Group Benefit Plan Forms & Publications
| Group Plan Common Claim & Other Forms | |
| Claim Forms | |
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Health Benefits Claim Form For health claims submitted by GMS Group Advantage® and Custom Quoted Group Benefit Plan members. This form can also be used to submit dental claims. |
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Group ASO Claim Form For health and dental claims submitted by Administrative Services Only (ASO) Plan members |
| Other Forms | |
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Pre-Authorized Debit Agreement Authorizes a monthly debit from your bank account to pay your premiums. This form can also be used to make changes to your Pre-Authorized Debit information. |
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Pre-Authorized Debit Cancellation Notice Cancels a monthly debit from your bank account. |
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Waiting Period Waiver Form Application to waive standard waiting period for group benefit coverage |
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Request for Information Form Request for the release of personal GMS information to you |
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Consent to Disclose Personal Information Form Authorization for the release of personal information by GMS |
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Student Verification Form Declaration of eligibility for student dependant status (annual requirement) |
| GMS Group Advantage® Forms & Publications | |
| Application Form | |
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GMS Group Advantage® Application Form |
| Brochures | |
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Group Benefit Plans Brochure Overview of GMS Group Advantage® and Insured Group Plans Effective April 1, 2009 |
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GMS Group Advantage® In Detail |
| Enrolment/Change Request Form | |
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GMS Group Advantage® Employee Enrolment/Change Form For enrolling employees into a GMS Group Advantage® plan and/or changing information for existing members Effective April 1, 2009 |
| Rate Card | |
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GMS Group Advantage® Rate Card Monthly premiums for all provinces Effective April 1, 2009 |
| Insured Group Benefit Forms & Publications | |
| Application Forms | |
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GMS Group Benefit Plans Application Form - Without Life Application for Custom Quoted Group Benefit insurance * For use with group plans which do not include Life & Disability Benefits |
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GMS Group Benefit Plans Application Form - CO Application for Custom Quoted Group Benefit insurance * Life & Disability Benefits provided by Co-operators Life |
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GMS Group Benefit Plans Application Form - WA Application for Custom Quoted Group Benefit insurance * Life & Disability Benefits provided by Wawanesa Life |
| Brochure | |
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Group Benefit Plans Brochure Overview of GMS Group Advantage®, Insured Group Benefit |
| Enrolment/Change Request Forms | |
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GMS Group Benefit Plans Employee Enrolment/Change Form - Without Life For enrolling employees into a GMS Group Benefit Plan and/or changing information for existing members * For use with group plans which do not include Life & Disability Benefits |
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GMS Group Benefit Plans Employee Enrolment/Change Form - CO For enrolling employees into a GMS Group Benefit Plan and/or changing information for existing members * Life & Disability Benefits provided by Co-operators Life |
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GMS Group Benefit Plans Employee Enrolment/Change Form - WA For enrolling employees into a GMS Group Benefit Plan and/or changing information for existing members * Life & Disability Benefits provided by Wawanesa Life |
| Other Forms | |
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Online Administration Account Registration Form Application to create an account to use the online plan administrator's tool |
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