700-4730 Kingsway, Burnaby, B.C., V5H 0C6
Mon - Fri : 09:00 - 4:30

Forms & Resouces

Access forms for the day-to-day administration of your plan, such as Employee Enrolment and Employee Change forms. Forms are PDF-fillable, and many can be digitally signed saving you from having to print and hard-sign the completed form. We do not require the hard copy of completed forms; simply email them to us.

Annual Student Declaration for 2020/21 school year.

If you have a child on your plan who is age 21 or more and a full-time student, use this form to continue coverage through to August 31, 2020 (or when they reach the plan's maximum age if earlier).

Click here to download the form.

Employee Enrolment

Use this form to enrol a new employee to your plan.

Click here to download the form.

Employee Change Form

Use this form to update a covered employee’s information. Examples: Add new family members, change names, update salary, terminate coverage, etc.

Click here to download the form.

Decline or Apply EHC and/or Dental

Use this form:

      • If you were enrolled for EHC and/or Dental, and now want to decline coverage because you’ve acquired coverage through another (e.g. spouse’s) plan
      • If you declined coverage for EHC and/or Dental, and now want to enroll because your other coverage terminated

Click here to download the form.

Beneficiary Designation

Use this form:

      • To designate your beneficiaries for Basic Life/Accidental Death, and/or Optional Life/Optional Accidental Death insurance
      • At time of initial enrolment if you want to designate more than 3 primary beneficiaries
      • To change your existing beneficiary(ies). The beneficiary(ies) listed here will replace your previous beneficiary designation

Click here to download the form.

Student Declaration Form

To continue coverage on your Extended Health and/or Dental plan beyond age 21 and up to the maximum age on your plan, your child must be:

      • Unmarried / not living in a common-law relationship, and-Attending school on a full-time basis, as defined by Canada Revenue Agency, or-Disabled and incapable of sustaining employment – Contact us for instructions.

If your child is about to turn or has recently turned 21, is not married or living in a common-law relationship, and is a full-time student, please complete this Declaration (one per child) and return to us to continue coverage on your plan.

Click here to download the form.

Confirmation of PharmaCare Registration

Complete this form to provide confirmation that you are registered for BC Fair PharmaCare.  

Click here to download the form.

Definitions

A benefit in a life insurance policy providing for the payment of an additional amount equal to the face amount of the policy in case of death by accident.

A form of health insurance that provides payment in the event of death or loss of one or more bodily members (such as hands or feet) or the sight of one or both eyes as a result of an accident.

An arrangement under which an insurance carrier or an independent organization will, for a fee, administer a health benefit plan and settle claims but not guarantee payments because the plan is uninsured.

A yearly study of a company’s coverage and claims history. This is completed to ensure that the plan is functioning efficiently.

A statement of information made by a person applying for insurance. It identifies the plan and the amount applied for, the life insured and the beneficiary, and provides other data useful in evaluating the risk.

In the context of health or dental claims, an arrangement for the employee to assign reimbursement payments to another. For example, a patient can assign payment to the dentist so that the dentist can bill the insurer directly and the patient does not have to pay the dentist up front.

Insurance plans designed for members of a professional association or trade association. Members may be protected under a group policy or by individual franchise policies.

The person who is to receive the insurance proceeds at the death of the insured.

A demand to the insurer by the insured person for the payment of benefits under a policy.

A provision in a health insurance contract by which the insurer and insured share, in a specific ratio, the covered expenses under a policy. For example, the insurer may reimburse the insured for 80 per cent of covered expenses, the insured paying the remaining 20 per cent of such expenses.

Specified hospital, medical and miscellaneous health care expenses that will be considered in the calculation of benefits due under a health insurance policy.

A living benefit product that provides a lump-sum cash payment on the first diagnosis of one of several contractually specified critical illnesses or events.

The amount of covered expenses that must be incurred and paid by the insured before benefits become payable by the insurer.

Life insurance for an employee’s spouse or children.

A physical or mental condition that makes an insured person incapable of performing one or more duties of his or her occupation.

A benefit added to some life insurance policies providing for waiver of premium and sometimes payment of a monthly income, if the insured becomes totally and permanently disabled.

A benefit that provides confidential counselling or resources to employees and their family members.

The waiting period an employee must be disabled before disability benefits become payable.

A medical questionnaire an employee must complete to disclose medical history.

A form of health insurance that provides, in one policy, protection for hospital and medical expenses not covered by government programs and usually other health care expenses, such as prescribed drugs, medical appliances, ambulance, private duty nursing, etc.. The policy may contain a deductible amount, coinsurance and high maximum benefits. Also called extended health benefits (EHB).

A benefit plan developed for an employer that could include coverage for life, disability, extended medical and prescription drugs , dental, and critical illness.

A benefit that covers an employee’s health care expenses. Claims are made against this account to pay for health and dental expenses that are not covered under the terms of the regular benefit plan.

Insurance purchased on an individual basis, covering only one person or, in some cases, members of his or her family as well.

A type of benefits plan that looks after injured or sick employees by continuing to pay a portion of their regular income while they are unable to work.

A business that sells insurance, known more commonly as an insurance company.

The party to the insurance contract who promises to pay losses or benefits. Also, any corporation licensed to furnish insurance to the public.

Insurance providing for the payment of benefits upon the death, whether by accident or otherwise, of the life insured.

A benefit plan that provides income replacement to an employee who has become totally disabled due to illness or injury.

The provincial health plan for British Columbia.

Additional life insurance that may be offered by the employer.

The daily management and implementation of a benefits plan. This might include handling claims, adjusting coverage, adding and removing employees, or any number of other procedures.

The employer, association, or union which holds the group insurance contract.

The legal document issued by the insurer to the policyholder that outlines the conditions and terms of the insurance.

The person who owns an insurance policy. Also called the "insured".

The payment, or one of the periodic payments, a policyholder is required to make for an insurance policy.

A benefit plan that pays an employee an income while he or she is unable to work due to non-work related illness or injury.

A benefits plan that only addresses one area of coverage. A dental plan is an example of a specific plan.

Employer-provided non-cash compensation that is subject to income tax.

A company other than an insurance company who manages businesses’ benefit plans. ICBA Benefit Services Ltd. is a TPA.

Insurance designed to pay for certain unexpected costs that may arise when you are travelling, such as emergency hospital/medical costs, trip cancellation, lost baggage and accidental death insurance.

The process by which an insurer determines whether or not, and on what basis, it will accept an application for insurance.