Get M Manulife Financial - Local 110

Filling out the M Manulife Financial - Local 110 form online can be a straightforward process when you follow the right steps. This guide will assist you in completing the form effectively to ensure that your claims are processed smoothly.

Follow the steps to successfully complete the online form.

1. Click ‘Get Form’ button to access the M Manulife Financial - Local 110 form in your browser.
2. Begin by entering your plan member information. Fill in your plan contract number, certificate number, birthdate, and your full name. Make sure to provide your complete address, including city, province, and postal code.
3. Indicate if the expenses are eligible for coverage under a worker's compensation board by selecting 'Yes' or 'No'. Also, clarify if you, your partner, or dependants are covered under any other plan for the expenses being claimed.
4. If applicable, provide your spouse's date of birth and their insurance information, including the company, plan contract number, and member certificate number.
5. Select whether you wish to sign up for direct deposit. Follow the instructions provided to register for the direct deposit if you choose this option.
6. Provide patient information for each expense. Include the patient’s name, date of birth, and their relationship to you as the plan member, especially for claims involving students aged 18 or older.
7. List any prescription drug expenses by ensuring all receipts are attached and compliant with requirements, including the drug identification number.
8. For practitioner expenses, attach an itemized statement with necessary details such as the practitioner's name, charge for treatment, and date of service.
9. Continue to other sections for equipment, appliance, and vision care expenses. Provide all relevant documentation as specified, such as a recommendation from a physician for equipment claims.
10. Review all information for accuracy, and ensure you have attached all original receipts as required. Confirm the total amount of all receipts submitted.
11. Sign and date the form at the designated signature section to confirm the accuracy of the information provided.
12. Finally, mail your completed claim form and receipts to the appropriate address based on your location.

Complete your claims online today for a smoother experience!