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Group insurance - Forms
Procedure for dynamic forms (PDF)
To fill out a form on the computer
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To fill out a form on a mobile device |
How to submit your documents
(see here the complete procedure to obtain your access)
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Forms and claims
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Trip Cancellation/Trip Interruption Insurance Claim (Dynamic PDF)
(PDF [395.92 KB]) -
Direct Deposit (Complete the online form available via your secured online services access)
(PDF [500.72 KB]) -
Change Request | Employee (Dynamic PDF)
(PDF [317.28 KB]) -
Disability Benefits Claim (Dynamic PDF)
(PDF [286.17 KB]) -
Physician’s Disability Form / Initial Demand (Dynamic PDF)
(PDF [772.90 KB]) -
Physician’s Disability Form / Additional report (Dynamic PDF)
(PDF [513.61 KB]) -
Medical and Paramedical Fees Claim (Complete the online form available via your secured online services access)
(PDF [206.53 KB]) -
Prior Authorization Request Exception prescription drug
(PDF [204.14 KB]) -
Dental Benefits Claims and Dental Treatment Plans (Dynamic PDF)
(PDF [240.84 KB]) -
Beneficiary Designation (Dynamic PDF)
(PDF [181.50 KB]) -
Beneficiary Change (Dynamic PDF)
(PDF [271.34 KB]) -
Death Claim (Dynamic PDF)
(PDF [209.01 KB])
Tools and Resources
Forms
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Insurability Declaration (Dynamic PDF)
(PDF [470.35 KB]) -
Declaration of insurability for dependents
(PDF [284.51 KB]) -
Group Insurance Subscription (Dynamic PDF)
(PDF [441.43 KB]) -
Exemption Requests (Dynamic PDF)
(PDF [271.24 KB]) -
Change Requests
(PDF [238.32 KB]) -
Online Services Subscription (for Administrators) (Dynamic PDF)
(PDF [274.28 KB]) -
Claims Administration (Dynamic PDF)
(PDF [178.91 KB]) -
Request for Automatic Direct Debits of Premiums (Dynamic PDF)
(PDF [325.67 KB]) -
Notice of return to work (Dynamic PDF)
(PDF [346.76 KB]) -
Disability Benefits Claim (Dynamic PDF)
(PDF [213.62 KB]) -
Death Benefits Claim (Dynamic PDF)
(PDF [302.72 KB])