Making a Claim
Managing your health and dental claims effectively can make a big difference in the value you derive from the benefits program. The program makes it easy for you in a number of ways.
There are several ways to make a claim against your Health and Dental benefits, and your Health Care Spending Account (HCSA) and taxable Wellness Spending account (WSA), if applicable. These include using your pay direct drug card, having your dentist submit your claim, submitting an electronic claim, or submitting a paper claim.
Ways to Make a Claim
To register for online access, you will need your plan contract number (87220) and your plan member certificate (Western ID number) which can be found on either a claim statement or on your benefits card. Go to the Manulife website, select Registration in the top right corner and provide the required information on the page. Be sure to enter your email address so you will be able to take advantage of the electronic notifications feature.
Once registered, you may access the Manulife website anytime and login to view the status of your most recent claims, submit online claims, review your claim history, download claim forms, check your HCSA and WSA balances, if applicable, look up drug eligibility, set up direct deposit and access the Manulife Wellness Learning Centre.
You can submit claims electronically through the Manulife Plan Member website or through their mobile app.
You can request any of your claims to be applied against your HCSA/WSA (if applicable) by utilizing the ‘Send a note’ function on the Manulife website or by calling 1-866-896-8515.
You will not need to mail your original receipts unless Manulife requests receipts through an audit process. Be sure to retain your original receipts for 12 months from the date of claim submission.
After registering with Manulife, you can install the Manulife mobile app for your smartphone or tablet which allows you the convenience of submitting and reviewing claims on the go. The mobile app can be downloaded from the following smartphone app stores:
- Apple App Store
- Google Play
- Windows Store
Paper claim forms for health care, dental, HCSA and WSA claims are available on the HR Benefits and Forms website and on the Manulife website. You can also request forms by contacting Human Resources. To use the HCSA for any portion of expenses not covered by Western's plan, check the box on the form to indicate you want the balance to be submitted to your HCSA.
Retain a copy of the completed form and receipts for your records, and then mail both directly to the insurance provider at the address indicated on the form.
Other Important Information
You can receive direct deposit of your claim reimbursements by registering and signing up on the Manulife website. You will then be able to add and update your Direct Deposit information.
Visit the Manulife website and select "Registration". You will need to enter information including your Plan Contract Number and your Member Certificate Number (your employee ID number). Both can be found on your Manulife Benefits card.
We encourage you to submit claims as they are incurred and not wait until the deadline is approaching.
Health Care and Dental Plan
Expenses incurred in a calendar year must be claimed by January 31 of the second year following the year the expense was incurred. In other words, you have 13 months after the end of the year in which an expense is incurred to submit any outstanding claims.
Health Care Spending Account (HCSA) and Wellness Spending Account (WSA) Claims
All claims must be received by the insurance provider no later than March 31 of the year following the year in which the expenses were incurred.
Unused credits in a Health Care Spending Account and Wellness Spending Account (taxable) will be carried forward and available the following calendar year. At the end of the second calendar year any credits remaining from the previous year will be forfeited. In November, those who have forfeited any HCSA/WSA credits may wish to re-evaluate credit allocations for the following year.
To see the current balance in your Health Care Spending Account and/or your Wellness Spending Account, login to the Manulife Plan Member website. Select "My Benefits", then the link that says HCSA Balance/WSA Balance. For the HCSA, you will see amount deposited in current year, claims paid, and your current balance. For your WSA you will see your cumulative balance. To see your claims history details for both the HCSA and WSA – see ‘Claims History’ then choose either HCSA or WSA.
Login to Western Financials to see the current balance in your Professional Expense Reimbursement Account.
If your spouse has coverage through their employer or another retiree program, a member may be able to receive up to 100% reimbursement for medical and dental expenses by submitting claims to both plans using an industry-wide procedure called co-ordination of benefits.
To co-ordinate benefits, first enroll your spouse and children as dependents in the Western benefits program. Your spouse must also enroll you and any children in their plan.
Further information on co-ordination of benefits may be found on the Canadian Life and Health Insurance Association web site.
- Have claims processed in timely manner to avoid denied claims or forfeiture of any HCSA/WSA funds.
- Unused HCSA/WSA credits are carried forward one plan year. Credits not used in the second plan year will be forfeited.
- HCSA/WSA deadline - March 31 of the year following the year in which the expense was incurred.
- Extended Health & Dental Plans deadline - Jan. 31 of the second year following the year in which the expense was incurred.
- WSA reimbursements to you are reported on your T4 as income in the year the reimbursement is made.
Published on and maintained in Cascade CMS.