Benefits forms and resources

Benefit plan resources

MyCHOICE plan

• MyCHOICE Benefits Handbook
• Benefit Partner Statutory Declaration
• Enrolment / Change form
• Premium Rates
• Statutory Declaration

1stchoice plan

• 1stchoice Benefits Handbook​
• Benefit Partner Statutory Declaration
• Enrolment / Change form​
• Premium Rates
• Statutory Declaration

Group Life Insurance Plan

MyCHOICE plan

• Application and Declaration for Non-Smoker Rates​​​
• Application for Advance Payment of Group Life Insurance
• Application for Conversion (for payroll use only)
• Application for Paid up Life Insurance (for payroll use only)
• Attending Physician's Statement
• Certificate of Attending Physician Dismemberment of Loss
• Claim for Accidental Dismemberment or Loss
• Designation of Beneficiary
• Evidence of Insurability
• Group Life Claimant Statement​
• Group Life Plan Sponsor Statement

1stchoice plan

• Application and Declaration for Non-Smoker Rate​​
• Application for Advance Payment of Group Life Insurance
• Application for Conversion (for payroll use only)
• Application for Paid up Life Insurance (for payroll use only)
• Attending Physician's Statement
• Certificate of Attending Physician Dismemberment of Loss
• Claim for Accidental Dismemberment or Loss
• Critical Illness Claimant’s Statement
• Critical Illness Confidential Physician’s Report
• Designation of Beneficiary
• Evidence of Insurability
• Group Life Claimant Statement
• Group Life Plan Sponsor Statement​

Dental Plan

MyCHOICE plan

• Alberta Blue Cross Dental Claim form​

1stchoice plan

• Alberta Blue Cross Dental Claim form 

Extended Medical Benefits Plan

MyCHOICE plan

• Alberta Blue Cross Health Services claim form

1stchoice plan

• Alberta Blue Cross Health Services claim form
• Alberta Blue Cross Emergency Out of Province / Country claim form

Prescription Drug Plan

MyCHOICE plan

• Alberta Blue Cross Health Services claim form

1stchoice plan

• Alberta Blue Cross Health Services claim form

Long Term Disability Income Continuance (LTDI) Plan

MyCHOICE plan

• Long Term Disability Income Continuance Plan Handbook
• Employee's Statement
• Employer's Statement
• Long Term Disability Income Continuance plan brochure
• Long Term Disability (LTD) Contacts
• LTD Appeal Process: A hands-on guide and reference
• Notice of Appeal

1stchoice plan

• Long Term Disability Income Continuance Plan Handbook
• Employee's Statement​
• Employer's Statement
• Long Term Disability Income Continuance plan brochure
• Long Term Disability (LTD) Contacts
• LTD Appeal Process: A hands-on guide and reference
• Notice of Appeal​

Special Accidental Death and Dismemberment Insurance

• Appointment of Beneficiary form