Below you will find links to your group benefit forms and a series of frequently asked member questions. Click on the form titles marked with a plus (+) to get a list of form links.
ProBenefits Inc. claims can be emailed to firstname.lastname@example.org. Please ensure that a signed claim form, as well as quality scanned copies of your receipts are included.
ProBenefits Inc. Mobile app (Symbility Health Mobile Claims)
+ Health and Vision
+ Health Care Spending Account
+ Cost Plus
+ Change Form
+ Over Age Form
+ Direct Deposit Form
+ Assignment of Benefits Form
Plan Member FAQs
- How do I submit and check on the status of my claims? Claims for dental services can be submitted electronically by your dental provider, should they participate in electronic submission. If you are submitting your dental expense, please have your dental office complete a standard dental claim outlining the procedures completed and forward to our office via mail. Healthcare and visioncare expense receipts must be attached to the healthcare/visioncare claim form and submitted in the mail. The status of your claim can be checked by signing up for online access with your insurance carrier, at the link below.
- Can I submit claims electronically? Yes, claims can be submitted electronically, depending on your current plan contract and carrier provisions. At this time, with ProBenefits Inc., claims cannot be submitted electronically using the online claims access site. This site is to review and access your claims experience and benefit policy and view and update your personal information.
- What does my plan cover? You would have received an Employee Benefit Booklet outlining the benefit coverage you have in place. If you have not received a booklet, you can access a copy through the online access or contact your plan administrator for a copy.
- How long do I have to submit a claim? Each insurance carrier has their own guidelines; please review your Employee Benefit Booklet for details.
- Where do I find my group and certificate numbers? This information is located on your benefit id and drug cards (if applicable), which you would have received from your plan administration at the time you became effective on the program.
- My plan is supposed to pay 100% for basic dental services, yet I still have to pay out of pocket for some of these services, why? If you reside in a province where there is no official dental fee guide for the current year, your dentist may charge more than what our suggested fee guide is; thus you will have to pay the difference.
- When are children no longer eligible to be on my benefit policy? For most policies, dependent children are those under age 21, and over age 21 to age 25 for those that are attending full time studies at a recognized post-secondary institute. If you have a disabled dependent over age 25, please contact our office to discuss further. Please review your benefit booklet to confirm dependent eligible age.
- When should I get a pre-authorization on health and dental treatment? For dental services, have your dentist submit a pre-authorization when your treatment is expected to be a large sum or for services you may not be certain are covered under your program. Certain health expenses may require pre-authorization. Contact our office for details.
- I submitted a till receipt for my drug purchase, but it was declined, why? A till receipt is declined for coverage as it does not identify what the purchase was, does not include the drug identification number, is missing the claimants name, and the date of service. Please ensure you are submitting official receipts for assessment.