FAQ
How to download a Digital Card
The new MFCW Dental Plan Portal provides you with secure and ready access to your Plan information and your Dental Card. Simply present your digital or hardcopy Benefit Card to your health and/or dental providers for convenient claims payment. To print your card, simply:
Visit the “MFCW Dental Plan Portal Login”
Click Sign In
Enter username and password or click “Create new account” to register for the first time. (For instructions on how to “Create new account” see above)
Click “Benefit Card” on the left menu.
Save the card on your smartphone or download into your digital wallet for easy access. Alternatively, you can print the card.
How do I use my Dental Card?
Present your card to your Dental Practitioner, in order for them to access the electronic pay-direct system. Using your card allows for immediate claims processing without the need for you or your Dental Practitioner to mail in a claim form. Your Practitioner will let you know if there is any amount owing.
How do I submit claims?
You are encouraged to use your Dental Card for quick and efficient claims processing. This limits your out-of-pocket expenses!
If you choose to pay directly for any service, you may submit your claim manually to PBAS using the following methods.
Online using the MFCW Dental Plan Member Portal.
Have your Dental Practitioner complete a Dental Claim Form and submit it to PBAS manually via email or mail.
Can I submit a claim online?
Online claim submission is a quick and practical way to submit your claims for reimbursement. Simply complete the required fields and use your smartphone to upload pictures of your claim form. By submitting your claim electronically, you avoid waiting for your claim to reach us by mail.
When submitting claims online, you are required to retain your original receipts for twelve (12) months, as the Plan Administrator may request these documents at any time for audit purposes.
Can claims be paid directly to my provider?
The majority of Dental Practitioners direct bill to PBAS. If your Dental Practitioner is not currently set up to do so let PBAS know by submitting a Dentist and/or Orthodontist contact form on the Public Website or by emailing their contact information to mfcwdental@pbas.ca.
How do I know when my benefit maximums have been reached?
You can view any remaining coverage under Benefit Balance in the MFCW Dental Plan Portal.
How do I sign up for Direct Deposit?
You can take advantage of direct deposit for your claim reimbursements once you have registered as a member on the MFCW Dental Plan Member Portal or website and have updated your profile. You will begin to receive reimbursements by direct deposit 2-3 business days after you submit your request.
To make this process simple, have a blank cheque or direct deposit form from your bank on hand when you register. These documents include all the information required to set up direct deposit. Your payments can be deposited into a chequing or savings account. If you have another kind of account, please call your financial institution to find out what accounts you can use for direct deposit. Alternatively, you can complete the Direct Deposit form on the Public Website and submit it to PBAS either electronically or by mail.
You can change your direct deposit at any time by updating your information under your profile. It can take up to 3-5 business days to process your request. Please take note of that when changing your bank account information. To remove your direct deposit information, please contact PBAS.
Before the payment has been deposited into your account, you will receive an email detailing the payment. This is called an Explanation of Benefits. With normal bank clearing procedures, your payment should be deposited within 2-3 business days.
How do I utilize Coordination of Benefits (COB)?
If you are eligible for coverage under your spouse’s benefit plan or an alternative plan, the primary benefit plan for you will be this Plan. You can coordinate this Plan with another benefit plan to receive maximum coverage.
In order to do this, you must:
Submit the claim to your primary benefit plan* Submit the unpaid portion to the secondary benefit plan*, including a copy of the Explanation of Benefit (EOB) and a copy of the original claim form. *If your spouse has their own benefit plan, then this Plan will be their secondary plan.
If your children are covered under both benefit plans, then please first submit your child’s claims to the plan of the parent whose birth month falls earliest in the year (regardless of year of birth). Once the claim is processed, any unpaid portion showing on the related Explanation of Benefits that accompanies the claim reimbursement is, then, submitted to the other parent’s benefit plan for processing.
Can I view my claims payments on the Plan Member Portal?
With the April 17, 2023 launch of the MFCW Dental Plan Member Portal, all claims paid from launch onwards will display daily so that you always have the most current information about your submitted claims. You will find Claim History information under the Claims section of the MFCW Dental Plan Member Portal.
You have the option to print or download the Explanation of Benefits (EOB) for any claim that you have submitted. This document details the claim information and reimbursement issued according to your Plan rules. This information is useful if you have to submit it to another insurance plan or for income tax purposes.
Can I submit feedback?
We welcome your feedback and encourage you to share your suggestions. Plan Participant feedback and suggestions will assist the Trustees and PBAS with the future development and customization of your Plan. Therefore, please take advantage of the Contact form in the MFCW Dental Plan Member Portal.
We look forward to hearing from you.
Can I submit feedback?
How does eligibility work for my Dental Benefits?
REQUIREMENT FOR SINGLE COVERAGE: an average of at least 12 hours of work per week in the last 12 consecutive weeks of employment. For example, hours worked in August, September and October are processed in November, for December’s eligibility.
