Sun Life: Group Benefits Plan
This guide will help get you started so you can begin making the most of your group benefits.
Eligibility
All permanent and fixed-term employees working a minimum of 20 hours per week are eligible for most benefits on their first day! To ensure no interruption in coverage, you will be required to complete a benefits enrollment form to enroll you and your eligible dependents into our group benefits plan with Sun Life. Look out for the onboarding task assigned to you BambooHR!
Prior to contacting Sun Life directly, please reach out to Payroll (Mike Bui) for any questions related to our benefits plan or if you need to make changes to your coverage. Many common questions can be answered by our team, and most requests usually need to go through our team first. If you wish to complete a benefits change form you can request this through a People Support Request Form.
Provincial Coverage Requirements
It's important to note that coverage through our Sun Life group benefits plan is contingent on having provincial coverage in the province in which you reside. Additionally, the address you use to enrol in our group benefits plan must match the address that is connected to your provincial coverage as taxes differ between provinces.
MSP (BC Team Members)
For team members located in BC, the Medicare Protection Act states that enrolment with MSP is mandatory for all eligible BC residents. It is the responsibility of the team member to ensure they enrol in provincial coverage and keep their personal information up-to-date with MSP and Sun Life.
BC PharmaCare (For BC team members):
British Columbia’s Fair PharmaCare program is available to everyone who lives in BC. The program helps pay for the costs of prescription drugs. Your Sun Life plan usually covers the cost of drugs that the province doesn’t pay for.
Please note: It is the responsibility of the team member to ensure that they are registered for Fair PharmaCare and that this number is provided to Sun Life if necessary in one of the following ways:
- Call Sun Life at 1-800-361-6212 and provide our policy number, your member ID, and your Fair Pharmacare registration number.
- Sign in to mysunlife.ca and select “secure messages” to send a secure message to Sun Life with your registration number.
Benefits Highlights
Below is a summary of the coverage your plan provides. For a more comprehensive summary about what is covered under Sun Life, please refer to the Sun Life Group Benefits Booklet or login at mysunlife.ca after setting up your online account.
- Prescription Drugs: 90% if dispensed through Costco (membership not required) or 80% at other pharmacies
- Paramedical Services
- Mental Health: 90% up to $3,000 annually for psychologists, psychotherapists, social workers, and clinical counsellors
- Physical Therapy: 90% up to $750 annually for massage therapists, physiotherapists, kinesiologists, and chiropractors
- Other Specialists: 90% up to $500 annually for speech therapists, naturopaths, acupuncturists, audiologists, dieticians, osteopaths, podiatrists, and chiropodists
- Vision Care: 100% up to a maximum of $250 in any 24-month period; 1 exam/person in any 24-month period
- Dental Coverage: 80% for basic/preventative and 60% for major up to maximum of $2,000/person/year; 50% for orthodontic up to a lifetime maximum of $3,000/person
- Emergency Travel Assistance: Out-of-province emergency travel assistance for up to 90 days after leaving your province of residence up to a lifetime maximum of $3,000,000/person
- Life Insurance: Coverage equivalent to your annual basic earnings up to a maximum of $500,000; spousal coverage at $40,000; child coverage at $20,000
- Health Spending Account: Non-taxable annual funds to be used for eligible medical expenses
- Personal Spending Account: Taxable annual funds to be used for a broad range of non-medical expenses
- And much more!
While our Life Insurance is covered through Sun Life, our Accidental Death and Dismemberment (AD&D) insurance is provided through AIG as part of our group benefits plan, for more information, please review the AD&D Booklet.
Setting Up Your Account
After completing the Sun Life benefits enrolment form, our team will need to process your enrollment form so that Sun Life can create your account. It may take 2-5 business days for Sun Life to process your enrollment and create your account after your start date. If you have trouble registering initially, please try again in 1-2 days. Note: regardless of when you are able to set up your benefits, you'll still have coverage as of your first day.
