| Download
Forms
This page provides downloadable forms for
your convenience in filing your benefits claims. To view and print
these forms you will need Acrobat Reader, available as a free
download from Adobe.
 Some
features of the new benefit claim forms:
• Once downloaded, you can complete it online
• Print button right on the form, sign it and attach
receipts
• Plan sponsor name and contract number have been added for you
• Insurance Company name has been added to the dental claim form for
ease in completion
• Direct deposit sign-up option right on the form, receive payments
up to 70% faster
Dental
Claim English
Dental Claim French
Part 2: Plan Member Information includes
Health Care Spending Account option if Eligible
| If you live outside
Quebec: 1-800-465-2071 |
Pour
les résidents du Québec
: 1-800-361-2833 |
| Manulife Financial Group
Benefits Dental Claims |
Assurance Collective
Financière Manuvie Règlements Frais Dentaires |
| P.O. Box 1654 |
C.P. 5000, Succ. B |
| Waterloo ON N2J
4W2 |
Montréal QC H3B
4B5 |
Health Claim English
Health Claim French
Part 1: Plan Member
Information includes
Health Care Spending Account option if Eligible
| If you live outside
Quebec: 1-800-465-2071 |
Pour
les résidents du Québec
: 1-800-361-2833 |
| Manulife Financial Group
Benefits Health Claims |
Assurance Collective
Financière Manuvie Règlements Maladie |
| P.O. Box 1653 |
C.P. Box 2580, Succ. B |
| Waterloo ON N2J
4W1 |
Montréal QC H3B
5C6 |
Health
& Welfare Plan Application English
Health &
Welfare Plan Application French
Emergency
Travel Assist English
Emergency Travel Assist French
|
