Benefit plan resources
MyCHOICE plan
- MyCHOICE Benefits Handbook (PDF, 725 KB)
- Benefit Partner Statutory Declaration (PDF, 55 KB)
- Enrolment/Change form (PDF, 471 KB)
- Premium Rates (PDF, 300 KB)
- Statutory Declaration (PDF, 124 KB)
1stchoice plan
- 1stchoice Benefits Handbook (PDF, 787 KB)
- Benefit Partner Statutory Declaration (PDF, 55 KB)
- Enrolment/Change form (PDF, 406 KB)
- Premium Rates (PDF, 355 KB)
- Statutory Declaration (PDF, 124 KB)
Group Life Insurance Plan
MyCHOICE plan
- Application and Declaration for Non-Smoker Rates (PDF, 278 KB)
- Application for Advance Payment of Group Life Insurance (PDF, 165 KB)
- Application for Conversion (for payroll use only)
- Application for Paid up Life Insurance (PDF, 537 KB) (for payroll use only)
- Attending Physician's Statement (PDF, 148 KB)
- Certificate of Attending Physician Dismemberment of Loss (PDF, 111 KB)
- Claim for Accidental Dismemberment or Loss (PDF, 101 KB)
- Designation of Beneficiary
- Evidence of Insurability (PDF, 503 KB)
- Group Life Claimant Statement (PDF, 68 KB)
- Group Life Plan Sponsor Statement (PDF, 66 KB)
1stchoice plan
- Application and Declaration for Non-Smoker Rate (PDF, 258 KB)
- Application for Advance Payment of Group Life Insurance (PDF, 165 KB)
- Application for Conversion (for payroll use only)
- Application for Paid up Life Insurance (PDF, 375 KB) (for payroll use only)
- Attending Physician's Statement (PDF, 148 KB)
- Certificate of Attending Physician Dismemberment of Loss (PDF, 145 KB)
- Claim for Accidental Dismemberment or Loss (PDF, 101 KB)
- Critical Illness Claimant’s Statement
- Critical Illness Confidential Physician’s Report
- Designation of Beneficiary
- Evidence of Insurability (PDF, 498 KB)
- Group Life Claimant Statement (PDF, 68 KB)
- Group Life Plan Sponsor Statement (PDF, 66 KB)
Dental Plan
MyCHOICE plan
- Alberta Blue Cross Dental Claim form (PDF, 221 KB)
1stchoice plan
- Alberta Blue Cross Dental Claim form (PDF, 221 KB)
Extended Medical Benefits Plan
MyCHOICE plan
- Alberta Blue Cross Health Services claim form (PDF, 159 KB)
1stchoice plan
- Alberta Blue Cross Health Services claim form (PDF, 159 KB)
- Alberta Blue Cross Emergency Out of Province / Country claim form (PDF, 903 KB)
Prescription Drug Plan
MyCHOICE plan
- Alberta Blue Cross Health Services claim form (PDF, 159 KB)
1stchoice plan
- Alberta Blue Cross Health Services claim form (PDF, 159 KB)
Long Term Disability Income Continuance (LTDI) Plan
MyCHOICE plan
- Long Term Disability Income Continuance Plan Handbook (PDF, 310 KB)
- Employee's Statement (DOC, 338 KB)
- Employer's Statement (DOC, 241 KB)
- Long Term Disability Income Continuance plan brochure (PDF, 540 KB)
- Long Term Disability (LTD) Contacts
- LTD Appeal Process: A hands-on guide and reference (PDF, 140 KB)
- Notice of Appeal (DOC, 115 KB)
1stchoice plan
- Long Term Disability Income Continuance Plan Handbook (PDF, 277 KB)
- Employee's Statement (DOC, 338 KB)
- Employer's Statement (DOC, 241 KB)
- Long Term Disability Income Continuance plan brochure (PDF, 496 KB)
- Long Term Disability (LTD) Contacts
- LTD Appeal Process: A hands-on guide and reference (PDF, 140 KB)
- Notice of Appeal (DOC, 115 KB)
Special Accidental Death and Dismemberment Insurance
- Appointment of Beneficiary form (PDF, 468 KB)
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