FAQs

Frequently asked questions:
General administration

Am I automatically entitled to coverage under LiUNAcare Local 183?

All LiUNA Local 183 members are entitled to coverage provided they meet the eligibility requirements.

Who should I report a change of address to?

Please complete a member Change of Address form and send it to Member Services by mail, fax or email.

How do I add a new beneficiary to my coverage?

Contact  Member Services for assistance. Adding a new beneficiary to your coverage usually takes one business day. 

What is the difference between the Member Services department and Member Health Management Services?

Our Member Services department handles all general day-to-day administrative assistance and routine claims for members such as prescription drugs, dental and paramedical benefits.

Member Health Management Services is our new in-house department created to help you manage all matters relating to major medical events (critical illness, accidental death, life insurance), disability, workers’ compensation, and other benefits to get you back to health. In addition to helping you access short-term and long-term disability benefits, we will guide you to the right treatment and services for all your health and wellness requirements.

Does my plan include parental leave benefits?

If you take time off work for the birth of your child, you may be entitled to parental leave benefits. You will need to complete a parental leave application form and provide us with a letter from your employer on company letterhead stating the dates of your absence. You will also need to provide a copy of your child’s temporary health card.

I sent a benefit payment in the mail. Will I receive confirmation once it has been received?

We do not send out confirmation notices. To make sure your payment has been received and applied, please contact Member Services.

If I am on CPP disability, do I have to keep paying for my benefits?

If you’ve been approved for Canada Pension Plan (CPP) disability benefits, you can apply to have your benefit payments waived. To do this, you’ll need to provide our Member Health Management Services department with a letter of confirmation from CPP and complete an Extension of Benefits form for review. If approved, you must continue to submit proof from CPP annually until your 65th birthday. Contact Member Health Management Services for more information.

Do I continue to pay for my benefits if I am on WSIB disability?

If you’ve been approved under Workers Safety Insurance Board (WSIB) disability benefits, you may be eligible for 12 months of full payment assistance, after which you may be eligible to receive your benefit at a reduced fee of $95/month. Contact Member Health Management Services for more information.

Where can I get a copy of my T4A?

We automatically issue T4As to all members. If you have not received yours, or if you have misplaced it, feel free to request a duplicate by contacting Member Services.

When can I apply for the Retiree Benefit Plan?

You can apply for the Retiree Benefit Plan provided a) you are at least 55 years old on the date of retirement; b) you are a member in good standing with the union; c) you were working for the five consecutive years leading up to your retirement; and d) you are eligible for benefits under your active plan when applying. 

Do I need to report vacation pay on my income tax return?

No. Any vacation pay you receive will be processed through your employer’s payroll and taxes will automatically be deducted so there is no need to report it on your return. 

How do I request vacation pay?

To request vacation pay, you can either visit our office and complete a Vacation Pay Withdrawal Application in person or submit your completed application by mail, fax or email.

Your vacation pay should be ready for pick-up within three to five business days of receipt of your application. Alternatively, you can request to you have your payment mailed to you. This typically takes five to seven business days.

Will I receive confirmation that my vacation pay request has been received?

We do not send out confirmation notices. To make sure your request has been received, please contact Member Services.

How do I make my benefit payments?

Initially, benefit payments must be made in person by debit/personal cheque or money order at Member Services. After your initial payment, can mail in a cheque or money order, with your name and union ID/SIN on memo line or on the back of cheque to avoid any delays. Union dues must be up to date.

How can I find out if my union dues are up to date?

Please contact your union office directly. 

How long will my benefit coverage continue once I’ve stopped working for LiUNA Local 183?

If you have hours in your hour bank account, they will be used first for benefit coverage. Following the exhaustion of all hours in your account, you can self-pay for benefits for a maximum of 12 consecutive months provided you remain a member in good standing with LiUNA Local 183. 

Claims

How do I submit a benefit claim?

Claims can be submitted either by mail or via eClaims. Either way, be sure to include all relevant receipts, as well as any other documentation requested. If your submission is incomplete, your payment may be delayed.

How long do I have to submit a claim?

Medical and dental claims must be submitted within 18 months of the service date. Speciality claims must be submitted within 12 months of the service date. 

How long does it take to receive payment after submitting a claim?