Online Registration Steps
You will need our policy number (103088) and your Member ID (your Employee ID in BambooHR) to complete your online enrolment.
- Go to mysunlife.ca and select Register.
- Enter your first name, last name, and email address (this will be your personal email address as this is the email we use to create your account and process your enrollment form).
- Create your password.
- Next, choose a verification question and the answer so Sun Life can verify your identity if you forget your password in the future. Choose a question and answer that you'll remember.
- Enter your date of birth and postal code. Click Next.
- Sun Life will email you a temporary registration code.
- When you get the code, enter it to finish your registration. The code expires after 48 hours.
* It's important to note that if you have previously had coverage with Sun Life, you may have issues setting up your account. In this case, please call Sun Life's customer care centre at 1-800-361-6212 and a customer care rep will be able to merge your accounts and/or provide you with a registration code. *
Adding Dependents to Your Plan
Simply include your dependents and check off 'Family' coverage when completing the Sun Life enrollment form. In the future, you'll also be able to add/remove dependents or make changes to your beneficiaries at any time by submitting a People Support Request Form, then completing a benefits change form. To be considered an eligible dependent, they must have provincial coverage (i.e. MSP in BC).
- Spouse: If you have a common-law* or civil union partner, or you are married, you are eligible and encouraged to add your partner to our benefits plan regardless of if they already have coverage through their employer. By adding your partner to our benefits plan, you are able to take advantage of coordination of benefits (COB) between our benefits plan, and your partner's benefits plan. COB means that you and your partner can submit leftover amounts that are not covered by your primary plan so that you aren’t left paying out of pocket for expenses.
*Common-law: To be considered common-law, you must be living together in a conjugal relationship. There is currently no cohabitation period that would need to be satisfied in order to be considered a common-law spouse under our benefits plan. - Child(ren)
You'll be able to add your child(ren) to our group plan. This includes an adopted or surrogate child as long as they have provincial coverage at time of birth or legal adoption. Your children will be covered on your group benefits plan until the age of 21 (or 25 if they are a full-time student).
If you have a child with a disability who is nearing the age of 21 (or 25 if they are a full-time student), the child can be added as an over-age disabled child and will continue to be covered beyond the plans maximum age if they are not able to support themselves financially and must rely on the plan member financially.
If your spouse's benefits coverage changes, or they no longer have coverage and our plan becomes the primary plan, you'll need to login to mysunlife.ca to make changes to your coordination of benefits information following the steps below:
- Login to mysunlife.ca
- Click on the person icon in the top right hand corner and select Personal Information. From there, select Coordination of Benefits.
- The first screen under Coordination of Benefits is if the Spouses plan is also with Sun Life, select Yes/No depending on the change you are making.
- If they have no coverage and our plan is now the primary plan, select No and click continue. Then click update under one of the policies listed and change all contracts to say “There is no other coverage elsewhere” and click submit.
Managing Your Account
You can use Sun Life online or Sun Life’s Mobile App to manage your Sun Life account. You can login anytime to check your benefits details, claims history, access your benefits card, find local service providers, and make updates to your personal information* (such as your mailing address, email notifications, etc).
*Note: Not all changes can be done through the mobile app. You will need to login to mysunlife.ca to update banking information and mailing address.
To update your banking information, navigate to Benefits Centre and select Coverage Information, then in the grey box to the right of the screen titled Take me to, select Direct deposit and online claim statements. Select update under banking information and input your new banking information.
To update your mailing address, click the person icon in the top right corner > Contact Information > Address for Benefits.
If at any point you need to make changes to your Group Benefits Plan please submit a People Team request for a Sun Life change form. All change forms will be processed by our People team and sent to Sun Life to complete the change.
FAQs
How do I submit a claim?
When submitting a claim, some service providers offer the option for direct billing which saves you time having to submit a claim and deducts the portion covered by Sun Life at the time of payment. You can also submit any unpaid portion of a group benefits claim through your Health or Personal Spending Account (HSA/PSA).
