All of the forms required to make an application to the Health Care Providers group benefits program are available from the table below. It is not necessary for every applicant to complete all of the forms. Please refer to each form’s description to determine if your application requires that form.
No problem. You’ll find the C1 Change Form in the table below. Complete this form online and send it in to us and we’ll be happy to make your changes.
All claims are processed by Green Shield Canada and should be sent directly to their offices.Claim forms can be found here: Claim forms for do-it-yourself claim submission
All claim and claim form inquiries should be directed to Green Shield Canada directly by calling 1-888-711-1119.
Please remember to send TWO cheques in with your application. For a brief explanation of the TWO cheques click here.
If you have any questions at all please contact us: 1-866-768-1477
Statement of Health Form
Any applicant wishing to be considered for a LEVEL of Health Care coverage which would be an increase to the coverage he or she may be guaranteed to receive, must complete this form.
Employees Group Health Form
Any applicant to whom ONE OR MORE of the following applies
Worksheet /Request for Optional Life and Long Term Disability Coverage
Any applicant who chooses to apply for Optional Life insurance and/or Excess Long Term Disability coverage must complete this worksheet.