Submit a Benefits Claim

Extended Health

The extended health plan helps you with medical expenses such as prescription drugs, vision care, medical services, and supplies. Check out what's covered under the plan and confirm your eligibility on GroupNet before to your purchase. Eligible expenses are subject to the deductible, coinsurance, and plan limits. If you have questions about eligible expenses, contact Great-West Life at 1-855-644-0538.

Assure Card

The Assure Card is your benefits ID card that has your Great West Life Plan number on it. You can share this number with your dentist, pharmacist and other healthcare service providers. If you have not received your ID card in the mail, you can register with GroupNet and print out a card. Register using Plan number 50088 and your ID number. If you do not know your ID number, or if you have problems registering with GroupNet please call GWL at 1-855 644-0538. Note: you and your spouse have an Assure Card. Any dependent children do not receive one but you will see them listed under your coverage through GroupNet.

Access GroupNet

You are able to register for GroupNet through the online form which gives you access to your benefits and claims information. You can also download the GroupNet Mobile app to your personal device. Remember, when you are entering your 10 digit ID found on your assure card, drop the leading zeros (for example, instead of 0000123456, enter only 123456).

You will see your plan numbers 50088, your group plan and 170688, your travel assistance plan in GroupNet. The travel assistance plan provides assistance if you experience a medical emergency while traveling out-of-province. See the Travel Assistance brochure for further details.

Updating your information

If you need to update your benefit enrolment information (such as adding or cancelling a spouse or dependent), find out how for Bargaining Unit Employees and Excluded Employees in the Flexible Benefits Program.

Please ensure that your address is up to date with your employer and in GroupNet for Plan Members. If you have access to Employee Self Service (ESS), you can update your address online. Or, call MyHR (1-877-277-0772) and a Service Representative will be able to update your information in PeopleSoft.

Deadline

You should submit your claims immediately after treatment. You are responsible for ensuring that claims are received by Great-West Life on or before the claiming deadline. Great-West Life must receive both extended health and dental claims no later than 15 months from the date of service. Late claims will not be accepted.

Submitting claims

You can make your extended health claim in several ways:

  1. Pay Direct: Show your Assure card to your pharmacy or provider. You will pay only the part of the expense that is not covered under your benefit plan. Also show your spouse’s benefits card if you have coordinated benefits. See the Coordination of Benefits section for more information. Great-West Life offers direct claims submission for prescription drugs, chiropractors, physiotherapists, acupuncturists, naturopathic doctors, podiatrists, psychologists, massage therapists and optical stores/optometrists/ophthalmologists. Your provider must be participating in the Great-West eClaims service. Check if your provider is registered in the Great-West eClaims Service. If they are not, use one of the methods below
  2. Online: You can submit your expenses for reimbursement through GroupNet for prescription drugs, physiotherapy, massage therapy, acupuncture, chiropractic services, naturopathy, psychology, podiatry and vision care expenses. Remember to keep your original receipts in the event that you are asked to submit them
  3. Mobile app: You can download the GroupNet Mobile app to your personal device. When you enter your 10 digit ID found on your assure card, drop the leading zeros (for example, instead of 0000123456, enter only 123456)
  4. Mail: For all other eligible health expenses, you can mail in your claim. If you are submitting a paper claim, complete the Extended Health Claim Form (Bargaining Unit) (PDF, 620KB) or the Extended Health Claim Form with Healthcare Spending Account (Flexible) (PDF, 568KB). Follow the submission instructions found on the form. Photocopy your expense receipt(s) as the originals will not be returned to you

Mail the signed form with your receipts to

Great-West Life
PO Box 6040, Station Main
Winnipeg, MB R3C 0S2

Prior Authorization for Prescription Drugs

Certain prescription drugs need prior authorization from Great West Life. These drugs need a detailed assessment and management process to ensure that they are a reasonable treatment.

If you are prescribed one of these drugs, complete and submit a prior authorization form. Choose the drug from the list on the Great-West Life prior authorization form web page. You will receive instructions on the steps involved in submitting these claims.

Dental

The dental plan helps you with the cost of your dental care and reimburses most basic and major dentistry and orthodontic services.

