Coordination of Benefits Claims – Change
Posted on Thursday, October 15th, 2015
The group insurance industry, including Sun Life, is changing the way in which Health and Dental claims are being coordinated going forward.
Effective immediately, the amount of reimbursement under both group insurance plans, under which a claim is being coordinated, will be based on the Reasonable and Customary (R & C) costs as determined by each respective insurer. In most instances, there will be no change in the overall amount being reimbursed. However, depending on the amount billed by a service provider and the R & C amount used by the coordinating insurer (if other than Sun Life), there could be a change in the amount of reimbursement that the plan member receives.
Communiqué from Colleges of Applied Arts and Technology
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