Question 1

Health & Welfare Claims

Accepted Answer

Drug and Supplementary Health Care Claim
Use this form for any drug or supplementary health (such as physiotherapy, hearing aids, etc) or emergency medical travel insurance claims.

Bereavement Claim
Use this form if you encountered wage loss at the time of death of a family member.

Parental Leave Claim
Use this form if you encountered wage loss at the time of the birth/adoption of your child(ren).

Dollar Bank Account Freeze
Use this form to have your dollarbank frozen while you are receiving wage loss benefits from one of the following sources:
- EI Maternity or Parental or Compassionate Care benefits
- WSIB
- Income replacement benefits from your private insurance provider as a result of a MVA.

Private Duty Nursing Care Pre-Approval
This form should be to initiate a pre-authorization process for IUOE Local 793 Plan to cover private nursing expenses.

Dismemberment Benefit Claim
This form must be used if you a suffered a dismemberment within 365 days of an accident that occurred any time of the day, on or off the job.

Question 2

Dental Claims

Accepted Answer

Dental Claim
This form should be used for any dental claims.

Question 3

Health Care Spending Account

Accepted Answer

Health Care Spending Account
This form should be used if you have covered, out-of-pocket medical and dental expenses that exceed your Active Benefits Plan coverage.

Question 4

Legal Claims

Accepted Answer

Group Legal ClaimUse this form for the reimbursement of legal services set out in the current schedule of benefits up to the maximum amount indicated. Jury Duty or Subpoenaed WitnessUse this form if you encountered wage loss if you were on jury duty or a subpoenaed witness.

Question 5

Personal Information Form

Accepted Answer

To update your personal, dependant, and beneficiary information, please fill-out the Request for Personal Information Form by accessing this link: Request for Personal Information Form (PIF)

Personal Information Form (Staff)
If you are a staff of Local 793, please contact HR to update your personal, dependant, and beneficiary information.

Question 6

Request for Direct Deposit

Accepted Answer

Banking Information for Direct Deposit/ Electronic Funds Transfer (EFT)

Use this form to update your banking information for Claims, Pension, and Disability deposits.

You may update your Direct Deposit/EFT banking information for Claim Payments (Medical, Extended Healthcare, Leaves, Drugs, Dental, and Legal) directly via the OEBAC Mobile App (Apple / Android) without this form.

This form is required to update banking information for Pension and Disability deposits.

Question 7

Prior Authorization Forms (for specialty drugs)

Accepted Answer

Erectile Dysfunction DrugsUse this form to initiate the prior authorization process for erectile dysfunction drugs (i.e. Cialis, etc.), to be reviewed and considered for coverage under the IUOE Local 793 Plan. All claims for these drugs require prior approval at least once every 12 months.GLP-1 MedicationsUse this form to initiate the prior authorization process for GLP-1 medications (i.e. Ozempic, etc.), to be reviewed and considered for coverage under the IUOE Local 793 Plan. All claims for these drugs require prior approval at least once every 12 months.All Other FormsUse the link below to access forms to initiate the prior authorization process for specialty drugs used to treat complex medical conditions through the FACET Program. Completed forms can be submitted via fax to FACET at 1-844-446-1575.https://www.facetprogram.ca/en/

Question 8

Disability Forms

Accepted Answer

Short Term Disability Claim
Use this form to start your claim for disability benefits.

Question 9

Appeals

Accepted Answer

Appeal to Trustees' Appeal Committee
This form is to be used if you want to appeal the decision of a claim.

FORMS