Benefits Forms and Information

Dental Plan

• Dental Claim Form (pdf)
• Dental Booklet (pdf)
• Maximum Reimbursement Schedules
• Participating Employers, Group and Division Numbers (pdf)
• Great West Life Direct Deposit Authorization (pdf)
• Great-West Life Claim Inquiry (pdf)
• Benefit Plans Enrolment Form (print on on legal paper) (pdf)

Extended Health Care

• Pre-Authorized Payment Application Form (pdf)
• Retiree Enrolment Form (pdf)
• Extended Health Care Plan PS/GE SGEU Retiree Booklet (pdf)
• Extended Health Care Plan CUPE 600-3 Booklet (pdf)
• Extended Health Care Plan Booklet PS/SGEU and CUPE 600-3: Effective January 1, 2004 (pdf)
• Extended Health Care Claim Form (pdf)
• Co-ordination of Benefits (pdf)
• Extended Health Care Plan Information Update (pdf)
• Employee Communications for Retirees (January 1, 2006 - December 31, 2007)
  • In-Scope CUPE 600-3 (pdf)
  • In-Scope SGEU (pdf)

Extended Health Care Plan for Certain Other Employees

• Pre-Authorized Payment Application Form (pdf)
• Retiree Enrolment Form (pdf)
• Retiree Claim Form (pdf)
• Extended Health Care Plan PS/GE SGEU Retiree Booklet (pdf)
• Extended Health Care Plan Booklet (Management) Employees: Effective January 1, 2004 (pdf)
• Extended Health Care Claim Form (pdf)
• Benefits Plan Enrolment Form (print on legal paper) (pdf)
• Extended Health Care Plan Information Update (pdf)

Group Life Insurance Plan

• Group Life Booklet (pdf)
• Participating employers (pdf)
• Non-smoking Health Declaration Form (pdf)
• Benefits Plan Enrolment Form (print on legal paper) (pdf)
• Optional Group Life Insurance Application Form (pdf)
• Statutory Declaration by Disinterested Third Party (pdf)
• Statutory Declaration by Employee (pdf)
• Retirement Death Benefit Certificate Checklist (pdf) *

Deferred Salary Leave Plan

• Application Form (print on legal paper)(pdf)
• Deferred Salary Leave Plan Booklet (pdf)
• Participating Employers
• Benefit Plan Enrolment Form (print on legal paper) (pdf)

Disability Income Plan

• Disability Income Plan Booklet (pdf)
• Disbility Income Plan for Certain Public Employees in Province of Saskatchewan (pdf)
• Participating Employers (pdf)
• Benefit Plan Enrolment Form (print on legal paper) (pdf)