Get Employee Enrolment Form

Filling out the Employee Enrolment Form online is a straightforward process that ensures your enrollment in the benefits program is completed accurately. This guide provides a step-by-step walkthrough of each section of the form to assist you in providing the necessary information efficiently.

Follow the steps to complete the Employee Enrolment Form online.

1. Press the ‘Get Form’ button to access the Employee Enrolment Form and open it in your preferred editor.
2. In Section 1, 'Administrator', fill in the relevant details including the company name and the effective date for the health spending account (HSA). Choose whether this is a new application or a re-instatement, and indicate the employer sponsored products if applicable.
3. Section 2 requires you to provide personal information. Input your first and last name, gender, date of birth, street address, city, province, postal code, telephone number, and email address. Ensure all information is accurate for effective communication.
4. In Section 3, 'Dependents', list any dependents who will be included in the HSA plan. Provide their names, date of birth, and relationship to you. Confirm documentation for over-age dependents if required.
5. Section 4 pertains to direct deposit for claims. You will need to provide banking information to ensure claims can be reimbursed directly. Include your financial institution's information and attach a voided cheque or similar proof.
6. Finally, Section 5 requires your signature and the date signed. Double-check all information provided, ensuring it is true to the best of your knowledge, and then sign the form.
7. Once the form is completed and signed, you can save your changes, download a copy for your records, and submit the form to the designated address or by fax as specified.

Complete your Employee Enrolment Form online today to ensure your benefits enrollment is processed promptly.