After 15 years of experience, I would say my top 5 tips for employees of benefit plans are:

  1. Always, and I mean always, make and keep a copy of the completed claim form and attached receipts before sending to an insurance company for payment.
  2. When calling an insurance company call centre, take down the name of the person you spoke to, note the date and time, and confirm by repeating back to them what you understood when they answered your question. Will save you headaches in the long run, but will also help insurers identify training needs for their staff when wrong information is provided to callers.
  3. Incurring a large expense and thinking it will be paid by the insurer under your health or dental benefits plan? Get confirmation in writing from the insurer what will be covered for the expense unless you can afford to be out of pocket the amount of the expense. Doing this is known as obtaining a pre-determination on the dental benefit side, but can also be done on the health benefit side. Insurers will usually do this for free for potential claims over $300.
  4. Read your insurance booklet and when in doubt, ask for help in understanding your coverage.
  5. Lifestyle change? Married? Divorced? New child? Child going away to university? Odds are your lifestyle change impacts your benefits in some way or another. It’s important to notify the person responsible for handling your benefits as soon as the change happens. And please don’t wait more than 30 days after the change to notify as there could be serious implications.

Hope this information helps. If you have any questions, don’t hesitate to ask!