Coordination of Benefits

If your spouse/common-law partner has alternate coverage, you can receive up to 100% reimbursement of your family’s eligible healthcare and/or dental expenses by coordinating your coverage.

You are entitled to claim benefits from your Plan(s) and your spouse/common-law partner’s plan(s) as long as the total benefits received does not exceed the actual expenses incurred.

If services are provided to you, and they are covered under the HEB Manitoba Healthcare and/or Dental Plans, Manitoba Blue Cross would be the "primary" carrier and would pay benefits first. The other insurer would be responsible for any unpaid eligible expenses. If there are still eligible expenses after your secondary insurer has paid and you are entitled to an HSA benefit, the balance may be claimed through your HSA. Should your spouse/common-law partner also have an HSA, and if a balance is still unpaid, you may then forward that unpaid balance to your spouse/common-law partner's HSA. The HSA is always the final payer of any benefits.

If other coverage is in place, please provide the following when submitting to Manitoba Blue Cross:

  • A completed Manitoba Blue Cross Claim Form (including contract number),
  • A copy of the receipts, and
  • The statement of benefits or rejection notice from the other insurer.

Your Expenses


Submit your expenses in the following order:

  1. HEB Manitoba Healthcare or Dental Plan through Manitoba Blue Cross.
  2. Your spouse/common-law partner’s healthcare or dental plan, if applicable.
  3. HEB Manitoba HSA through Manitoba Blue Cross, if applicable.
  4. Your spouse/common-law partner’s HSA, if applicable.

Your Spouse/Common-law Partner’s Expenses

Submit your spouse/common-law partner’s expenses in the following order:

  1. Your spouse/common-law partner’s healthcare or dental plan, if applicable.
  2. HEB Manitoba Healthcare or Dental Plan through Manitoba Blue Cross.
  3. Your spouse/common-law partner’s HSA, if applicable.
  4. HEB Manitoba HSA through Manitoba Blue Cross, if applicable.

Your Eligible Dependant Child’s Expenses

Submit your dependant child’s expenses in the following order:

  1. To the healthcare or dental plan of the covered person with the earlier month and day of birth.
  2. To the healthcare or dental plan of the covered person with the later month and day of birth.
  3. To the HSA of the covered person with the earlier month and day of birth.
  4. To the HSA of the covered person with the later month and day of birth.

If you are separated or divorced, submit your dependant child’s expenses in the following order:

  1. To the healthcare or dental plan of the parent with custody of the child.
  2. To the healthcare or dental plan of the spouse/common-law partner of the parent with custody of the child.
  3. To the healthcare or dental plan of the parent without custody of the child.
  4. To the healthcare or dental plan of the spouse/common-law partner of the parent without custody of the child.
  5. To the HSA of the parent with custody of the child.
  6. To the HSA of the spouse/common-law partner of the parent with custody of the child.
  7. To the HSA of the parent without custody of the child.
  8. To the HSA of the spouse/common-law partner of the parent without custody of the child.

In cases of joint custody, i.e., when both parents have plans and their children are covered under both as dependants, the plan of the parent with the earlier birth date in the calendar year pays first.

© 2017 HEB Manitoba

 

Disclaimer - This website provides a basic overview of the Healthcare Employees' Pension Plan (HEPP) and the Healthcare Employees' Benefits Plan (HEBP) (collectively the HEB Manitoba Pension and Benefit Plans). Not all employers participate in all Plans. Please check your eligibility for benefits with your employer.

HEB Manitoba is a name notation registered by the Healthcare Employees’ Pension Plan – Manitoba and the Healthcare Employees’ Benefits Plan – Manitoba and under which each of their respective undertakings is carried out.

The information on this website is for convenience of reference only and has no official sanction. View our full disclaimer here.