Get Cost Plus Claim Form - Employer - Canwest Group Benefits

This guide is designed to assist users in completing the Cost Plus Claim Form - Employer for Canwest Group Benefits online. By following the steps outlined below, you will ensure that you effectively complete the form and submit your claim accurately.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the employer or company name in the designated field to identify the claiming party.
3. Fill in the employee's last name and first name, ensuring accuracy as this information is crucial for the claim processing.
4. Indicate the employee's sex by selecting the appropriate option for 'M' or 'F'.
5. Provide the employee's date of birth in the format MM/DD/YY to verify their identity and eligibility.
6. Enter the complete mailing address of the employee, including city, province, and postal code.
7. Input a contact phone number where the employee can be reached for any follow-up questions regarding the claim.
8. Respond to the question regarding whether any of the attached receipts have been paid by another insurer by selecting ‘Yes’ or ‘No’. If 'Yes', attach a copy of the Explanation of Benefits.
9. Separate all eligible expenses by claimant and attach original receipts. Only receipts dated within ONE FULL YEAR prior to the submission date will be accepted, provided the employee was actively on the plan at that time.
10. List the name of the patient for whom the expenses were incurred and their relationship to the employee.
11. Describe the services received (e.g., massage, prescriptions, dental, vision) in the description field for clarity on the nature of the claim.
12. Indicate the number of receipts submitted for each service under the '# of Receipts' column.
13. Calculate and fill in the total claim amount in the designated box (Line A).
14. Add the administration fee (10% of Line A) and enter it on Line B.
15. Calculate the GST on the administration fee and enter the amount in Line C.
16. Sum Lines A, B, C, and D to determine the total amount enclosed, which should be entered in the final box.
17. Review all information entered to ensure accuracy before signing and dating the form.
18. After completing the form, attach original receipts and a cheque payable to Canwest Group Benefits Inc. then mail or drop off the submission.

Complete your Cost Plus Claim Form online today to ensure timely processing of your benefits.