Forms

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Enrolment
Application: Supplemental Package
Admin, Enrolment
Appointment of Beneficiary(ies)
Change
Change Application: Early Retirees
Change
Change Application: Employees Actively at Work
Change
Change Application: Supplemental Package
Claim
Claim Form: Dental Care
Claim
Claim Form: Emergency Out-of-Country
Claim
Claim Form: Extended Health Care and Vision Care
Admin
Consent to Disclose Personal Information
Admin, Claim
Coordination of Benefits Information
Admin, Enrolment
Désignation de bénéficiaire(s)
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Ankylosing Spondylitis
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Chronic Hepatitis C
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Crohn's Disease/Colitis
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Multiple Sclerosis
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Psoriasis
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Psoriatic Arthritis
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Rheumatoid Arthritis
Enrolment
Late Applicant Medical Information: Supplemental Package
Admin, Enrolment
Oral Health Exception Request: Health Conditions
Admin, Enrolment
Oral Health Exception Request: Permanently Disabled Over-age Dependant
Admin, Claim
Prescription Drugs Request: Early Refill
Admin, Claim
Prescription Drugs Request: Greater Than 100 Day Supply