Benefits Claim Procedures

Follow the steps below when sending a health and/or dental claim to Sun Life.

Refer to your benefit booklet for coverage details.

 

Claim Procedures 

E-Claims - Easy, fast and convenient!

Most benefits claims can be submitted online directly to Sun Life.

Just click here to get started or for more information: www.workingatmcmaster.ca/benefits/mysunlife

 

Paper-Based Claim Submissions:

  1. Sun Life requires original receipts for all claims. Please keep photocopies of all receipts and claim forms, especially when coordinating benefits.
  2. Submit all eligible expenses no later than 90 days following the end of the benefit year. The benefit year runs July 1 to June 30th of the following year. Late claim submissions will not be reimbursed.
  3. Claims can be mailed directly to the address on the back of the Sun Life Extended Health Care Claim Form. You can also send in a claim via the McMaster internal mail system.
    Mail Services forwards claims to Sun Life on a weekly basis. Just mark your sealed envelope “Sun Life” and the envelope will be forwarded on your behalf.
  4. Reimbursements will be mailed directly to your home address or you can enroll in the direct deposit program. You must contact Sun Life either by phone or the internet to set up direct deposit payment. 

Dental Claims

Claims for reimbursement of dental services may be made using a Sun Life Dental Claim Form or using a Standard Dental Claim form available at your dental office. You and your dentist must complete parts of these forms. Please ensure that your employee ID and address has been entered correctly on this form. If your dentist’s office has the ability to process claims electronically, Sun Life will accept your claim electronically.

Please note however, you must pay for the dental services in full and Sun Life will reimburse you accordingly. For procedures that will cost greater than $500, we suggest that you send an estimate to Sun Life before the work is done. Sun Life will then advise how much of the planned treatment is covered by your plan.

 

Health Benefits

Ontario Health Insurance Plan:
Standard ward coverage, physician’s and some health practitioner’s bills will be reimbursed by OHIP. You must present your OHIP card to the hospital or physician when these services are required. Visit the OHIP website for more information.

Paramedical Services:
Claims for services provided by Massage Therapists may require an accompanying doctor’s prescription. Please refer to your benefit booklet for further details.

 

To access your policy information with Sun Life, you may call 1-800-361-6212. Hours of operation are Monday to Friday from 7am to 8pm. Be sure to have your member ID # and  policy number (25018) ready.

For specific drug coverage inquiries, please ensure that you have the D.I.N (Drug Identification Number) for this drug.