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Coordination of Benefits

If you and your spouse/partner both have medical and dental "family" benefits, or if you are covered for similar benefits under two separate plans, you can use both of your plans to maximize the amount of money you get back for your health or dental claims. This is called Coordination of Benefits. Learn more in the dropdowns below about how to get 100% reimbursement by coordinating your benefits, and the guidelines for submitting claims.

Click on the sections below for more information.

If your spouse/partner has benefits from an employer, you can usually co-ordinate the two benefits plans (check the wording of your spouse’s plan). This means you may submit your receipts to both plans and get up to 100% of your eligible expenses reimbursed. If you plan to submit claims to your benefits plan and your spouse’s/partner's benefits plan, insurance industry guidelines determine where to send claims first. The order is important!

After submitting your receipts to the first plan (or using your pay-direct drug card), you will receive your reimbursement and an Explanation of Benefits statement. Next, submit the Explanation of Benefits statement along with a new claim form to the second plan to claim the balance of your expense. If you and your spouse/partner both have pay-direct drug cards, ask the pharmacist if they can submit your claim to both plans at the same time.

These are the insurance industry guidelines when submitting claims:

Your claims:
 

Submit them to your SLB Flex plan first.

Your spouse’s/partner's claims:
 

Submit them to your spouse’s/partner's own plan first.

Children’s claims:

  • If your birthday is earlier in the year than your spouse’s/partner's, submit them to the SLB Flex plan first.
  • If your spouse’s birthday is earlier than yours in the year, submit them to your spouse’s plan first.

If you need to update your Coordination of Benefits status, please contact the SLB Canada Benefits Centre (1-866-557-5222).

Login to your Sun Life account and read more under FAQ about Coordination of Benefits and what the rules are based on.

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