Frequently Asked Questions

Enrolment in the CLAC Health Fund varies by collective agreement and your company's type of participation. If your company participates on a pay-direct basis, you are enrolled on the first day of the month following the receipt of premiums from your employer. If you are enrolled on an hour-bank basis, your coverage begins on the first day of the month following the accumulation of two months' worth of premiums in your hour-bank account.

To add dependents to your coverage, contact the Benefit Administration office and ask for an enrolment card. Return the completed card as soon as possible to the Benefit Administration office in order to activate the dependent coverage.

If you already have family coverage and you need to add a newborn child, please contact the Benefit Administration office, and we can update your dependent information via telephone.

If your pharmacist is unable to process your transaction, please contact the Benefit Administration office for immediate assistance. Alternatively, you can purchase your prescription and submit the original pharmacy receipt, with a note attached indicating the plan member's name and identification number, to the Benefit Administration office. Please notify us of the problem so that we can resolve the issue and prevent future denials.

No. Claim forms are generally not required. Prescription drugs are processed automatically by drug card. This assumes the plan member has completed and submitted an enrolment card correctly and has received his or her drug card. If not, the individual must submit original pharmacy receipts to the Benefit Administration office, with a note attached indicating the plan member's name and identification number. Once we have received your fully completed enrolment card, you will be issued a drug card.

Non-prescription medical expenses only require an original receipt to be submitted to the Benefit Administration office, along with the plan member's identification number and name.

Dental claims can be processed directly by electronic data interchange (EDI). Initially, you will need to supply your dentist with your group plan number, plan member ID (listed on your wallet identification card), and your carrier name (Standard Life). Alternatively, dental claims can also be submitted manually by your dental office completing the Standard Dental Claim Form. The completed form should not be sent directly to the insurance carrier but to the Benefit Administration office for processing, via fax or mail.

Claim's inquiries should be directed to the Benefit Administration office at 905–945–1500 or 1–800–463–2522.

Yes. Direct deposit forms can be downloaded from the CLAC website or can be obtained by contacting the Benefit Administration office at 905–945–1500 or 1–800–463–2522. Once completed, please forward them to the Benefit Administration office.

If your spouse has benefit coverage, then any expense for your spouse must be claimed under his or her plan first. The claim can then be submitted to the Benefit Administration office for any remaining eligible amount unpaid by your spouse’s plan. When you submit the unpaid amounts to the Benefit Administration office, you must submit copies of the original receipts and the Explanation of Benefits (EOB) from your spouse's plan. If the expense is yours, first submit it to the Benefit Administration office, and once you receive the EOB, you can submit it to your spouse's plan.

If the expense is for a dependent child, the expense must be submitted in the order specified by the birthday rule. According to the birthday rule, the claim must first be submitted to the plan of the parent who has the earliest birthday in the calendar year and then to the plan of the other parent for any remaining eligible amount. For example, if your birthday is January 1 and your spouse's is January 3, you must submit your dependent's claim to the Benefit Administration office first, before submitting the claim to your spouse's plan, because your birthday is earlier in the year. Again, please keep copies of receipts and EOBs for submission to your spouse's group plan.

For every hour that you work, your employer remits a dollar amount as specified by your collective agreement. These funds are placed into your hour-bank account and are used to pay for your monthly health insurance premium. Enrolment occurs on the first of the month following the accumulation of two months' worth of family premiums in your account.

Benefits are coordinated with various insurance carriers depending on the type of coverage. Standard Life is the main carrier for health and dental coverage.

Contact the Benefit Administration office at 905–945–1500 or 1–800–463–2522.