As a Member of the NDT Health Benefit Plan, you are eligible to receive certain benefits as outlined in your Health Benefit Plan Booklet.
In order to receive the benefits that you are entitled to, you must notify the PLAN ADMINISTRATOR by submitting the appropriate claim form and attaching the applicable detailed receipts.
Use the Dental Claim Form if you’ve paid your dentist the full cost of the services that are covered under the Plan and you wish to be reimbursed. Many dentists will bill the Plan directly for the portion payable under the Plan using their own Standard Dental Claim Form.
Use the Extended Health Benefits Claim form if you’ve paid for Extended Health expenses (prescription drugs, physiotherapy, chiropractor, eyeglasses, etc) that are covered under the Plan.
Use the Weekly Indemnity Benefits Claim form to make your claim for Weekly Indemnity benefits if you have become unable to work, while covered for this benefit, because of an accident, sickness or pregnancy, provided you are under the regular care of a physician.
Use the Statement of Claimant for Long Term Disability Benefits if you’ve been totally disabled (through sickness or injury) for at least 52 weeks and are now wishing to apply for LTD benefits. Once you have applied for LTD Benefits, you may be required to complete the Attending Physician’s Initial LTD Benefits Statement before your LTD claim can be approved.
Questions on completing the forms should be directed to the PLAN ADMINISTRATOR.
Completed forms should be forwarded to the PLAN ADMINISTRATOR.