5060 Tecumseh Rd. E.
Suite # 326
Windsor, ON N8T 1C1
Phone: 519-252-0303
Fax: 519-974-9078

Forms
 

Enrolment / Administration

Application to Insure Dependent Over Age 21	English | Français
Employee Application	English | Français
Employee Change Request	English | Français
Firm Benefit Change	English | Français
Group Benefit Plan Waiver	English | Français
Group Life Insurance Conversion Waiver	English | Français
Intent to Convert Group Life Insurance	English | Français
my-benefits Enrollment	English | Français
Pre-Authorized Payment	English | Français
Salary Change Request	English | Français
Statement of Health	English | Français
Statement of Income Worksheet	English | Français

Claims

Cost Plus	English | Français
Dental	English | Français
Dental Accident	English | Français
Direct Deposit Authorization	English | Français
Health	English | Français
Life / Accidental Death & Dismemberment	*Please Call  1-800-665-3365
Disability	*Please Call  1-800-665-3365
Out-of-Country Emergency Medical	English | Français
Short Term Disability	*Please Call  1-800-665-3365
Vision	English | Français
Voyage Assistance	English | Français

*Please contact the Service Centre for help submitting this type of claim. The information we need may vary so please contact a service representative so we can help speed the process for you.  Call 1-800-665-3365