|
|
|
|
|
|
Health Benefit FAQs |
|
|
|
|
|
The following are the most commonly asked questions by
Members regarding their Health Benefit Plan. If you still have questions after reading this information,
please contact the Plan Administrator. |
|
|
|
|
|
Where do I get information on what or
how much coverage I have?
Every Member of a Health Benefit Plan is issued a Plan Booklet upon
enrolment. Please refer to your Health Plan Booklet for a detailed
description of the benefits for which you are covered and the amounts for
which you may be eligible to be reimbursed. If you did not receive a
Plan Booklet or have misplaced your copy, please contact the Plan
Administrator, your employer, or local union hall for a replacement copy.
|
|
|
Can I get access to my personal claims
history on this web site?
No. Individual information such as claims history is not
available on this web site. Please contact the Plan
Administrator for this information.
|
|
|
The form that I am looking for is not
on this web site. What should I do?
Some Plans may have customized forms that are not available on
this web site. Please contact the Plan Administrator, your
employer or your local union hall for a paper copy of any form
that you can't find on this web site.
|
|
|
What is co-ordination of benefits?
If a Member or any eligible Dependents are entitled to
receive similar benefits simultaneously under their Health Benefit Plan or any
other group insurance plan (including Provincial Plans), to prevent over
payment, benefits payable under their Plan would be co-ordinated with the other Plan.
For example: A Member's wife is covered under her employer's plan under with
family coverage. The Member, his spouse and their three children are all covered
under both Plans. The responsibility of the initial reimbursement is determined
as follows: Between the Member and the spouse, whoever's birthday falls first in
the calendar year, their plan is responsible for the initial payment of benefits
for the dependent children, then, any amounts that are not paid by that Plan are
submitted to the other spouse's plan.
Therefore, in the event that the Member's birthday is in April and the spouse's
birthday is in January. The spouse's plan would be primarily responsible for her
claims and the claims of the children. Any amounts not paid by her plan can be
submitted to the Member's Plan for reimbursement.
|
|
|
|
|
|
|
|
|
|
