Plan Member Forms and Resources

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As a plan member, you may be asked to provide additional documentation when you submit your claim. Please go through the sections below to find any forms relevant to your situation.

Change Forms

When life changes happen, you may need to modify your policy.

Life Insurance Claims

When you or someone on your plan dies.

Critical Illness

When you or someone on your plan is diagnosed with a life altering illness, you may be eligible for a Critical Illness benefit payment.

Disability

Whether long or short term, when you experience a disability, you may need additional medical information.

Health and Dental

Forms for when you have dental or health claims not covered by provincial insurance.

Spending Accounts

If you have a Personal Spending Account or an Employee Assistance Program.

Have a claim?

Most claims can be submitted online. For others, visit

Group Insurance Claims

Frequently asked questions

What is prior authorization?

An approval process for Plan Members who need certain high-cost drugs. This process ensures patient safety and appropriate drug use by requiring specific medical criteria to be satisfied before expenses are considered eligible for reimbursement under the plan. For example, patients are required to try initial drug therapies before moving on to more expensive treatments, ensuring less expensive alternatives are used first.

What requires prior authorization?

Certain high-cost drug, biologics (specialty drugs) and drugs with a potential to be used inappropriately. To check if your drug needs prior authorization, use the Drug (Prescription) lookup tool in the Wawanesa app or plan member portal, or call the Health & Dental Claims Call Centre at 1-800-665-7076, option 1.

What if I already received an approval from my previous insurance carrier?

If you are currently taking a drug that requires prior authorization, Wawanesa may honor the approval from your previous insurance carrier for up to six months from the Wawanesa approval date, if:

The previous carrier approved the drug or medical supply within six months of your enrollment in the Wawanesa Life Group plan;
You provide a claim statement with an explanation of benefits (EOB) or a pharmacy receipt showing the drug was covered under the previous group plan; and
The drug or medical supply is covered under your Wawanesa group plan.