Forms for Plan Members and Administrators
Here are our most used forms. If there’s something you need that you don’t see listed below, contact your Client Services Center.
Plan Member Forms
Health & Dental Claims
- Green Shield Canada Dental Claim Form
- Green Shield Canada Extended Health Claim Form
- Green Shield Canada Health Spending Account Claim Form
- Pacific Blue Cross Dental Claim Form
- Pacific Blue Cross Extended Health Care Standard Claim Form
- Pacific Blue Cross Medi-Assist Brochure
- Pacific Blue Cross Out-of-Province Claim Form
Life/AD&D/Disability Claims
Contact: [email protected]
Administrator Forms
Enrolment and Administration Forms
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- Electronic Administration System (EAS) Access Form
- Group Insurance Change Form
- Group Enrolment Form
- Preauthorized Payment Agreement Form
- Blue Cross Life Statement of Health – contact: [email protected]