Protecting your benefits from fraud

This month, we are raising awareness about benefits fraud and sharing practical steps you can take to help protect your benefits.

What is benefits fraud? 

Benefits fraud includes: 

  • Billing for services not received  
  • Falsifying health conditions  
  • Inflating claims  
  • Sharing benefits with ineligible individuals  

The part we play in protecting our benefits 

While Sun Life uses several measures to address fraudulent claims, there are a few ways plan members can contribute to the sustainability of the benefit plans. Here are some tips to keep in mind: 

Know your plan  

Understand what’s covered. That way you can use the benefits to their fullest, and there is value for all benefit plan members  

Action: Explore the Benefits Tree for a snapshot of the benefits available to you and your dependents.  

Know your transactions 

Sun Life does a great job of keeping you updated on claims made to the plan. It is always a good idea to review these transactions as though they took place directly with your banking institution. 

Action: Review your transactions, make sure you keep your receipts in case of an audit, and if something seems amiss, contact Sun Life. You can review your transactions through mysunlife.ca or the Sun Life mobile app. 

Protect your info  

Don’t share your benefits ID or drug card with non-dependent benefit plan members. Fraud can also look like bad actors using your information to make claims. There are also a range of scams and other efforts to take money from plan members through the plan. These include fraud and scam efforts like fake lotteries, personal loans, and wire transfers. Stay vigilant and do what you can to protect your identity. 

Action: Read Sun Life’s list of the most common fraud/scam complaints. 

Avoid delisted providers 

Sun Life will investigate and disallow certain healthcare service providers, clinics, facilities, or medical suppliers from claims processing and reimbursement. Sun Life does this to better protect the benefits plans.  

You can double-check that you aren't using an inappropriate provider by reviewing Sun Life’s Delisted providers' information. 

  • Sign in to www.mysunlife.ca
  • Navigate to the Benefits Centre
  • On the navigation on the right, you will see “Delisted providers list” 

By avoiding these providers, you can ensure your claim does not get rejected.

Action: Review Getting the most out of your UBC Benefits story to learn more about avoiding delisted providers.  

Report suspected fraud 

If something doesn’t seem right, contact Sun Life’s fraud department. 

Tagged

  • HR
  • Benefits FYI

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