Note: As the primary plan member, you will always be responsible for submitting all claims (if direct billing is not available) to Sun Life through your account whether they be for you, or your dependents. When submitting a claim, you'll be prompted to select "Who it's for" from the drop down menu and you will see your name, and the names of your dependents on our plan.
Mobile App Submission (Preferred, for appointments up to 60 minutes only)
*IMPORTANT: If you are making a claim for an appointment that has a duration of over one hour (for example, a RMT massage that was 75 minutes) please use the online claim submission below instead since the mobile app only reimburses up to one hour.
- Open the Sun Life app on your mobile device (To download, search “Sun Life” in the App Store or Google Play Store)
- Sign in using the email and password you used when you registered online
- Navigate to “Submit a Claim”
- Follow the prompts for the type of claim you are submitting—You can choose from Medical, Drug, Vision, Dental, Disability, HSA or, PSA. For each new provider, you will need the provider’s registration number (and/or full name, address and, phone number), usually found on their invoice.
- Click "Submit" and your claim is submitted!
Ensure you enter all details correctly as filing a false or incorrect claim can have negative results. You will need to upload copies or photos of your invoice/receipt where required.
Online Claim Submission*
- Navigate to mysunlife.ca
- Sign in using the email and password you used when you registered
- Select “Submit a Claim”
- Follow the prompts for the type of claim you are submitting—You can choose from Medical, Drug, Vision, Dental, Disability, HSA or, PSA. For each new provider, you will need the provider’s registration number (and/or full name, address and, phone number), usually found on their invoice.
- Click "Submit" and your claim is submitted!
Ensure you enter all details correctly as filing a false or incorrect claim can have negative results.
*Please note: Not all providers can be submitted through the online portal. For example, if you see a counsellor versus a psychologist, you will need to submit your claim through the mobile app to be able to upload a copy of your invoice or photo of your receipt.
Claims can take 5-7 business days to process. You will receive an email when your Sun Life claim has been assessed and will know whether it was approved, denied, or requires more information. If you don't receive an email in 5-7 days, log back into your profile to check the status of your claim in the "Recent Claims" section.
Once your claim is approved, a refund will be deposited directly into your bank account in 1-3 days.
Submitting Claims for Fertility Services
Our extended benefits plan with Sun Life includes coverage for fertility services. In order to submit claims, you'll need to complete the paper claim form and mail your documentation to Sun Life directly as these claims cannot be submitted electronically through the desktop or mobile app. Once received by Sun Life, claims will be processed and paid in 3-5 business days. For more information on eligible expenses, how to submit a claim and mailing address details, please read the Sun Life Fertility Services flyer.
How do I view my dependents on the plan?
You can view the dependents on your plan through two different ways:
- From the Desktop Site
- Login into mysunlife.ca on your desktop
- From the home page, click on your profile icon located in the top right corner of the page, and select Personal Information
- Click the Personal and dependent information hyperlink under the Dependents section to view a list of dependents on your plan
- From the App
- After logging in, click Submit a Claim from your app home page
- Select Medical as the claim type and you will be able to view the dependents on your plan from the drop down list
- Click Cancel once done.
What are reasonable and customary fees?
There are a range of fees most providers in each province typically charge for certain services or procedures. Insurance companies use these reasonable and customary fees as the basis for pricing their benefit plans and paying claims. Reasonable and customary fees will typically differ depending on the length of the visit as well so it's important that you submit your claim using the correct submission process based on the length of your visit - more on this in the next section. Most paramedical expenses claimed will fall within the reasonable and customary fee range. If a healthcare provider chooses to charge more, you’ll be responsible for the extra cost. You can also ask the provider whether or not they charge within the reasonable and customary fees based on provincial fee guide before booking an appointment as well.
You can find the reasonable and customary fees on both the mobile app and on mysunlife.ca
Note: If you are making a claim in a province that you do not live in (ie. making a claim in Ontario when you reside in BC), Sun Life will pay the claims by following the fee guides and reasonable and customary amounts of the province that you reside.