Deadline

Great-West Life must receive dental claims no later than 15 months following the date of service. You should submit your claims immediately following treatment to avoid missing the deadline. Late claims will not be accepted.

Submitting claims

Most dental offices will bill Great-West Life directly when you present your Assure card (and the card for your spouse's plan if you have coordinated benefits). You will pay only the part of the service not covered by your benefit plan(s).

If your dental office does not submit claims directly to Great-West Life through eClaims, fill out a the Great-West Life Extended Dental Plan Claim Form (Bargaining Unit) (PDF, 218KB) or Extended Dental Plan Claim Form with Healthcare Spending Account (Flexible) (PDF, 607KB).

  • Mail the signed form with your receipts to

Great-West Life
PO Box 6040, Station Main
Winnipeg, MB R3C 0S2

You can submit monthly orthodontic treatments for reimbursement through GroupNet.

Reimbursement

If you have provided Great-West Life with your banking information, they will deposit your reimbursement into your bank account. You will also receive an email confirmation that your claim statement is available to view and download on GroupNet. You can set up banking information on the Great-West Life website. Learn how to sign up for GroupNet for Plan Members and Direct Deposit. If you are not set up for direct deposit, you will receive a cheque in the mail.

Processing

Most health and dental claims are processed electronically through member eClaims or provider direct billing. Electronic claims are usually processed within the next business day. Paper claims are processed within 5 calendar days.

Pharmacare

All plan members must sign up for PharmaCare to assist with prescription coverage. This limits the impact on your lifetime maximum. For some high-cost drugs you need to complete a Special Authority Request Form (HTML) before you can be reimbursed.

Health Spending Account (Excluded Employees)

Pay direct

If you are using Pay Direct, any part of your expenses that are not covered can be claimed against your Health Spending Account (HSA). Complete the form and submit with your receipt(s).

Online claims

If you are making an online claim through GroupNet, you can claim any unpaid balances to your HSA.

Paper claims

To mail in your claim, complete the Health Claim Form and include your receipts. Check off that you would like to apply any unpaid balance(s) to your HSA.

You must submit claims for eligible medical expenses to your extended health and dental plan and then to any other plans before to claiming from your HSA.

Deadline

The HSA Claim deadline is February 28, following the year that you obtained the service. Late claims will not be accepted.

Coordination of Benefits for Extended Health & Dental

Great-West Life allows you to coordinate benefits to receive maximum coverage if you are covered under more than one plan. If you and your spouse are both with Great-West Life, you only need to submit one claim form and Great-West Life will coordinate benefits for you. Ensure you include your spouse’s information and ID number on the claim form.

If your spouse is with another carrier, check if your spouse's benefit plan allows for coordination of benefits.

Insurance companies follow the guidelines below to determine which plan pays first and how benefits are calculated.

Your claims

If the expense is for you, claim first under your own plan. Great-West Life will provide an explanation of benefits statement. Send this statement to your spouse's insurance company.

Your spouse's claims

If the expenses are for your spouse and they are covered under another plan, you must submit the claim to their plan first.

Children's claims

Submit claims for children first to the plan that covers the spouse whose birthday falls earlier in the calendar year (for example, if your birthday falls in February and your spouse's falls in June, submit your children's claim to your plan first).

You can submit any part of the claim not covered under the first plan to the other spouse's plan along with the explanation of benefits statement.

Retiree coverage

A retiree plan will always pay after any group plan that covers you as an employee.

How to Make a Claim When You Coordinate Benefits

  • Make sure that you have added your spouse's plan information to your record in GroupNet
  • Submit your claim to both plans at the same time by showing the ID cards at any service provider who offers Pay Direct, such as the pharmacy, paramedical services, and optometrist/optical offices
  • If your spouse's plan does not offer Pay Direct, you must submit to their plan separately along with the explanation of benefits statement (which you receive after submitting to your plan)
  • Otherwise, submit to your plan first online through GroupNet or by mailing Great-West Life a paper Great-West Life form. Great-West Life will send you an explanation of benefits statement which you will then submit to the other insurance company.

Life Insurance

To initiate a life insurance claim, contact MyHR at 1-877-277-0772. A representative will mail the claim information to the beneficiary and will be available to answer questions.