Benefit and Pension Plans
- Clinical Faculty

 

Submitting claims by mail

(See below for "Submitting Claims over the Internet")

Member of Western University HCSA plan only

UWO HCSA Contract:  150033
UWO HCSA Member ID:  Western Employee ID Number

• Complete sections 1-3 of the Health Spending Account Claim Form (HSA-150033-E)
• Attach original receipts to claim form
• Verify all information is correct and you have signed and dated in Section 3.
• Mail completed form to:

Sun Life Assurance Company of Canada
PO Box 2010 Stn Waterloo
Waterloo, ON  N2J 0A6

 

Member of Western University HCSA plan and other Sun Life Benefit plans such as: OMA-OPIP plan or Spousal Plan

UWO HCSA Contract:  150033
UWO HCSA Member ID:  Western Employee ID Number
OMA-OPIP Contract:  50131
OMA-OPIP Member ID:  Provided by OMA-OPIP plan

• Submit claim using the Extended Health Care Claim Form (EHC-E-11-10)
• Complete section 1 using your OMA-OPIP Member ID
• Complete section 2 to coordinate benefits with other Sunlife benefit plans including your Western University HCSA
• Complete sections 3-4
• Attach original receipts to claim form
• Verify all information is correct and you have signed and dated in Section 4.
• Mail completed form to:

Sun Life Assurance Company of Canada
PO Box 2010 Stn Waterloo
Waterloo, ON  N2J 0A6

 

Member of Western University HCSA plan, OMA-OPIP plan and Spousal Benefit Plan that is not Sun Life

UWO HCSA Contract:  150033
UWO HCSA Member ID:  Western Employee ID Number
OMA-OPIP Contract:  50131
OMA-OPIP Member ID:  Provided by OMA-OPIP plan

• Submit claim using the Extended Health Claim Form(EHC-E-11-10)
• Complete section 1 using your OMA-OPIP Member ID
• Complete sections 2-4
• Attach original receipts to claim form
• Verify all information is correct and you have signed and dated in Section 4.
• Mail completed form to:

Sun Life Assurance Company of Canada
PO Box 2010 Stn Waterloo
Waterloo, ON  N2J 0A6

• Upon receipt of explanation of benefits from the OMA-OPIP plan, submit claim against Spouse’s benefit plan using the explanation of benefits provided.
• Upon receipt of explanation of benefits from spousal plan, submit any unpaid expenses to the Western University HCSA plan using the Health Spending Account Claim Form (HSA-150033-E)
• Complete sections 1-3 and attach the explanation of benefits from the spousal plan to the claim form
• Verify all information is correct and you have signed and dated in Section 3.
• Mail completed form to:

Sun Life Assurance Company of Canada
PO Box 2010 Stn Waterloo
Waterloo, ON  N2J 0A6

Submitting claims over the Internet

• Sign into the Plan Member Services website.  If you have not registered, please review the tutorial on www.sunlife.ca/mybenefitsonline
• From the main menu, click “my claims”
• Click “Health Spending Account e-claim”
• Confirm banking and contact information and click “continue”
• Accept Terms and Conditions by click “I agree”
• Indicate who the claim is for and click “continue”.  If the dependent is not listed, click on update and add the dependent information.
• Enter claim details and click “continue”
• Review claim summary and validate information is correct.
• Submit claim
• When complete, you will see the explanation of benefits on your claim

If you have any questions regarding claims submissions, please contact Sun Life at 1-800-361-6212
Monday-Friday, 8am-8pm ET