| Jim Barlow | Bill Debosky | ||
| Larry Lytle | Doug Hutchinson | ||
| Gerry Tyhuis | Bill MacDonald |
Use this form for all claims other than dental and prescription drugs.
The member's signature is required to process the claim.
Submit original invoices with the claim. Claims sent by fax can not
be processed, as the insurance company will only accept original receipts and paperwork.
Make all submissions to the Union Office.
Open Form
Use the standard dental claim form available at your dentist's office, or
download this one from Manulife. The member's signature is required to process the
claim. Make all submissions to the Union Office.
Please note that this is a two-page document. You need only print the first page.
Open Form
This form is required to file for Weekly Indemnity (Short Term Disability) benefit.
The form must be completed by the physician, signed by the member, and submitted to
the Union Office, along with the Member Statement, below.
Open Form
This form is required to file for Weekly Indemnity (Short Term Disability) benefit.
The form must be completed and signed by the member, and submitted to
the Union Office, along with the Physician's Statement, above.
Open Form
Use this form to submit prescription drug expenses for which you require reimbursement.
Please note that the Group # is 5881, and the Certificate Number
is the member's Social Insurance Number.
Open Form
Your Spouse and your unmarried Children, including adopted, foster and step-children, who
are less than 21 years of age, and who reside in Canada, are eligible.
Unmarried Children over the age of 21 who are full-time students and dependent upon you
for support are also eligible. You are required to complete the Claimsecure Over-Age Dependant
Form for each year of extended eligibility.
Submit the completed form to the Union Office. The $5.00 fee is only payable if the dependant
requires his/her own drug card.
Open Form
This form must be completed for drugs requiring special authorization. The completed form
must be faxed or mailed to Claimsecure, according to the instructions on the form.
Open Form
This document outlines the Emergency Travel Assistance plan for members and dependants.
If the expense you incur is for $200 or less, you will be required to pay for these costs yourself and seek
reimbursement upon your return.
Important numbers: The World Access No. and Plan Contract Number appear at the bottom
right of the first page.
The
Plan Member Certificate Number is the member's social insurance number.
In the event that assistance
is required, emergency contact numbers appear on the bottom left of the second page.
Open Form
View an online copy of the Group Benefits Booklet. Booklets have been mailed to all plan members.
The Health & Welfare Trustees are pleased to inform you they have authorized an improvement to the basis of payment for
eligible dental services, incurred on/after January 1, 2012 to the 2010 Ontario Dental Association suggested Fee Guide for General
Practitioners. The dental coverage currently pays claims based on the 2009 Ontario Dental Association Fee Guide.
The Health & Welfare Trustees also had the opportunity to meet with ClaimSecure, the prescription drug carrier of the Benefit Plan.
It is useful to know that on the ClaimSecure website there is a list of all
“Special Authorization Drugs” as well as an eProfile site
that a member can sign into. The site has a substantial amount of information including member drug claims history and research tools
to learn more about your health.
The Trustees are pleased to announce that Manulife Financial has renewed the premium rates. They have
negotiated a decrease in the rates and a refund cheque will be coming back to the Welfare Fund. The Trustees,
therefore, have decided it is not necessary to increase the drawdown totals.
The Trustees have decided that in future the "Pay Direct Notices" sent to members on a monthly basis will be
sent by registered mail. These notices are sent to members who have less than the current premium amount in their
Health & Welfare dollar bank. If the member has not worked the required number of hours to cover the premium,
then the member has the option to buy the Benefit Plan. The Trustees want to ensure that members are receiving
these letters. Please keep your addresses up to date with the Union Office.
ClaimSecure has informed us that if for some reason you don't use your prescription drug card and need to submit
a paper claim, that the paper claim can now be submitted by email through the
ClaimSecure Web site.
You would set up an eProfile account with ClaimSecure in order to submit
a claim. If you have any questions regarding this service, you can call ClaimSecure at 1-888-479-7587.
The Health & Welfare Trustees are pleased to announce that there is an improvement to the dental plan. Effective January 1, 2011 eligible dental services will be paid based on the 2009 Ontario Dental Association Fee Guide. This is an increase from the 2008 Ontario Dental Association Fee Guide.
Effective August 1, 2008, the monthly Dollar Bank Drawdown and Pay Direct charge will be increased.
Currently an Active Member's Dollar Bank Draw Down is $310.00 per month.
Effective August 1st, 2008 the monthly Draw Down will be $350.00. This
increase partially takes into account the recent increase in the
Contribution Rate. The increase in the Contribution Rate also allows the
Member's Dollar Bank to continue to grow.
Effective August 1st, 2008 the maximum a Member can hold in his Health &
Welfare Dollar Bank will increase to $4,200.00
The current charge for Active Members who are on Pay Direct is $267.00, plus
taxes. Effective August 1st, 2008 the Pay Direct charge will be $275.00.
Provincial Sales Tax of $22.00 and $1.18 of Ontario Premium Tax will be
added to the monthly Pay Direct charge for a total monthly Pay Direct charge
of $298.18. Since this increase is effective for the benefit month of
August 2008 the first payment would be due September 10th, 2008.
The Trustees have decided to leave all other Pay Direct charges the same and
to continue to subsidize these costs out of the Unallocated Reserve.
If you have any questions regarding these changes you may contact Sue O'Neill
at the Union Office.
The Health and Welfare Trustees are pleased to inform you there are new revised “Member Information Cards”
available at the Union Office. These cards are used to record your beneficiary information for the Benefit Plan’s Life
Insurance coverage.
Please be aware the insurance company will not issue a cheque for life insurance to beneficiaries under the age of 18.
On the new “Member Information Cards” a member can name beneficiaries younger than 18 as long as they name a Trustee.
It would then be the Trustee named on the card that would receive the life insurance payment.
Also, if a member wishes, he/she may name a primary and a contingent beneficiary on the revised card. An example of this
would be to name the husband or wife as primary beneficiary and the children as contingent beneficiaries, and if husband
and wife both die at the same time, the contingent beneficiaries would receive the life insurance benefit.
If you wish to review or update your beneficiary information please contact Sue O'Neill at the Union Office.