Forms at your fingertips
Save time by accessing our most frequently used forms, in a fillable format.
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.
Adobe Acrobat Reader version 5.0 or higher is required to view and print these forms.
Administrative forms |
G1053 |
Evidence of insurability |
G1223 |
Request for conversion of group life insurance |
G1285 |
Notice of change |
G2229 |
Confirmation of school attendance |
GE8000 |
Application form |
GE8001 |
Request for change (I) |
GE8002 |
Optional benefits |
GE8003 |
Request for change (II) |
GE8033 |
Address confirmation |
GE9874 |
Beneficiary designation |
PC GE10158 |
Participant authorization |
PC GE10352 |
Application for total and permanent disability status for a dependent child |
PC GE8289 |
Direct deposit |
PC GE8004 |
Refusal to join |
PC GB1306 |
Order form |
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Claim forms |
Health care |
GE10468 |
Medical and paramedical claim form |
GE9205 |
Drug card claim reimbursement form (Assure health) |
PC GE9183 |
Approval form – exception drugs |
Dental care |
GE8228 |
Dental claim form |
G2019 |
Dental claim – accidental injury |
Disability |
GE10342 |
Disability claim form |
G2277 |
Attending physician's supplementary statement |
Life |
G2007 |
Death claim |
GB959 |
Living Benefit claim |
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