Plan Forms

Forms marked with an asterisk * You will need Adobe Acrobat Reader to view and complete any forms. These forms work best with Google Chrome or Firefox web browsers.

Benefits Email Authorization Form*
 

 Application for Accidental Dismemberment or Specific Loss * Part 1 - Claimant's Statement

 Application for Accidental Dismemberment or Specific Loss * Part 2 - Attending Physician's Statement

 Optional Group Life Insurance Application * Medical and Lifestyle Questionnaire

 Application for Non-smoker Rate *

 Statutory Declaration By Disinterested Third Party - used for deceased

 Statutory Declaration By Employee - used for deceased

 Statutory Declaration By Disinterested Third Party

 Statutory Declaration By Employee

 Coverage While on Leave of Absence or Layoff *

Executive Government Employees

 Designation of Beneficiary *

 Election to Continue to Age 65 *

 Election to Continue to Age 75 *

 Group Life Enrolment *Salary-based

 Group Life Enrolment *Unit-based

 Retirement Death Benefit Certificate Request *

 Retirement Death Benefit Certificate Checklist *Executive Government Retirees

All Other Employees

 Designation of Beneficiary *

 Election to Continue to Age 65 *

 Election to Continue to Age 75 *

 Group Life Enrolment *Salary-based

 Group Life Enrolment *Unit-based

 Retirement Death Benefit Certificate Request *

 Retirement Death Benefit Certificate Checklist *

Retirees

Designation of Beneficiary*

 Retirement Death Benefit Certificate for Change of Beneficiary for Retirees