Turnaround time on payments typically ranges from five to ten business days, depending on the information submitted.

How do I submit a hospital cash claim?

Hospital cash claims can either be submitted in-person to Member Services, or submitted by mail, fax or email. Please keep all receipts on file as insurers have the right to request these at any time in the future.

I need to submit a specialty claim for my wife. Should I sign it, or should she?

All specialty claim forms need to be signed by the member, regardless of who the claim is for, unless a Power of Attorney (POA) is on file.

I need emergency dental treatment. How long will it take to get my dental estimate assessed?

Estimate assessments usually take five to 10 business days. If the matter is urgent, you can contact Member Services and ask them to put a rush on your assessment.

I obtained a dental estimate three months ago and plan to get the work done next month. Is my estimate still valid?

Estimates are only valid for three months. If you had other dental work done within the three-month period, an exception may be made. That said, we recommend you resubmit your estimate before doing the work it covers, just to be safe.

My spouse no longer has coverage with their benefit plan. What do I need to provide to have them covered under my plan?

We require a letter from the spouse’s insurance company stating type of coverage, policy number and the termination date of coverage for your spouse. If the policy was with Great West Life, then we will accept a letter from the employer with this information.

I am currently unable to work. Can I claim short-term disability?

Provided a) you are a member in good standing with LiUNA Local 183; b) you are entitled to short-term disability benefits; and c) you are not claiming short-term disability as a result of a motor vehicle accident, you can claim short-term disability by contacting Member Health Management Services.

My spouse has passed away. How do I make a life insurance benefit claim?

You’ll need to complete a Life Insurance claim form and submit it to Member Services. If your spouse passed away in Canada, you will need to attach a copy of their death certificate. If your spouse passed away out of the country, please provide the original death certificate. 

How do I change my life insurance beneficiary?

You will require a new Application Card to change the dependent listed or both dependent and beneficiary.

My son just turned 21. Is he still covered under my plan?

Dependent children between 21 and 25 years of age are eligible for coverage under your plan provided they are attending an accredited school, college or university as a full-time student. You’ll be required to provide proof of student registration, on official school letterhead, to Member Services annually. 

Prescription drugs

Can I pick-up my prescription drugs from any pharmacy?

Yes, you may use any pharmacy in Canada, provided it accepts your drug card. 

Why is my drug card not working?

There are many reasons your drug card may not be working. For example, you may not have benefit status, your application card may not have been completed in full, your dependents may not be active on your benefit plan, the spelling of your name or your date of birth may be incorrect, or the pharmacy may be entering incorrect information. Please contact Member Services for assistance.

I just received my drug card but my name has been misspelled. What should I do?

If your name has been misspelled on your drug card, then it may have been misspelled on your Application Card. You’ll need to complete a new Application Card so that we can generate a new drug card for you. Application Cards are available online. Be sure to complete all fields and drop off or mail in to Member Services.

What is a “maintenance” drug?

Maintenance drugs are prescription medications commonly used to treat conditions that are considered chronic or long-term. These conditions usually require regular, daily use of medicines. Examples of maintenance drugs are those used to treat high blood pressure, heart disease, asthma and diabetes. Maintenance drugs can be prescribed for three month periods.

What is an “acute” drug?

Acute drugs are prescription medications prescribed for a short time frame, for cold or flu medication. Acute drugs can only be prescribed in 30-day supply.

Can I get a three-month supply of my acute drug?

We only cover acute drugs, or non-maintenance drugs for a maximum of 30 days. If you are traveling for a longer period please provide us with a doctor’s referral indicating the date you are leaving and the date you are returning, along with the name of medications that you’ll need during that time. You can fax this directly to our office at (416) 240-7488. This request can take up to five business days.

I am travelling tomorrow but my doctor’s office is closed, so they cannot provide the referral mentioned above. What should I do?

You can pay for medication out of pocket and once you return, you can get your doctor’s referral and submit that along with a claim form and receipts for the drugs purchased. 

My doctor has prescribed Sovaldi® but the pharmacist will not dispense it without approval. Why?

For some prescription drugs, the insurance company wants to be certain that a pre-determined clinical condition exists before allowing the pharmacy to dispense them. If approval is required, please contact Member Services to request a Prior-Authorization Application.