Postdoctoral Associates - Benefits

Member of Western HCSA plan only
(ie. no other Health or Dental Coverage)

Western University HCSA Contract: 87221
Western University HCSA Member ID: Western Employee ID Number

• Complete sections 1-5 of the Health Spending Account Claim Form
• Attach original receipts to claim form, keep copies for your records
• Verify all information is correct and you have signed and dated in Section 5.
• Mail completed form to:

Manulife Financial
Group Health Claims
PO Box 1653
Waterloo, ON N2J 4W1

Member of Western HCSA plan and another Benefit Plan (eg. SOGS)

Western University HCSA Contract: 87221
Western University HCSA Member ID: Western Employee ID Number

• Submit claim to other Benefit Plan
• Upon receipt of the explanation of benefits from the other Benefit Plan, submit claim against the HCSA plan using the explanation of benefits provided.
• Complete sections 1-5 of the Health Spending Account Claim Form
• Attach explanation of benefits to claim form, keep copies for your records
• Verify all information is correct and you have signed and dated in Section 5.
• Mail completed form to:

Manulife Financial
Group Health Claims
PO Box 1653
Waterloo, ON N2J 4W1