Forms at your fingertips

Save time by accessing our most frequently used forms.

Select the form you need and complete all necessary fields on-screen. Once complete, simply print the filled form and send it to the appropriate claims and administration office.

To order hard copies of any of these forms, please complete and return the Order form PC GB1306 PDF (138Kb).

G1053 PDF (245Kb) Evidence of insurability
G1223 PDF (113Kb) Request for conversion of group life insurance
G1285 PDF (128Kb) Notice of change
G2229 PDF (82Kb) Confirmation of school attendance
GE8000 PDF (182Kb) Application form
GE8001 PDF (190Kb) Request for change (I)
GE8002 PDF (104Kb) Optional benefits
GE8003 PDF (55Kb) Request for change (II)
GE8033 PDF (42Kb) Address confirmation
GE9874 PDF (51Kb) Beneficiary designation
PC GE10158 PDF (43Kb) Participant authorization
PC GE10352 PDF (66Kb) Application for total and permanent disability status for a dependent child
PC GE8289 PDF (58Kb) Direct deposit
PC GE8004 PDF (57Kb) Refusal to join
PC GB1306 PDF (138Kb) Order form
Health care  
GE10468 PDF (224Kb) Medical and paramedical claim form
GE9205 PDF (79Kb) Drug card claim reimbursement form (Assure health)
PC GE9183 PDF (131Kb) Approval form – exception drugs
Dental care  
GE8228 PDF (196Kb) Dental claim form
G2019 PDF (150Kb) Dental claim – accidental injury
Disability  
GE10342 PDF (614Kb) Disability claim form
G2277 PDF (99Kb) Attending physician's supplementary statement
Life  
G2007 PDF (151Kb) Death claim
GB959 PDF (132Kb) Living Benefit claim