Filing a Claim
As a Member of the Ironworkers Local 97 Health & Welfare Plan, you are eligible to receive certain benefits as outlined in your Health & Welfare Plan Booklet.
In order to receive the benefits that you are entitled to, you must file a claim with the Plan Administrator. This can be done in different ways, depending on the benefit you are looking to claim.
When you qualify for benefit coverage, you are sent a pay-direct card from the Plan Administrator.
- Present this card to your pharmacy each time you fill a prescription.
- Present this card when you visit participating paramedical practitioners (physiotherapist, registered massage therapist etc.)
- Present this card when you have an eye examination.
- Present this card when you purchase eye glasses or contact lenses.
- Present this card to the receptionist when you arrive at your dental appointment.
All other eligible expenses (with the exception of Dental/Transportation Assistance/Weekly Indemnity/Long Term Disability) can be submitted directly through the D.A. Townley My Claims portal or mobile app.
You can complete the applicable claim forms (see below) and submit them to the Plan Administrator:
Use the Dental Claim Form if you’ve paid your dentist the full cost of the services that are covered under the Plan and you wish to be reimbursed.
Use the Extended Health Benefits Claim form if you’ve paid for Extended Health expenses (prescription drugs, physiotherapy, chiropractor, eyeglasses, etc) and did not use your pay-direct card for the purchase.
Use the Weekly Indemnity Benefits Claim form to make your claim for Weekly Indemnity benefits if you have become unable to work, while covered for this benefit, because of an accident, sickness or pregnancy, provided you are under the regular care of a physician.
Use the Statement of Claimant for Long Term Disability Benefits if you’ve been totally disabled (through sickness or injury) for at least 26 weeks and are now wishing to apply for LTD benefits. Once you have applied for LTD Benefits, you may be required to complete the Attending Physician’s Initial LTD Benefits Statement before your LTD claim can be approved.
Use the Transportation Assistance Claim Form to claim for eligible transportation expenses incurred by you or an eligible dependent.