How do I submit a dental care claim and/or a Health Spending Account claim (HSA)?
You may use the Industrial Alliance Claim Request – Dental Care/HSA (PDF – 302 KB) or your dentist’s form. If you wish to have a portion not covered by your group policy to be paid under your Health Spending Account , please use Claim Request – Dental Care/HSA (PDF – 302 KB) and complete the appropriate HSA sections. • Make sure your policy number, the policyholder’s name and your certificate number are included on the form. • Make sure that Part 1 is completed in full and signed by the authorized person in your dentist’s office. • Make sure that Part 3 is completed in full and that you signed the Member Confirmation/Authorization section. • Keep a copy of the form and the receipts in case your original claim fails to reach Industrial Alliance.
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- How do I submit a dental care claim and/or a Health Spending Account claim (HSA)?
