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Spousal Declaration

Common Law Spouse Declaration

If you have listed a common law spouse as a dependent on your Health Benefit Plan Enrolment Card, you may be required to complete the Common Law Spouse Declaration form and submit with your enrolment card for your common law spouse to be eligible for Extended Health and Dental coverage.

Information Needed to Complete the Form
To complete the form, the following information is needed:

  • Member’s name and address,
  • Common law spouse’s name,
  • Address at which you are currently residing, and
  • Signature of a Notary Public or Commissioner for taking Affidavits.

A licensed Notary Public or Commissioner must sign the form before you send it to the Plan Administrator.

Completed forms should be forwarded to the Plan Administrator.

More Information
Questions on completing the form should be directed to the Plan Administrator.

Health Benefits

Health Benefits

Security against financial hardship accompanying sickness.

Protection against financial hardship that often accompanies sickness, accident or death is important to all of us. Your Plan is intended to bring greater peace of mind and an increased feeling of security to you and your family.

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Pension Plans

Pension Plans

Plans designed to provide income for life.

Walking along a tropical beach, hitting the links for 18 holes or just sitting under a shady tree with a cold drink – everyone’s idea of retirement is slightly different. Your group’s Pension Plan is an important part of being free to live out your dreams.

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Employers

Employers

We can help make sense of all your options.

We work with you to understand your needs and advise you of all the market has to offer. One size doesn’t fit all, so we propose customized solutions to each of our clients based on their unique needs and circumstances.

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Brokers

Brokers

We're in business to mind your business.

We pride ourselves on delivering exceptional service to our business partners. We survey the entire market so that you can be assured that the Plan we propose is the best that the market has to offer to your client.

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