UBC faculty and staff who are enrolled in more than one extended health or dental plan have the option of coordinating coverage between their multiple plans (also known as coordination of benefits or COB). This means that if you submit an eligible claim to the first plan and there’s a portion that was not paid or only partially reimbursed, you can submit that portion to the second plan where it may be considered for reimbursement up to 100% of the allowable amount that can be paid to that claim.
Order matters when coordinating your claims
If the claim is for yourself:
- You will need to submit it through your plan first, and then any other plan coverage you have.
If the claim is for your spouse or partner:
- First, they will need to submit it through any coverage they are the plan member for, and then your plan coverage.
For dependent children:
- The claim will need to be submitted through the plan of whichever parent’s birth month is first in the calendar year, and then through the other parent’s plan second (i.e. if one parent was born in March and the other in November, the claim is submitted through the March-born parent’s plan first, and then through the November-born parent’s plan).
How to set up a COB with Sun Life
If you and your spouse or partner are both UBC employees or if your other plan is also with Sun Life, here’s how to set up a coordination of benefits through the Sun Life Plan Members’ website:
1. Click on “Submit a Claim”.
2. Click on “My Claims” under the Claims tab.
3. Click on “Coordination of Benefits” and answer the questions as indicated.
Your spouse or partner must also set-up their Sun Life account to allow for coordination of benefits before COB claims may be submitted. Any extended health and/or dental claims submitted through your spouse or partner’s plan for yourself will be reimbursed directly to your spouse or partner as any reimbursement is paid to the person who is the plan member.
Note: You cannot coordinate claims through the Sun Life Mobile app at this time.
If your insurance coverage is not with Sun Life
As a UBC employee, if your other coverage is with an insurance plan that is not Sun Life, here’s how to set up a coordination of benefits through the Sun Life Plan Members’ website:
- You will need to confirm with your other insurance plan that they allow for coordination of benefits.
- If your other coverage does not allow for COB, you will only be able to submit claims through your Sun Life plan for reimbursement.
- If your other coverage allows for COB, follow the same steps above to set up coordination through your Sun Life account.
- You will need to contact your other insurance plan to determine how to set up COB for your coverage through their plan.
- Once you receive reimbursement from Sun Life and their Explanation of Benefits (EOB), you can then submit any remaining balance through your other coverage, along with the EOB for further reimbursement.
Need help setting up your coordination of benefits?
For additional assistance when it comes to setting up COBs for extended health and dental claims, call Sun Life at 1-800-361-3612. Remember to provide the UBC group number (025205) and your member ID (7-digit UBC employee number).
For more information about coordination of benefits, check out the following resources:
- To set-up or end coordination of benefits under UBC’s extended health and dental plans
- Canadian Life and Health Association guide to coordinating benefits
Do you have questions? Contact the Health, Wellbeing & Benefits team at email@example.com.