ENROLMENT FORM PLEASE PRINT and complete each section clearly in ink. Certificate # Remit a signed original to RWAM and keep a copy for your records. Employee must meet all eligibility requirements.

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How to fill out the Enrolment Form - RWAM Insurance online

Filling out the Enrolment Form for RWAM Insurance is a straightforward process that ensures you receive the necessary coverage. This guide will provide you with detailed instructions on how to complete the form online, making the experience seamless and efficient.

Follow the steps to successfully complete the form online.

  1. Click ‘Get Form’ button to access the Enrolment Form for RWAM Insurance and open it in your chosen editor.
  2. Begin by providing your employer's data. Include the employer name, group number, date of permanent full-time hire, and job classification details. You will also need to specify whether this is a new enrolment or a reinstatement.
  3. In the Employee Statement section, enter your surname, first name, date of birth, and select your sex and marital status. Also, ensure to provide your contact address and email, as this is critical for online claims submissions.
  4. Indicate your coverage preference by selecting either single or family for Extended Health Care and Dental options. If applicable, provide your spouse’s employer and group insurance carrier information.
  5. List your eligible dependents by providing their names, dates of birth, and relationships to you. Remember to follow the guidelines regarding student dependents.
  6. Complete the Beneficiary Designation section to specify who will receive your group life insurance benefits in the event of your passing. Fill in necessary information regarding the beneficiaries and trustees if applicable.
  7. Review the Authorization section carefully and ensure that you understand the implications. Once confirmed, provide your signature and the date to finalize your consent.
  8. After completing the form, ensure all sections are filled accurately. You can now save your changes, download copies for your records, print the form, or share it as needed.

Complete your Enrolment Form for RWAM Insurance online today for a hassle-free benefits experience.

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What is the phone number for RWAM insurance?

Call Us 1-877-888-7926 or Email Us Our team is here to help.

Nav has invested heavily into its wealth management and group benefits capabilities, acquiring RWAM Insurance Administrators Inc and Programmed Insurance Brokers (PIB) Inc.

RWAM Insurance Administrators Inc. is one of Canada's largest Third Party Administrators of Group Insurance Benefits offering superior service with a personalized touch.

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