Group insurance adjustments forms

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• Group insurance adjustments (under 75 employees) – M266(SEL)  | PDF 110 kb

  Use this form to record group insurance adjustments such as termination, earnings change, new plan member etc.

• Group insurance adjustments (over 75 employees) – M5726  | PDF 84 kb

  Use this form to record group insurance adjustments such as termination, earnings change, new plan member etc.

• Workplace benefits plan adjustments form - Montreal - M5733  | PDF 80 kb

  Use this form to record group insurance adjustments such as termination, earnings change, new plan member etc.

• Workplace benefits plan adjustments form - Regina - M5726(Regina)  | PDF 88 kb

  Use this form to record group insurance adjustments such as termination, earnings change, new plan member etc.