Forms & Resources
Enrolment/Administration
Find everything you need to manage your coverage.
- Application for Over-Age Disabled Dependent Coverage
- Application to Insure a Dependent who is Over Age 21
- Beneficiary Designation
- Email and Fax Authorization Request
- Employee Change Request
- Employee Statement of Dependent Health
- Employee Statement of Health
- Intent to Convert Accidental Death & Dismemberment Coverage
- Intent to Convert Group Life Insurance Coverage
- National Formulary
- Optional Life Insurance Application
Claims
Should you ever need to submit a claim, you’ll find your forms here.
- Dental Accident Claim
- Dental Claim
- Direct Deposit of Health & Dental Benefit Payments
- Employee Reimbursement Form for ASSURE Drug Claims
- Extended Health Claim
- Life / Accidental Death & Dismemberment Claim | * Please call (info below)
- Long Term Disability Claim | * Please call (info below)
- Short Term Disability Claim | * Please call (info below)
- Voyage Assistance
*Please contact the Service Centre for help submitting this type of claim. The information we need may vary so please contact a service representative so we can help speed the process for you.
Call 1-800-665-3365
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What's Covered?
Browse our Health and Dental Glossary to find out what’s covered under the Chambers Plan.
Read more“This plan allows us access to a variety of great employee benefits at costs that are reasonable for a small organization.”
Laura,
Saskatchewan