Plan Administrator Tools and Support

Most plans allow for coverage of dependent children to at least age 19. Most plans will cover beyond that for full time students at accredited post-secondary institutes up to age 25 or 26. Please check your benefits booklet for your specific plan’s details. We require an updated Overage Dependent form each new school year to confirm eligibility. Disabled dependent children can be covered indefinitely.

This can be done in several ways. You can fill out a Change of Record form, which can be found on our download page. This form can be emailed to your plan administrator or admin. You can call and speak to a client service representative. Lastly, you can enter the address on the claim form when making a claim. If you elect to do this, you should highlight the fact that it is a new address to ensure that it is not missed.

Certainly, just give us a call, and we will send a new card to your administrator. If you have lost your travel card, contact your administrator to get a new one. If they do not have a supply on hand, we may need to order more, so try to do this well in advance of your travel date.

The amount that is deducted from your pay cheque is decided entirely by your employer, so this question should be referred to your Human Resources Department.

It is the 3 or 4 digit number on your benefits card and booklet. Sometimes also referred to as a contract or plan number.

Premium Tax is 2.0%, Provincial Insurance Tax is 8.0%, and HST is 13.0%.

The member’s name should always be filled in at the top of the claim form.

We strongly suggest that the member fills out and signs each claim themselves. The member is ultimately responsible for any information on the form. Filling out your own form limits the possibility of being taken advantage of by fraudulent service providers.

Failure to enter the required information on our claim forms could lead to delays in processing your claim.

Using our Benefits Trust app eliminates the need to fill out any claim details. Simply upload your receipt, and we’ll take care of the rest.

Download iOS App| Download Android App

Our claims turnaround time is 1 to 3 business days in-house. Nearly all claims are reimbursed the day they are received.

We must wait 2 weeks from the issue date before placing a stop payment on the initial cheque at the member’s request.  It has been our experience that delays at the postal office, while rare, can result in cheques taking this long to reach their destination.

We encourage all members who receive cheques to consider switching to direct deposit for faster processing and return on their claims. For a direct deposit form, please visit the Employee Resource Centre Forms page.

Yes, we accept faxed or emailed submissions.  Please keep your original receipts in the event of an audit. For further information on email submissions, click here.

You should always send your own claims to your primary insurer first, even if you know that the item is not covered. For children, claims must be sent to the plan of the parent whose birth date comes earliest in the calendar year. Please note that copies of receipts are acceptable for coordination of benefits.

Please note that HSAs are the exception to this. If you have a healthcare spending account, you should always submit through the other plan first, as HSAs always pay last.

You may refer to your benefits booklet for plan details. If you do not have a booklet, speak to your administrator, as they should have a supply on hand or an electronic copy available for you. If you have any questions or require any clarification, please call us and we will be happy to help you.

We have claim forms on our download page that you can fill out and print. You can also get original claim forms from your Human Resources Department. We also include a claim form when mailing reimbursements to your home.

This field applies only to prescription drugs and can be left blank for all other claims. Each drug has a drug identification number (DIN) assigned to it that helps us determine the eligibility of the drug. This number is not to be confused with the Rx number (prescription number) or Tx number (transaction number).

Vision care claims must be submitted with a Medical and Drug Expense Claim form. We do not use separate claim forms for vision care.

It is possible that they are sending the claim to the wrong company. Please have your dental office call us to have this sorted out.

This information is for your dentist to submit claims electronically. This information is not specific to your group. Our EDI network is NDC Health/ACE, our CDA # is 610146, and we use batch/version 2.

A Standard Dental Claim form provided by your dental office is perfectly acceptable.

This refers to Health Care Spending Account plans. This may or may not be applicable to your plan. Please refer to your booklet to confirm or give us a call.

For plans that have both core benefits and Health Care Spending Accounts, we will always pay first through the core portion. Only the amounts that we are not able to process through the core portion will be paid through the Health Care Spending Account.