Making a Claim
The University health and dental coverage is provided through Sun Life. Claims for reimbursement of expenses are typically submitted in the following two ways:
1. Completing a Paper Form
Expenses can be submitted using forms located in the Forms Cabinet. Specific claim information is outlined below. Coverage is provided through Sun Life using the contract number 25379. When using a paper form, make a copy of the claim along with copies of the original receipts (if applicable) for your records. Mail the signed form, with your receipts (if applicable) to the following address:
Sun Life Assurance Company of Canada
PO Box 2010 Station Waterloo
Waterloo, Ontario N2J 0A6
2. Online Submission of Claims through Sun Life Member Services
Expenses can be submitted on-line using the Sun Life Member Login. To learn more and register for the on-line service visit the Sun Life Member Services page.
Types of Claims
Prescription Drug Claims
- Direct Bill: Show your Sun Life identification card as proof of coverage when ordering your prescription and your pharmacist can bill Sun Life electronically.
- Reimbursement: You may pay for prescription drugs directly and then submit a claim for reimbursement under your Supplementary Health Care Plan by completing an Extended Health Claim Form available in the HRS Forms Cabinet.
Dental claims can be submitted online with Sun Life and by completing a paper form. In addition, there are two other ways to arrange payment:
- Make arrangements for "assignment" billing by signing the top right hand corner of the Dental Claim/Treatment form. Payments will then go directly to your dental provider; or
- Pay your dentist and have your dental office complete a Dental Claim Form. Most dental offices have electronic claims submissions and will submit the claim to Sunlife on your behalf.
Please note: If your plan is the second payer you must send in a paper claim. Ensure you attach the Explanation of Benefits (EOB) from your spouse’s plan.
Supplementary Health Care Claims
Extended Health Care claims can be submitted for paramedical services, health equipment and reimbursement drugs. Most claims can be submitted online. If submitting via the paper form, all claims for expenses must be accompanied by original receipts, supporting documentation if required (written order of a physician as one example) and/or the Explanation of Benefits (EOB) form if your spouse's plan has paid a portion of the expenses.
All vision claims, including eye exam expenses can be submitted both online and by completing the paper form. If submitted via the paper form, all claims for vision expenses must be accompanied by original receipts, supporting documentation if required (change in prescription following eye surgery) and/or the Explanation of Benefits (EOB) form if your spouse's plan has paid a portion of the expense.
Health Spending Account claims
If you have questions about your Academic Staff Health Spending Account or your Support Staff Health Spending Account or to view a list of eligible expenses please see the links below:
Co-ordination of Benefits
There are certain rules that govern the reimbursement of claims when both you and your spouse have benefit coverage with your respective employers. There are additional considerations when you or your spouse begin coverage under the Alberta Blue Cross Seniors Program. Visit the Co-ordination of Benefits page for more information.
Claims must be submitted 90 days following the end of the calendar year in which the expense was incurred.