Get your Group Benefits forms

Below, you’ll find all of our Group Benefits forms organized by product. When selecting the applicable forms for your needs, please ensure you’re downloading all of the necessary forms, noting that some may be for plan members, plan sponsors and treating physicians.

The forms on this page are for administrative and claims purposes, and in most cases, will include requisite instructions and corresponding mailing addresses.

How to use and submit forms

Save the forms to your computer. In some cases, you can fill them in directly before printing. Otherwise, print them out and complete them by hand before mailing to the address indicated on each form.

Administration forms

Extended Health and Dental Claim forms

Extended Health Claim forms

Drug - Prior Authorization forms

View the list of drugs and access the necessary forms.

If you have been prescribed one of the listed drugs, have your prescribing physician complete the appropriate form and submit to The Co-operators. Any costs incurred for the completion of pre-authorization request forms are the responsibility of the patient/plan member.

Dental Claim forms

Emergency Out of Country

Disability Claim forms

Early Intervention

Long Term Disabilty

Short Term Disability

Life and AD&D Claim forms

Life Claim forms

Living Assistance

AD&D Claim forms

Life Waiver of Premium

Critical Illness Claim forms

Physician's Statement

If you would like to order more forms, please use the following links: