Royal LePage and Corporate Benefit Consultants Ltd. have organized a forms library to assist you in applying for, administering and submitting claims for group insurance.
| Manulife Forms |
Description |
| Application for Change |
Submit this form for plan member name changes, beneficiary changes, requests to add/terminate benefits, and/or requests to add/terminate dependent coverage within 31 days of the change in coverage.
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| Extended Healthcare Claim Form |
Submit this form to claim the eligible extended health care benefits costs covered under your Manulife Financial Group Benefits plan. These may include drug and other medical expenses (e.g. medical supplies), equipment and appliances, vision care expenses, and practitioner expenses.
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| Dental Care Claim Form |
Most dentists provide plan members with a standard Canadian Dental Association (CDA) claim form. If the dentist does not provide a CDA form, use this form to claim the eligible dental care benefits costs covered under your plan.
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| Group Benefits Materials Re-Order Form |
Complete and mail or fax this form to Manulife Financial when re-ordering a supply of claim and/or administration forms.
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| Request for Over-Age Dependent Coverage |
Continued coverage for full-time students, beyond the age specified in your group benefits plan, can be requested by submitting this form to Manulife Financial Group Benefits. This form must be re-submitted by July 31st each year to confirm over-age student status coverage is continuing for the next school year. Coverage will then be extended up to August 31st of the next school year, the upper limit of the dependent definition age, or until coverage is terminated.Continued coverage for children with disabilities, beyond the age specified in your group benefits plan, can also be requested using this form.
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Evidence of Insurability
Manulife Financial |
As a plan member, you should complete this form when: |
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You are late applying for your coverage, and therefore are considered a Late Applicant |
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You re-apply for insurance on any person whose application for insurance had previously been declined.
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RCB Insurance FormsDescriptionLife & Accidental Death Claim FormUse this form to report the initial notice of claim for Group Life Insurance or Accidental Death
Long-term Disability Claim Form
Long Term Disability Claim Form
Evidence of Insurability
RBC Insurance
RBC Insurance’s Evidence of Insurability Form
Voluntary Life Benefit ApplicationSubmit this form to apply for Voluntary Life Benefits from RBC Insurance.
Request for Conversion InformationPlan members are able to continue all or part of their Group Life Insurance coverage when it reduces or terminates, by converting to an Individual Policy. Submit this request form to obtain full details of the conversion privilege as well as a premium quotation.
Request for Group Insurance Supplies
Use this form to order additional suppliesGroup Request for ChangeComplete this form for name changes, changes in dependant coverage or changes in beneficiaries.
Beneficiary Designation CardUse this form to designate the beneficiary of your group life insurance.
