Get Enrolment Form - Healthcareathome.ca

Filling out the Enrolment Form for HealthCareAtHome.ca is an essential step in securing your healthcare benefits. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to complete your enrolment form online.

1. Press the ‘Get Form’ button to access and open the Enrolment Form. Ensure that the form is displayed correctly in your viewing device.
2. Complete Section 1, which requires both plan administrator and plan member information. Print clearly and use ink. Fill out your plan number, sponsor details, employee number, member ID, eligible date of employment, and effective date of coverage by specifying the month, day, and year.
3. Provide your occupation, earnings (indicate the payment frequency), and your province of residence and employment. Fill in your name, date of birth, and mailing address, ensuring you include postal code.
4. Indicate whether you have a spouse or dependant children. Provide details of your dependants, including their names, dates of birth, and whether they are full-time students or functionally impaired. Make sure to list additional dependants if necessary.
5. In the Mandatory Healthcare Benefits section, select your coverage option (single, family, or waive). If waiving coverage, confirm that your spouse is enrolled in family health coverage.
6. Complete the Optional Benefits section as per your preference, including Optional Employee Life and Optional Spousal Life. Specify the amounts you wish to elect or decline.
7. Designate your beneficiaries for basic life and optional coverage. Be clear in detailing their names and percentage allocations.
8. If appointing a trustee for a minor or individual lacking legal capacity, fill out the appropriate details in the Trustee Appointment section.
9. Complete the Contingent Beneficiary Designation, if applicable, ensuring to provide relevant names and relationship information.
10. Review the Privacy section to understand how your information will be protected. Finally, read and complete the Authorization and Declaration section, signing and dating the form in ink.
11. Once all sections of the form are filled out and reviewed, save any changes made. You can then download, print, or share the completed form as necessary.

Begin filling out your enrolment form online today to ensure you receive your healthcare benefits.