海角社区

海角社区.CA / Human Resources / Benefits / Insurance & plan details / Supplemental health & dental plans

Submitting a supplemental health and dental claim

Provider Information

Insurance Provider: Manulife

Plan contract number: 85210

Plan member certificate number: your 海角社区 ID number.

Plan sponsor: 海角社区

Customer Service/Claim Inquiries: 1-800-268-6195

Manulife ID

Manulife ID is a new and secure way of accessing all your Manulife products and services. As of December 2022, all plan members must convert their Manulife login to a Manulife ID. Please consult the following links to learn more about Manulife ID.

Claims Submission

Claims for health and dental expenses incurred in a benefit year must be submitted to Manulife by March 31 of the following year. Claims received after March 31 will not be accepted, even if postmarked earlier. The benefit year is from January 1st to December 31st.

Submit Online

  • Sign in to the Manulife Group Benefits Plan Member Secure site with your Manulife ID.
  • Keep your receipts for a minimum of one year.
  • For questions about the submission process of online claims, contact Manulife directly at 1-800-268-6195.

Mobile App

Download the Manulife Mobile App on the , or on .

By downloading the app, you will be able to:

  • Submit claims from your smartphone.
  • View your most recent claims.
  • Browse claim details.

Download the app today and enjoy the convenience of managing your benefits on the go.

Paper Claims

Paper submissions can be made by mail. Download and print a or .

Claims can be mailed to the addresses listed on the form.

Pay Direct/Direct Billing

When filling a prescription, your pharmacist will send your claim electronically to Manulife and will be able to let you know immediately if the drug is covered under your plan. You will then only pay the remaining portion, normally the co-insurance amount.

Benefits Card

You can print a personalized benefit/travel card for you and the eligible dependents covered under your 海角社区 Supplemental Health Plan from . Under the 鈥淢y benefits鈥� tab, choose 鈥淰iew my benefits card鈥�

When paying for medications or services, present your benefits card to your pharmacist, dentist, or health professional service provider, and they will submit an electronic claim directly to Manulife for processing.

Family Coverage and Coordinating Payments

Family Coverage and Coordinating Payments

If both you and your spouse have health and/or dental coverage through your respective employers, you can claim payment for health and dental expenses under both plans.

To coordinate payment, you will need to follow the following steps:

  • If you have incurred the expense: You must submit your claim through the 海角社区 plan first. If an unpaid portion is remaining, your spouse can submit a claim for this amount through their听plan.
  • If your spouse has incurred the expense: Your spouse must submit their听claim through their听plan first. Any unpaid portion may be claimed through your 海角社区 plan, provided you have family coverage.
  • If your child has incurred the expense and you both have family coverage: The claim must be submitted first to the plan of the parent whose birthday falls earlier in the year. Any unpaid portion can then be submitted under the other spouse's plan as the secondary payer.
  • For information regarding coordination of benefit scenarios, please consult the 辫补驳别.听

Once you receive payment from the first insurance company, submit the claims statement showing the amounts considered and paid by the first insurance company online through the insurance carrier's website or Mobile App.

Additional Information by Claim Type

Benefit Claim Process
Hospital

If the hospital bills the insurer directly:

  • Advise the admitting clerk that you are covered under plan contract number 85210 with Manulife.
  • Give them your 海角社区 identification number.
  • The hospital will bill Manulife directly.

If the hospital requires that you pay the bill:

  • Obtain the completed hospitalization claim form from the hospital (keep a copy for your personal records).
  • Submit the claim form to Manulife
Private Duty Nursing

You must submit a pre-determination to Manulife before nursing services can begin; otherwise, your claim could be refused or reimbursed at a lower level. Please contact Manulife for information about the documents听and details needed before听submitting a听Manulife Supplemental Health claim form.
Orthotics and Orthopaedic Shoes

For each claim and/or pre-determination for orthotics and orthopedic shoes, you must supply a detailed prescription from the prescribing medical practitioner indicating all of the following:

  • A diagnosis of the condition (symptoms alone will not suffice),
  • A list of symptoms and the main discomfort,
  • A description of the physical findings from the clinical examination,
  • A brief narrative description of the gait abnormality with the diagnosis,

A detailed receipt from the supplier indicating:

  • The provider's qualifications.
  • Confirmation that the orthotics or orthopedic shoes have been custom made.
Ophthalmologist If your medical claim is for an eye exam performed by an ophthalmologist who is registered with Medicare, a detailed explanation of the services rendered, as well a separate charges, must be indicated on the receipt.
Emergency medical and out-of-country/province claims For information, see Emergency travel assistance for active faculty staff or for retired employees.
Dental Claims

Pre-determination

  • If the total treatment is expected to cost more than $400, it is recommended that you submit a treatment plan to Manulife before the treatment begins to avoid surprises.

Electronic claims submission by your dentist

  • Some dentists are able听to submit dental claims electronically to Manulife, in which case no paperwork is required. Simply provide your dentist with your Manulife policy number 85210 and your plan member certificate number (your 海角社区 ID number).

Paper claim submission

  • Before visiting your dentist, obtain a .
  • Complete Part 2 of the form.
  • Have your dentist complete Part 1 of the form.
  • You can assign your benefit payment directly to your dentist by signing in the appropriate box on the form.
  • Otherwise, sign, date and forward the completed form directly to Manulife. The address is provided on the form. Keep a copy for your records.

Dental claims as a result of an accident

  • Submit a pre-determination under the 海角社区 Supplemental Health Plan using a . Include from your dentist: x-rays, details of treatment, including procedure codes, tooth #, tooth services and fees and details of the accident. Once the estimate is approved, the claim must be mailed and not submitted electronically.
Life Insurance and Accidental Death and Dismemberment Claims Your beneficiary or the executor of your estate should contact the HR Service Centre at 514-398-4747, or by hrhr@尘肠驳颈濒濒.肠补听(别尘补颈濒)听as soon as reasonably possible to advise of your death. A representative will help them complete the claims process.
Provincial Plan Replacement Coverage Refer to the Provincial Plan Replacement Coverage for further information.

Direct Deposit

Automatic Registration

海角社区 provides Manulife with the required information from your employee file (i.e.banking information, email address, etc.) to ensure that your claim payments are automatically registered for direct deposit.

This means that:

  • Your health and dental claims payments will be automatically deposited directly into your 海角社区 payroll designated bank account.
  • You will receive claim payments faster -in most instances- within 48 hours.
  • You will receive an email from Manulife when your claim is processed.

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If your service provider is not set up on the Manulife eClaims network

Manulife Provider eClaims service for electronic claims submission, adjudication and reimbursement was developed in partnership with TELUS Health. Your service provider will need to consult the TELUS Health website for information on how to register.

When you leave the university

You have 90 days from the day your employment is terminated to submit any outstanding claims for charges incurred before your termination date. You will no longer have access to Manulife's Secure Site once you leave the university, therefore all claims must be submitted by mail. If you need to print out a summary of your claims for income tax purposes, you must do it before leaving the university.

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