Get your Group Benefits forms

Below, you’ll find our most used Group Benefits forms organized by product. If the form you need does not appear below, you can find it by logging on to Benefits Now^®. Please download all the necessary forms to meet your needs and note that some forms are for the plan member, while others are for the plan sponsor or treating physician.

The forms on this page are for administrative and claims purposes, and in most cases will include instructions and the address to send them to.

How to use and submit forms

Save the forms to your computer. In some cases, you can fill them in directly before printing. Otherwise, print them out and complete them by hand before mailing to the address indicated on each form.

Administration forms

Direct Deposit Application - Health Care/Dental Payments

Direct Deposit Application - Disability Benefit Payments

Health Evidence Questionnaire

Optional Accidental Death and Dismemberment Insurance Application

Optional Critical Illness Insurance Application

Optional Group Life Insurance Application

Plan Member Enrolment Form

Smoking Status Declaration

Student Eligibility Form

Extended Health and Dental Claim forms

Extended Health Claim forms

Extended Health Claim Form

Drugs – Prior Authorization List of Drugs

View the list of drugs.

If you have been prescribed one of the listed drugs, have your prescribing physician complete the appropriate form and submit to The Co-operators. Any costs incurred for the completion of pre-authorization request forms are the responsibility of the patient/plan member.