8am to 8 pm EST.
Or connect online through your MySunLife account. Visit www.mysunlife.ca and enter your access ID and password.
Types of questions Connection Point can assist with:
- What date does my coverage begin?
- What type of benefit coverage am I eligibile for?
- How do I submit a claim?
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