REQUIREMENT FOR DEPENDANT COVERAGE: an average of at least 20 hours of work per week in the last 12 consecutive weeks of employment. For example, hours worked in August, September and October are processed in November, for December’s eligibility.
ON MATERNITY OR PARENTAL LEAVE, APPROVED LEAVE OF ABSENCE OR LAYOFF: eligibility can be maintained for up to 18 months by making self-payments of $45 per month.
AT RETIREMENT: if proof of retirement is submitted, eligibility is maintained for up to 12 months at no cost.
IF ILL OR INJURED: eligibility will continue for up to 24 months at no cost.
What is a Dependant?
DEPENDANT means your Spouse and Dependant Child or Children.
SPOUSE means a person who is legally married to you, and is living with you, or a person living with you in a common-law relationship if such person is publicly represented by you as your husband or wife and such person has been living with you for a period of at least:
(a) one continuous year if neither of you are married; or
(b) 3 continuous years if either of you remain legally married to another person.
If you do not list a common-law Spouse on your initial Registration Form, such person must subsequently be listed on the records of the Administrator, for at least 12 months prior to becoming eligible for benefits.
If you have more than one Spouse, the person last designated by you, and filed with the Administrator, in writing, will be considered to be your Spouse.
DEPENDANT CHILD OR CHILDREN means your unemployed, unmarried, natural or legally adopted child, stepchild, a child over whom you have legal guardianship, or the child of a common-law Spouse, who is:
(a) under 18 years of age; or
(b) 18 years of age or older but less than 25 years of age and is enrolled in and attending a full curriculum of education at a recognized school, college or university (proof of which must be provided annually); or
(c) 18 years of age or older and is not capable of self-sustaining employment by reason of mental or physical disability which commenced prior to the child’s 18th birthday,
provided you or your common-law Spouse contribute regularly to the support of such child.
A child of a common-law Spouse is considered to be a Dependant, after the child has lived with you for a minimum of 12 consecutive months.
Your common-law Spouse and the children of your common-law Spouse must be listed on this form. If not listed, or you enter into such a relationship after registering, they must be listed on the Administrator’s records for at least 12 months in order to be considered to be your Dependant.
If you need to add a Spouse or Dependant Child to the Plan after registering please contact the Administrator to assist you.
How does eligibility work for my Dental Benefits?
REQUIREMENT FOR SINGLE COVERAGE: an average of at least 12 hours of work per week in the last 12 consecutive weeks of employment. For example, hours worked in August, September and October are processed in November, for December’s eligibility.
REQUIREMENT FOR DEPENDANT COVERAGE: an average of at least 20 hours of work per week in the last 12 consecutive weeks of employment. For example, hours worked in August, September and October are processed in November, for December’s eligibility.
ON MATERNITY OR PARENTAL LEAVE, APPROVED LEAVE OF ABSENCE OR LAYOFF: eligibility can be maintained for up to 18 months by making self-payments of $45 per month.
AT RETIREMENT: if proof of retirement is submitted, eligibility is maintained for up to 12 months at no cost.
IF ILL OR INJURED: eligibility will continue for up to 24 months at no cost.
What is a Dependant?
DEPENDANT means your Spouse and Dependant Child or Children.
SPOUSE means a person who is legally married to you, and is living with you, or a person living with you in a common-law relationship if such person is publicly represented by you as your husband or wife and such person has been living with you for a period of at least:
- (a) one continuous year if neither of you are married; or
- (b) 3 continuous years if either of you remain legally married to another person.
If you do not list a common-law Spouse on your initial Registration Form, such person must subsequently be listed on the records of the Administrator, for at least 12 months prior to becoming eligible for benefits.
If you have more than one Spouse, the person last designated by you, and filed with the Administrator, in writing, will be considered to be your Spouse.
DEPENDANT CHILD OR CHILDREN means your unemployed, unmarried, natural or legally adopted child, stepchild, a child over whom you have legal guardianship, or the child of a common-law Spouse, who is:
- (a) under 18 years of age; or
- (b) 18 years of age or older but less than 25 years of age and is enrolled in and attending a full curriculum of education at a recognized school, college or university (proof of which must be provided annually); or
- (c) 18 years of age or older and is not capable of self-sustaining employment by reason of mental or physical disability which commenced prior to the child’s 18th birthday, provided you or your common-law Spouse contribute regularly to the support of such child.
A child of a common-law Spouse is considered to be a Dependant, after the child has lived with you for a minimum of 12 consecutive months. Your common-law Spouse and the children of your common-law Spouse must be listed on this form. If not listed, or you enter into such a relationship after registering, they must be listed on the Administrator’s records for at least 12 months in order to be considered to be your Dependant.
If you need to add a Spouse or Dependant Child to the Plan after registering please contact the Administrator to assist you. Provider Contact and Contact Us: Please ensure that they are going to mfcwdental@pbas.ca