By Human Resources Communications on February 21, 2019
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 firstname.lastname@example.org.
By Human Resources Communications on May 13, 2016
Have you ever wondered which paramedical services are used the most under the Extended Health plan?
We’ve reviewed the Sun Life Extended Health claims data from 2015, and below are the top paramedical services, by practitioner type, for all claims:
All (staff, faculty and dependents):
- Massage Therapist: 30% of all paramedical claims
- Physiotherapist: 20%
- Psychologist: 18%
- Chiropractor: 11%
- Acupuncturist: 10%
Ways to Claim Paramedical Expenses:
Sun Life offers a number of ways to submit Extended Health claims, including claims for paramedical services. In addition to paper claims, you can submit certain claims online via mysunlife.ca, by mobile app, or using your prescription drug card.
Online at mysunlife.ca:
Once you have set up an online account with Sun Life (www.mysunlife.ca), you will be able to submit some claims online. You can also set-up direct deposit for your reimbursements so that you can receive payment for your claims faster, and typically with 24-48 hours.
You will need to register at mysunlife.ca to receive an access ID and password. You will be asked for your Contract Number (025205), and your date of birth and postal code to confirm your identity.
Claims that can be submitted online:
- Massage therapist*
*Your first claim for massage and/or psychological services cannot be submitted online because a doctor’s note must accompany the claim. Submit the first claim by using Sun Life’s mobile app (you can submit the note with their photo submission feature) or by paper. A doctor’s referral is required every 12 months.
With my Sun Life Mobile’s new photo submission feature, you can submit a range of supporting claim documents through the app, such as a doctor’s referral, and it’s as simple as snapping a photo.
Download the latest version of the mySun Life Mobile App for Android or Apple devices. Once logged in, you will be able to submit a claim and it will give you the option to attach a photo. Take a picture of your doctor’s referral or receipt of service and you are all set!
Claims that can be submitting using the mobile app:
- All services listed under the ‘Online Claims’ above, plus:
Claims with Supporting Photo of the Receipt:
- Clinical Counsellor
- Dietician (Registered)
- Occupational Therapist
- Social Worker
- Speech Therapist
As well as the following medical equipment/supplies and services:
- Diabetic Supplies
- Medical Equipment and Supplies
- Hearing Aid and Supplies
- Laboratory/Diagnostic Services
- Custom-made Orthopaedic Shoes and Orthotic Inserts
Can My Provider Submit the Claim to Sun Life for Me?
If your provider is registered with the Telus Health eClaims Network, they can submit claims electronically on your behalf to Sun Life. Your provider may ask that you:
- pay them for the amount not covered by the Plan (Sun Life reimburses them for what the plan covers), or
- pay them the full amount (Sun Life reimburses you for what the plan covers).
If you have any questions, please contact the Benefits team at email@example.com.
By Human Resources Communications on November 15, 2013
Effective Sept. 22, 2013, plan members may submit claims for acupuncture and osteopath services online at www.mysunlife.ca.
Acupuncture and osteopath services were added to a comprehensive list of paramedical services that can be submitted online:
- Acupuncture – NEW
- Massage Therapist*
- Osteopath – NEW
*The first claim for these services must be submitted via paper with a doctor’s note. All subsequent claims may be submitted online.
Other Extended Health claims for vision care, prescription drugs and health spending account (M&P and IUOE 882 only) continue to be eligible for online claims submission. Dental claims that are not submitted by your dental office are also eligible.
Signing up for www.mysunlife.ca
If you have not signed up for Sun Life’s Plan Member Services website (www.mysunlife.ca), you need to request an Access ID and password from Sun Life by telephone or online:
- Telephone: call Sun Life at 1-800-661-7334 and provide them with your Group/Contract Number (25205) and your Member/Certificate ID (7-digit UBC employee ID); or
- Online: visit www.mysunlife.ca and click on the ‘Register Now’ link after the question, “Don’t have an access ID?”
Once you have obtained your Access ID and password, you can start to submit claims online. You can also sign up for direct deposit and have your claims deposited right into your bank account – usually within 48 hours.