Human Resources - Employee Benefits

Employee Benefits Forms

Benefits Forms

• Benefits Change Forms
• Benefits Claim Forms

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Claim Forms

The following claim forms are submitted directly to Manitoba Blue Cross:

• Ambulance/Medical Transfer Service Claim Form
• Dental Claim Form
• Extended Health Benefits Claim Form
• Group Travel Health Plan Claim Form
• Health Spending Account Claim Form
  
• Vision Care Claim Form

The following claim form is submitted to Human Resources:

• 2013 Wellness & Sustainability Claim Form

2013 Claim Deadline: Friday, December 6, 2013.*
Claim forms must be received by Human Resources on or before this date.

• Reimbursement is added to your bi-weekly pay and direct deposited into your bank account.  It will appear on your pay stub under Earnings as WELL TXB.

• *Due to the taxable nature of the program, current year claims must be submitted for reimbursement in time to be processed for the final pay of the year.

• If you are claiming a Duckworth Centre membership paid through payroll deductions, do not submit the claim form until the total amount of deductions have reached the claim amount.

• Information regarding Wellness & Sustainability claim items:

• Tax Credit for Public Transit Passes
• Summary of Carbon Offsets
• Types of Carbon Offsets

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Change Forms

Do you need to change your beneficiary designation? add or remove a dependent? add a trustee? change your address?

Please submit all change forms to Human Resources. 

• Change of Address

• Health Plans Change Form (for Manitoba Blue Cross benefits)
  

• Life Insurance Beneficiary Change Form
  

For pension change, ensure correct form below is completed: DC or DB (if unsure, contact Human Resources)

• DC Pension/RRSP Change of Records Form 
  
• DC Pension/RRSP Appointment of Trustee Form

• DB Pension Beneficiary Change Form 

• Pension Death Benefit Spousal Waiver Form