Access the most commonly used plan administrator forms by clicking on the form title to view, download, or print.

Forms

  • Plan member application form
  • Plan member change form
  • Over age dependant form
  • Beneficiary change form
  • Optional life insurance form
  • Salary change request form
  • Benefits continuance for maternity/parental leave form
  • Access to online administration system form
  • Pre-authorized debit agreement

Claims forms

  • Health claim form
  • Dental claim form
  • Wellness - claim form
  • HCSA - Health Care Spending Account claim form