D.A. Townley.  -  Plan Administrators      
 

health
benefits

        
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
 
 
   
 

Filing a Claim

As a Member of the Millworkers Health & Welfare Plan (Unifor), you are eligible to receive certain benefits as outlined in your Group Insurance Plan Booklet.

New Certificate Numbers October 1, 2020

Effective October 1, 2020, you have been assigned a new certificate number for claims purposes. The numbers on your previously issued card are changing and will expire at midnight on September 30, 2020.

It is very important that you and/or your dependents present this new card to your dentist on your next visit on or after October 1, 2020. They will require the new information to submit your claims directly to the Plan.

Any claim you submit for reimbursement to the Plan will need to have your new ID/Certificate number on the claim form.

In order to receive the benefits that you are entitled to, you must notify the Plan Administrator by submitting the appropriate claim form and attaching the applicable detailed receipts.

Use the Dental Claim Form if you've paid your dentist the full cost of the services that are covered under the Plan and you wish to be reimbursed. Many dentists will bill the Plan directly for the portion payable under the Plan using their own Standard Dental Claim Form.

Use the Extended Health Benefits Claim form if you've paid for Extended Health expenses (prescription drugs, physiotherapy, chiropractor, eyeglasses, etc) that are covered under the Plan.

Use the Extended Health Benefits Claim form if you've paid for prescription drug expenses that would normally be paid by your pay-direct drug card.

Use the Weekly Indemnity Benefits Claim form to make your claim for Weekly Indemnity benefits if you have become unable to work, while covered for this benefit, because of an accident, sickness or pregnancy, provided you are under the regular care of a physician.

Use the Statement of Claimant for Long Term Disability Benefits if you've been totally disabled (through sickness or injury) for at least 52 weeks and are now wishing to apply for LTD benefits. Once you have applied for LTD Benefits, you may be required to complete the Attending Physician's Initial LTD Benefits Statement before your LTD claim can be approved.


Notes
Questions on completing the forms should be directed to the Plan Administrator.

Completed forms should be forwarded to the Plan Administrator.



Plan Administrator
Millworkers Health & Welfare Plan (Unifor) Administrator
c/o D.A. Townley
4250 Canada Way
Burnaby, BC, V5G 4W6

Phone: 604-299-7482 or 1-800-663-1356
Fax: 604-299-8136

Email: Health
 

Related Links
Dental Claim
Extended Health Benefits Claim
Statement of Claimant for Long Term Disability Benefits
Attending Physician's Initial LTD Benefits Statement
Weekly Indemnity Benefits Claim
Direct Deposit Registration Form
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