Get Enrolment Or Change Form - Green Shield Canada - Greenshield
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How to use or fill out the ENROLMENT OR CHANGE FORM - Green Shield Canada - Greenshield online
Filling out the ENROLMENT OR CHANGE FORM for Green Shield Canada can be a straightforward process if you understand the components and requirements. This guide provides step-by-step instructions to help you accurately complete the form for enrolling or changing a plan member's information.
Follow the steps to complete the form online.
- Press the ‘Get Form’ button to access the ENROLMENT OR CHANGE FORM and open it in your preferred editor.
- In Section 1, plan administrators must complete details about the plan sponsor. Fill in the name of the plan sponsor and the contract reference code. Indicate the type of request by checking the appropriate box and providing the effective date along with the Green Shield Canada ID number if applicable.
- In Section 2, plan members need to enter their personal information. This includes their surname, first name, middle initial, address, preferred first name, date of birth, gender, city, province, postal code, date of hire, email address, and employment status. Make sure to fill these fields clearly.
- Complete the coordination of benefits section, where you indicate coverage with Green Shield Canada. Check boxes to confirm if you want health or dental coverage and provide your spouse’s insurance carrier information if relevant, including the plan or contract number.
- In the dependent information section, enter details for each dependent, including their full name, date of birth, and whether they are a full-time student or a disabled dependent. Make sure to indicate which dependent is secondary with Green Shield Canada using 'S' next to their information.
- Review all filled sections to ensure that the information is complete and accurate. The plan member and plan administrator must both sign and date the form to authenticate the information provided.
- Once finished, save changes to your document. You can also download, print, or share the form as needed.
Complete your ENROLMENT OR CHANGE FORM online to ensure a smooth benefits experience.
GSC was founded in 1957 with a mission to help Canadians get access to the health care they needed. Today, we continue this mission as a social enterprise, committed to making it easier for people to live their healthiest lives. Get to know us. Making a difference in the places we live and work.
Fill ENROLMENT OR CHANGE FORM - Green Shield Canada - Greenshield
Please complete this form to enrol a new plan member for benefits. OR to update an existing plan member's information. PPEB will need to review 'proof of eligibility' prior to adding new dependants as follows: Spouse- Marriage certificate or Service Canada. GreenShield offers a new model of care that combines insurance benefits with health providers to simplify your health journey. Green Shield Canada Forms. Administrative Forms: Insurer Form Page Enrolment Form Statement of Health. We're happy to announce that new members can now self enrol in their benefits plan at their own convenience, any time, anywhere no paper form required. Please print or type information. No information is available for this page. Simply find and download the form you need.
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