Health And Wellness Claim Form

Important Notice

A comprehensive review of direct billing by service providers is currently being undertaken.  Until such time as this review is completed, direct billing by service providers has been limited to Dental, Drugs, Ambulance and Hospital Room Charges.  All other direct billing by service providers has been put on hold until further notice.  Members will be required to make payment to the service provider and then submit their claims to the ACAW Trust Funds office.  There will be no exceptions to this notice.  Thank you for your patience in this matter.

Making Claims 

The Health & Wellness claim form with instructions for submitting the claim is available in pdf format below.  If your health care provider asks you for a contract or ID number, explain that the Plan is self funded so there is no contract or ID number.  If a contract number is required, use your Union Local number.  If a personal ID number is required, use your Union ID number. 

Medical expenses related to a work injury covered by Workers’ Compensation are not covered by the Supplementary Health Care Plan.  Submit the claim for these expenses directly to the WCB for reimbursement.  Some pharmacies will also bill the WCB directly. 

Deadlines for Submitting Claims to the Plan Office 

Supplementary Health Care and Dental claims – Claims must be received by the Plan Office within one year of the date the expense was incurred. 

Processing and Paying Claims 

If you submit your claim by mail, please allow at least three weeks for processing and payment.  If you drop your claim off at the Plan Office, allow at least two weeks for processing and payment.  Periods of high claims volume and holidays can require longer processing time.  Your patience and consideration are appreciated. 

You can avoid delays and help us to better serve you by:
Ensuring forms contain all of the required information, including the member’s signature.
Submitting fewer receipts at one time (five receipts can be processed more quickly than 25 receipts)

Health & Wellness Claim Form