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.
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 *
Retirement Death Benefit Certificate for Change of Beneficiary for Retirees
Executive Government Employees
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
Election to Continue to Age 65 *
Election to Continue to Age 75 *
Group Life Enrolment *Salary-based
Group Life Enrolment *Unit-based