Health Care Spending Account (HCSA) Claims

Clinical Staff

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 Care 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.


Published on  and maintained in Cascade CMS.