Forms

Group Benefits Enrolment Form (Extended Health and Dental) (PDF)
Complete this form to enroll in the benefits plan.
Group Change Form (Extended Health and Dental) (PDF)
Report changes, including addition or deletion of a family member, if you are enrolled under the group plan.
Over-Age Dependant Form (PDF)
Complete this form to enroll a dependant disabled child over the age of 21. (PDF)
60+ Health Plan Opt-In and Beneficiary Form (PDF)
Complete this form to enroll in the Benefits of Film 60+ Plan
Life Insurance – Beneficiary Designation Information and Form (PDF)
To add a beneficiary to your life insurance.

Healthcare Expenses Statement With Healthcare Spending Account M635D-HCSA-W (PDF)
Reimbursement of health care expenses, i.e. physio, massage therapy, chiropractor etc. (Active Group Number 58197, Retiree Group Number 58198)
Dentalcare Expenses Statement With Healthcare Spending Account M445D-HCSA-W (PDF)
Reimbursement of dental expenses. (Active Group Number 58197, Retiree Group Number 58198)
Statement of Claim - Out of Country Expenses Form (PDF)
Reimbursement of eligible out of country medical expenses (use for claims prior to June 1,2023 and all non-emergency claims).
Emergency Medical Claims (PDF)
CL Out of Country Claim process (to upload claims)

Allstate Application for Critical Illness. Printable Form | Download Fillable Form (The fillable form can be opened using a PDF reader – click to here and follow instructions to setup PDF reader on your system) (PDF)
Allstate-for claims starting from October 1, 2022.
How to submit a claim to Allstate (PDF)
Allstate Insurance Critical Illness FAQ (PDF)

Health Benefits Enrollment, Beneficiary and Change Forms