Benefit Forms & Documents.

The following information on the group benefits was created to provide information about your benefit plans.  

They are not legal documents.  In the event of a question or dispute, the terms, and entitlements of the plan

documents will prevail.  Click on Link or copy and paste to read:

DENTAL CARE PLAN.

1. Application for Coverage – Dental Care Plan 51057

2. Claim Form Dental Care Plan 51057

3. Dependent Information

 

HEALTH CARE PLAN/ VISION & HEARING.

1. Extended Health Care/Prescription Drug Plan (51391) Vision & Hearing Care Plan (51392)

    Claim Form (51391& 51392)

2. Extended Health Care Plan.

   Claim form Extended Health Care Plan (51390)

3. Covered Drug List/ Exception Form.

      Covered Drug and Exception Form.

4. Dependent Information.

 

LIFE INSURANCE 

1. Basic Life Insurance Plan

2. Canada Post Death Benefits Age 65 and Up

3. Short Term Disability Kit

LEAVE REQUEST

1. High Risk Application Form

2. Leave Request Form

3. Request for Unpaid Leave

 

CUPW PROVIDED BASIC LIFE INSURANCE.

http://www.coughlin.ca/CUPW/app_e.html

1. Application for Free Basic Coverage

2. Pre-Authorised Payment Forms

3. Change of Beneficiary

4. Benefit Change Form

5. Non Smoking Form