Submitting Claims

The online claims process is the quickest and easiest way to get reimbursed. Canada Life provides an online experience through GroupNet. GroupNet is an online tool that provides you access to your group benefits plan. It is important to register on Canada Life once your plan is active. For new students, there are up to 60 days from the start date of your term for the enrollment process to be completed.

To register visit https://my.canadalife.com

Through GroupNet you can submit claims, check balances, investigate claim status and history, and setup Direct Deposit of claim payments by completing the Banking section under your Profile. Once this has been completed you will be able to submit online claims and you will be notified by e-mail when your claim has been processed.

For direct billing at services such as vision care and paramedical services, update your complete address under the personal info tab under your profile.

If you prefer access to your benefits plan through your mobile, you can download and install the app on your android or apple device.

Watch a short video about submitting claims.

To submit a paper claim form, you need to download and complete the form. Then, attach the paper claim form, the original receipts, and other documents to support your claim. You must mail the package to Canada Life. Remember to keep a copy of all documents mailed for your records.

• Health Claim Form: If your claim is related to Health services included in the plan such as prescription drugs, ambulance services, paramedical, medical equipment, or vision expenses, please download and complete the Health Claim Form
• Dental Claim Form: If your claim is related to Dental services included in the plan, please download and complete the Dental Claim Form

The following information is required on the claim form:

• Plan Number: 177890
• Division Number: Not Applicable Leave Blank
• Plan Name: University Students’ Council of Western University

Please mail your manual claim to Canada Life at the following address:

Winnipeg Benefits Payments
PO Box 3050 Station Main
Winnipeg, MB. R3C 0E6

Pay direct allows service providers to directly bill Canada Life for eligible expenses. Direct billing is dependent on each service provider’s billing practices.

For direct billing at vision care and paramedical providers, you must register with Canada Life (GroupNet) and update your address in the personal info section on your profile.

To access direct billing, students must show their benefits card at the providers’ office and just pay the portion that is not covered by the plan. If you do not have your Benefits Card, you must generate the card online

A pre-authorization is when a form is submitted to Canada Life for a health care service, treatment plan, prescription drug, or medical equipment to pre-determine whether or not it is covered by the plan. Canada Life requires pre-authorization for certain services before you receive them, except in an emergency. When submitting a pre-authorization form, you will receive approval along with the amount that will be covered or an explanation of why it may have been denied.

To submit a pre-authorization form, you need to download the form according to the services that you need for approval and submit the completed form to Canada Life. The following are the forms:

• Drug Exception Request Form: Download and complete the Drug Exception Request Form to request coverage of a drug that is not automatically covered under the drug plan. Before downloading and completing this form, please use our Prescription Drug Search Tool to find out if your medication is covered by the plan. This form must be completed by your physician. Email completed form to cldrug.services@canadalife.com
• Drug Prior Authorization Form: Some prescription drug claims may be covered for specific conditions or circumstances only, and/or in pre-defined amounts and need to be approved before you can apply for reimbursement. Use the form to request coverage of a drug that is covered by the plan but has a note advising you that prior authorization is required after using the Prescription Drug Search Tool. Each prescription drug has a form, please download it from Canada Life Drug Prior Authorizations Forms. This form must be completed by your physician.
• Health Claim Form: Download and complete the Health Claim Form to request coverage of medical equipment, appliances and services covered by the plan. This form must be completed by the student and a physician's referral is required.
• Dental Prior Authorization: Please ask your dental office to submit a pre-authorization to Canada Life prior to treatment of specialist services and any treatment plan exceeding $500.

Once you have all sections of the form completed and signed, you can submit it online to Canada Life https://my.canadalife.com under the Make a Claim and other claims section. You will be notified by email, and you will see the result on the GroupNet website.

If you prefer a manual claim, please mail your form to Canada Life at the following address. You will be notified by mail.

Winnipeg Benefits Payments
PO Box 3050 Station Main
Winnipeg, MB. R3C 0E6

When accessing the Health and/or Dental claim form please use the below information as a guide to complete the required sections of the form:

• Plan Number: 177890
• Division Number: Not Applicable Leave Blank
• Plan Name: University Students’ Council of Western University

You are required to submit original copies of your claim form, receipts, and doctor's referral (if required) when sending in your claim to the insurance carrier. Remember to always keep copies for your records.

Please note: You have 15 months from the date the eligible expense is incurred to submit claims to Canada Life for consideration under your student plan.

Claiming Eligible Expenses Incurred While Studying in Home Country during 2020 and 2021*

*If you are still studying from your home country, please note that claims with a date of service after December 31, 2021 that are incurred outside of Canada will not be eligible for reimbursement. You can access your plan for eligible benefits once you come or return to Canada.

Claims for services eligible under your Student Health & Dental Plan, made from your home country, with a date of service prior to December 31, 2021, are eligible for reimbursement. You will have 12 months to submit these claims once you are back in Canada, but no later than December 31, 2022.

The benefits will be paid based on the existing insurance policy according to the terms of the contract with all reimbursements, maximums, physician requirements, fee guide, frequencies, policy details, etc. remaining in force.

If you have any questions, please contact Canada Life at 1-800-957-9777 for clarification of your individual situation.

Making Claims Now that You Are in Canada

There are two options for submitting claims as an insured International Student who studied from your home country.

1. Submit an ‘other’ claim with receipts upon arrival in Canada.
2. Submit a claim through your Groupnet account with Canada Life.

To submit claims while outside of Canada you must be registered for Groupnet and have a Canadian Bank Account. All Claims incurred outside of Canada are considered Out of Country claims which require using the online Other Claim process; this process uses electronic documents.

Health related claims including prescription drugs require:

• A completed health claim form including the patient’s name.
• An official receipt signed by the provider/pharmacist showing a breakdown of the charges and the currency billed, along with proof of payment.
• Detailed listing of the service provided.
• The service providers complete name, address, and phone number.

Dental related claims require:

• A completed dental claim form including the patient's name.
• A receipt signed by the dentist showing a breakdown of charges and the currency billed, along with proof of payment.
• The dental providers complete name, address, and phone number.

Eligible services are included in the myBenefits section of the plan website. Forms for submitting claims are in the Making a Claim section of the plan website.

Additional Notes:

• All claims will be paid in Canadian Funds.
• Applicable to the Student only.
• Family members are not eligible.
• Claims with a date of service before December 31, 2021 incurred outside of Canada will be eligible for reimbursement until December 31, 2022.
• >Claims incurred outside of Canada with a date of service January 1, 2022 or later, will not be eligible for reimbursement.
• Claims for services incurred in Canada after January 1, 2022, will be processed and reimbursed as per the terms and conditions.

Below are details on how to access the online Paper Claim process; this process utilizes electronic documents.

Note: You must register for Groupnet and complete your member profile prior to submitting your claims.

Step 1: Sign in to Groupnet

Step 2: Click on “Make a Claim”

Step 3: Click on “Start Other Claim”

Step 4: Follow instructions for “How to submit claim forms and documents online”