Sun Life Claim Procedures
As McMaster`s benefit provider, Sun Life offers a number of methods to manage your Sun Life claims.
How to Register for My Sun Life
Document that outlines steps to register for My Sun Life online.
Sun Life Plan Member Site and Online Claims Tutorial Video
Tutorial video on how to check benefit coverage online and submit claims on Sunlife.ca
Sun Life Mobile App Tutorial Video
Tutorial video on Sun Life Mobile App features including submitting benefit claims, provider search and checking benefit coverage.
Submitting Coordination of Benefits Claims on Sun Life Mobile App
Instructions on how to submit coordination of benefits claims on the my Sun Life mobile app
My Sun Life Brochure
Document that outlines all information about My Sun Life online, including how to access and sign in.
Navigating My Sun Life
Document that outlines the start page of My Sun Life, showing and explaining all the features.
Delisted Provider Communication
Document that outlines important information about delisted providers
Sun Life Benefit Conversion Brochure
Sun Life benefit conversion brochure for individuals losing their group benefit coverage
Sun Life Benefit Updates
Updates to keep our plan members informed with important news and information about your group benefits.
Express Scripts Drug Card Template
Prescription Drug Card Template - Note: Member ID is your employee ID with no leading zeros
Sun Life Pharmacy Benefits Manager Transition – Express Scripts Canada
Sun Life are transitioning to a new Pharmacy Benefits Manager, Express Scripts Canada, effective March 1st 2023
Sun Life Mobile App and mysunlife.ca Upgrades
New improvements made to Sun Life's member website and mobile app
Sun Life Benefit Forms
Sun Life Dental Claim Form
Form for paper-based claim submissions for all dental expenses and services.
Sun Life Extended Health Care Claim Form
Form for paper-based claim submissions for all medical expenses and services.
Extended Health and Dental Positive Enrolment Form
Form used to enroll employees and their eligible dependents into the Extended Health and Dental Plans.
Application for Extension of Emergency Out-of-Country Coverage Form
Form for faculty members travelling for Research or University Business purposes wishing to extend their coverage beyond 120 days.
Your Benefit Booklet is the official document which outlines benefit coverage. There are other tools available, such as the Drug Lookup Tool provided on the Sun Life website (www.mysunlife.ca), that may help you with understanding whether specific items are covered. While the Drug Lookup Tool is a convenient feature, it currently provides information about pay-direct drugs only. Other drugs, such as vaccines which are not available through the pay-direct card and have to be submitted with a paper claim, are not included in the Drug Lookup Tool.
Sun Life regularly looks at the claiming and administrative practices of medical and dental healthcare service providers and pharmacies. Sometimes, the review will lead to delisting. If you receive healthcare services or supplies from a delisted provider, Sun Life will not reimburse you for your expenses. You can still choose to obtain services or supplies from a delisted provider; however, your claim will be denied. You can see a list of providers by province by logging into your My Sun Life account. You are encouraged to check this list before you make an appointment, so you don’t unknowingly use a delisted provider. Additional information can be found here.
To understand your benefit plan coverage, refer to the appropriate booklet. If you have questions about your benefit plan provisions and would like to enquire about available coverage for specific items, you can also contact Sun Life directly. In the event of any discrepancy or inconsistency of information, the Benefit Booklets will govern.
Frequently Asked Questions
The benefit year runs from July 1st to June 30th. In order to have your claims processed, Sun Life must receive your claim prior to the September 30th following the end of the benefit year in which the claims were incurred.
Your dependent must be your spouse or your child and a resident of Canada or the United States and maintaining provincial health coverage.
A spouse includes someone who is legally married to you, or your partner of the same sex or opposite sex who has been publicly represented as your spouse for at least the last 12 months. You can only cover one spouse at a time.
A child includes unmarried children, legally adopted children, and children for whom you are the legal guardian. This would also include your spouse’s children if your spouse has sole responsibility by decree of divorce for support and maintenance of this child.
Children will be considered dependents up to age 21, or up to age 25 in the case of a full time student wholly dependent on you for support.
If you have a child who becomes handicapped before turning 21, we will continue coverage for that child as long as they are incapable of financial self-support because of a physical or mental disability, and are unmarried and dependent on you for support. In these cases you must notify Sun Life within 31 days of the date the child turns 21. Please contact your HR area office for more information on this process.
Further information on eligible dependents can be found in your benefit booklet.
You can do this by completing the Extended Health and Dental Positive Enrollment Form and submitting this form to your HR Area Office. Be sure to include all eligible dependents on this as we only keep the most recent form submitted on file.
You can call Sun Life directly at 1.800.361.6212 and one of their customer service representatives will set you up with a user ID and password. Once this is set up, you can log into the My Sun Life secure site here and view a history of your claims online. You will need your McMaster ID# and our Policy # 25018 ready when you call.
Benefit Booklets are provided for each employee group who has benefits. The benefit booklet is the official document which outlines benefit coverage.
There are other tools available, such as the Drug Lookup Tool provided on the Sun Life website (www.mysunlife.ca), that may help you with understanding whether specific items are covered. While the Drug Lookup Tool is a convenient feature, it currently provides information about pay-direct drugs only. Other drugs, such as vaccines which are not available through the pay-direct card and have to be submitted with a paper claim, are not included in the Drug Lookup Tool.
If you have questions about your benefit plan provisions and would like to enquire about available coverage for specific items, you can also contact Sun Life at 1-800-361-6212. In the event of any discrepancy or inconsistency of information, the Benefit Booklets will govern.
You can call Sun Life directly at 1-800-361-6212 and one of their customer service representatives will be able to assist you in reviewing your claim history and payments.
Hours of operation are Monday to Friday from 7am to 8pm. Be sure to have your member ID # and policy number (25018) ready.
Information Box Group
Information on additional benefits provided by McMaster can be found on the following pages: