You will need 300 hours in your hour bank to start your benefits (or reactivate your benefits if you have gone longer than 3 months without coverage). Hours are reported and paid for by your employer the month following when they are worked and then applied to your hour bank the following month. For example: Hours worked in March get reported and paid for in April and applied to your hour bank for May. Be sure to either wait until you receive your letter confirming your eligibility or call our office to confirm your eligibility before you incur any expenses you wish to submit for coverage. Please refer to page 6 of the Health & Wellness Booklet for full hour bank details.

130 hours are required each month to maintain your coverage once eligible.

The maximum number of hours you can bank in your hour bank is 780 hours, which is equal to 6 months of coverage.

Yes, you can make self-payments to extend your benefits for up to 6 months. The self-payment amount is currently $273.00 per month. There are specific time deadlines and eligibility, please refer to page 7 of the Health & Wellness Booklet at the link below for full self-payment details.

You will need to complete a Dependent Enrolment or Dependent Change Form to add or remove your dependents on file. Please contact the Plan Office by phone at 780-477-9131 Option #1, or email at info@acawtrustfunds.ca and the Plan Office will provide you with the appropriate forms to update your dependents listed.

Please be sure to notify the Plan Office immediately should there be a change in relationship to avoid any possible overpayment of claims.

Dependents aged 19-24 must be enrolled in full-time studies at a recognized school or university to remain eligible under the Plan.

A confirmation of enrolment letter from the registrar’s office must be provided to the Plan Office to review for extended coverage. The letter must state the start and end dates of the year and length of program and cannot be dated prior to the start date of attendance.

You will need to submit an updated letter each semester and/or school year.

If you have active benefits with the ACAW Health & Wellness Plan, a benefit card will be provided to you for use with prescription drug claims through TELUS AdjudiCare. You can submit this benefit card to your pharmacy for direct billing.

The Plan Office can accept direct billing for dental, pharmacy, hospital and ambulance services. All other claims/providers must be paid in advance by you and submitted to the Plan Office. Dental claims can now be submitted by email to dentalclaims@acawtrustfunds.ca

For direct billing for pharmacy, hospital and ambulance services, the provider’s information must be entered in the “Direct To Service Provider Payment” area of the ACAW Claim Form. Payment will be made directly to the provider.

Your dental office will need the following information to set up your file:
• The Plan Name: ACAW Trust Funds
• ID or Certificate Number: ID number or SIN

Your dentist will show you where to sign on the Standard Dental Claim Form to indicate if we are to pay you or the dentist. The Standard Dental Claim Form is provided by your dental office.

Signed Standard Dental Claim Forms can be emailed to dentalclaims@acawtrustfunds.ca.

Yes, a dental office can submit a dental predetermination to the Plan Office and it will be processed, with a response sent to both you and the dental office. The response will indicate whether the procedure is covered as well as how much will be paid. Predeterminations can also be emailed to dentalclaims@acawtrustfunds.ca.

Yes, contact the Plan Office with the drug identification number (DIN) for your medication and the Plan Office will let you know if it is a covered medication within your drug coverage. Your doctor or pharmacist can provide you with the DIN for your prescription.

Vision coverage for eyewear renews every 24 months for those aged 19 and over and every 12 months for dependents under 19 years of age.

The Plan allows $500 for eyewear for adults aged 19 and over, and $250 for dependents under 19 years of age.

Vision exams are covered up to $95 every 24 months for those aged 19-64 only.

We encourage members to call or email the Plan Office to check vision eligibility for themselves and their dependents prior to incurring any expenses.

Please allow four weeks for processing and payment of your claim. While you may receive payment sooner, periods of high claim volume and holidays can require longer processing time.

The Plan Office recommends using a traceable form of payment when paying for services you will be submitting for payment. This includes debit, credit, cheque, money order and e-transfer. Cash payments are not always accepted; for this reason, we recommend avoiding cash payments.

Handwritten receipts from providers must always be submitted with proof of traceable payment to be eligible for reimbursement. (Example: debit/credit receipt, e-transfer confirmation, bank statement or cashed cheque copy)

Yes, weekly disability benefits for non-work related injuries or illnesses are included as part of your benefit coverage to a maximum of 26 weeks. There are specific time deadlines and eligibility, please see the Weekly Disability page for the application package and eligibility details.

Yes, whenever you have active Health & Wellness benefits the member has $150,000.00 in group life insurance, any qualified spouse would have $30,000.00 in life insurance and any qualified dependent child would have $5,000.00 in life insurance.

You will need to complete an Appointment of Beneficiary Form to update your life insurance beneficiary on file with Health & Wellness. Please contact the Plan Office by phone at 780-477-9131 Option #1, or email at info@acawtrustfunds.ca and the Plan Office will provide you with the appropriate forms to update your beneficiary on file.

Please note, in the absence of a valid Appointment of Beneficiary Form on file, your beneficiary will default to your Estate.

Yes, optional life insurance is available for purchase for both the member and spouse where approved. Coverage is available in multiples of $10,000 to a maximum of $500,000 for both member and spouse. There are specific timelines and requirements, for details please see the Optional Life Insurance Brochure and Application form.

If you are a member in good standing with Local Union 1325, 2103 or 2010, there may be a funeral benefit of up to $5,000 available, provided you did not have active Health & Wellness life insurance at the time of passing. A Member age 65 or older or those in receipt of a retirement pension for 12 months or more are not eligible for this benefit. There is a deadline to apply for these benefits. For specific details and/or application forms, please contact the Plan Office.

You will receive a T4A from the Health & Wellness department each year provided you were eligible for benefits for the required period. T4As are mailed out each year by the end of February.

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