What is Lumino Provider Search?
Sun Life has a feature on both the mobile app and on mysunlife.ca called Lumino Provider Search. This feature allows you to easily find providers based on specialty and your location. Once you find a provider near you, you'll be able to open their profile which will tell you a number of important things such as: whether they are accepting new patients, if they do direct billing to Sun Life (so you don't have to pay upfront and then submit a claim), their rating, and most importantly cost information (specifically whether they charge less than, on par with, or more than the provincial fee guide - read more in the next section). For illustrative purposes, check out the below image comparing two providers found using this search feature. The $ signs will show you whether your chosen provider charges more than the reasonable and customary amount or less. If you go to one that charges more, Sun Life may not cover the full amount and you will have to pay for a portion out of pocket.
Can I refuse coverage?
If you you wish to opt out of extended health and/or dental coverage because you have comparable coverage under another group plan, please submit a People Support Request Form for support.
How do I contact Sun Life?
Should you need assistance or have questions you can now contact Sun Life in one of two ways:
1) By chat using Chatbot on mysunlife.ca. Questions that can be answered using Chatbot:
- paramedical and vision e-claims,
- how to update mail and email addresses, banking information, plus where to add and rate providers,
- how to find a claim form,
- where to find a Pay Direct Drug card and Travel Card,
- coordination of benefits questions related to e-claims, and
- Sun Life’s hours of operation and contact information.
2) By calling their customer care centre at 1-800-361-6212 for all other inquires not listed above.
Am I still covered for benefits while traveling out-of-province?
It's important to be aware that if you are travelling out of province, your Sun Life coverage typically only covers you and your dependents for up to 90 days and MSP coverage only lasts for up to 6 months out of province at which point you will lose coverage. If you are out of province and need to make a claim, Sun Life will typically ask you to provide your travel confirmation information to confirm that you are within 90 days and eligible for coverage.
To read more information on what our Emergency Travel Insurance covers relating to COVID-19 please read this Guru card: Sun Life Emergency Travel Insurance and COVID-19.
Still need additional assistance? For questions about travelling, eligibility, applying for MSP or PharmaCare read more information here or call 604-683-7151 from the Lower Mainland, or call 1-800-663-7100 toll free from the rest of BC.
How do I access my coverage card?
To get your coverage card:
- Sign in to my Sun Life.
- Under Benefits, click Benefits centre.
- Choose Print drug card or Print travel card under the Take me to drop-down menu.
- Click the Print button at the top right-hand corner of the web page.
Using your drug card is a convenient way to claim for prescription drugs. Participating pharmacies no longer need a plastic card to swipe through their systems. Instead, simply print your paper drug card and show it to your pharmacist. Your pharmacist will send in your claim electronically.
Your travel card lets you connect with support services if you have a medical emergency while you are travelling out of your home province.
To get drug and travel cards using your smartphone:
Download the app to use your smartphone as your coverage card:
- Sign in to my Sun Life Mobile using your email address and password.
- On the Main menu, click Benefits.
- Choose coverage card.
How do I update my address?
- Sign in to my Sun Life on your desktop (contact information cannot be updated on the Sun Life app) and click on the profile icon located at the top right corner of the webpage.
- Select 'Contact information' from the drop-down menu, and click the 'Your current address' hyperlink in the Address section.
- You will be directed to a new page. Click the 'update' button in the Personal Information section.
- Enter your new address directly in the address fields and click 'submit' once you are finished.
You can also call Sun Life at 1-877-786-5433 (1-877-SUN-LIFE), Monday to Friday, 8 a.m. to 8 p.m. ET. Please have your coverage card handy.
How do I update my banking information?
You can update your banking information for your group benefits plan online:
- Sign in to my Sun Life.
- Under Benefits, click on either Benefits centre or Coverage information in the list on the right.
- Choose Direct deposit and online claim statements from the Take me to drop-down menu.
- Under Banking information, click Update and enter your updated banking information.