Table of Contents
DENTAL
Local 213 Electrical Workers’ Welfare Plan processes your Dental claims (not Pacific Blue Cross). Identity cards are not issued and balances do not accumulate year to year. The Dental Care benefit is essentially a Healthcare Spending Account and the Welfare Plan office does not approve pre-determinations/pre-authorizations for procedures. If you/the Member has a sufficient balance to cover the service(s), and it is not an ineligible expense*, the Plan will reimburse. Due to privacy reasons, Member account balances will not be revealed to your Dental office, only to the Member.
A friendly reminder the deadline to submit 2024 dental and optical claims is March 31, 2025.
Effective Jan 1, 2024: Hearing Aid claims are to be reimbursed by Pacific Blue Cross ($1,000/3 calendar years) and should be submitted to the insurer if the date of service is on/after that date.
Coverage Comparison
The annual dental allowances are summarized in the table below:
| Benefit |
Plan A |
Plan B |
Plan C |
| Dental |
Prior to Jan 1, 2024: $2,500 dental/hearing aids (per family per year)** Effective Jan 1, 2024: $2,800 dental (per family per year)**, Hearing aid coverage moved to Pacific Blue Cross |
Not Applicable (Not Covered) |
$1,500/family combined per calendar year (with optical) Effective Jan 1, 2024: Hearing aid coverage moved to Pacific Blue Cross |
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Federal Dental Benefit for Seniors (Info for Plan C Members)
Please be aware that the new Federal Dental benefit for seniors requires that any applicants do not have access to dental insurance. This means that if you are on Plan C, or even Plan A because you are still working and qualify for coverage under that Plan, you should not apply for coverage under this new plan.
Any claims submitted to the office which show that the Federal Dental benefit was the first payor, expecting the Electrical Workers’ Welfare Plan to be second payor, will not be paid, as this means that the individual is misreporting their coverage status to the CRA and the Federal Plan.
Dental Claim Requirements
Payment will be made on presentation of the following:
- An ORIGINAL PAID RECEIPT and
- An ORIGINAL STANDARD DENTAL CLAIM FORM which shows
- the date of service,
- amount of payment
- name of member (or dependent)
- If there is another plan involved with a claim (i.e. spouse’s plan), members must provide copies of this coverage along with the above originals (an Explanation of Benefits/Statement of Claim) See example under Submission Methods.
Payment for dental can be made directly to your dentist. Your dentist must call the Welfare Plan office to have this arrangement set up. Expenses will be applied to the Member’s annual account balance based on the later of the date of service/proof of payment.
Notes:
- *Ineligible expenses: Unnecessary or cosmetic dentistry, including bleaching and veneers, are not covered by this Plan except with the consent of the Plan Trustees.
- Any dental expenses resulting from an accidental injury are covered under your extended heath plan, please check your Pacific Blue Cross brochure for details.
Please be advised that the Plan Trustees have the ability to pro-rate coverage.
**Members with less than four (4) months of coverage in the calendar year will be pro-rated to 1/12 of the dental limit for each month of coverage.
- How does dental expense pro-ration work? EWWP Breakdown of Pro-Rating on Dental
Hearing Aids
Effective Jan 1, 2024: submit claims to Pacific Blue Cross for reimbursement. Please check your Pacific Blue Cross brochure for details.
Submission Methods
The benefits office will accept claims by mail, e-mail, or fax for optical. Please keep your original receipts in case we ask to see them.
The following documents and information are required for reimbursement and it is the member’s responsibility to provide proper documentation for all claims. Documents must clearly match in terms of billed services, receipts, etc. and be clearly legible. Any required documents missing, documents which are difficult to read or indecipherable, or documents that do not clearly match in terms of amounts billed/reimbursed will result in a delay of your reimbursement:
- Original Paid Receipt and,
- Standard Dental Claim Form (dental only)
- Member’s Name
- Member’s Address (full Street Address, City, Province, and Postal Code)
- If a portion of the submitted expense was paid for under another insurance Plan before being submitted to our office, then an Explanation of Benefits or Claim Statement showing the amount paid for by the other Plan and remaining unpaid must be included.
Alternatively, we have direct reimbursement available for dental offices. To take advantage of direct reimbursement, your dental office should contact the Welfare Plan office for the required information.
Please send or ask the dental office to send PDF, JPEG or fax copies of the required documents.
E-Mail: info@213benefits.org
Fax: (604) 571-6544
Mailing Address:
Local 213 Electrical Workers’ Welfare Plan
1424 Broadway Street
Port Coquitlam, B.C.
V3C 5W2
The last day of payment for dental claims will be March 31st of the following year.
Frequently Asked Questions
Q: What is a Standard Dental Claim Form and how do I get one?
A: A Standard Dental Claim Form outlines the work performed by the dentist and is supplied by the dental office.
Q: What if a portion of my Dental expense was already reimbursed by another (my spouse’s) Plan.
A: Please see the section above about what is required for all claims (Submission Methods) and take note of the additional required item, #5, the Explanation of Benefits or Claim Statement.