Downloadable Forms

The following downloadable forms may be useful to you.
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PlanDirect Application
PlanDirect Rate Booklet
PlanDirect Brochure
PlanDirect Plan Comparision

Claims Form
Healthcare Expenses Statement
Dentalcare Claim Form
Out-of-Country Benefits Claim Form

Administrative Forms
Change of Beneficiary for Accidental Death Benefit
Appointment of Trustee

Please check to ensure that you have completed the following before forwarding your enrollment form to us:
Please include a personalized, blank cheque marked "VOID" to establish pre-authorized     payment.
Also enclose a cheque for your first two months' premium payable to 'PDAdmin Group'.
If you are applying for preferred or preferred plus rates, please provide us with the     following proof of prior insurance coverage:

• A letter from your previous employer stating the date your benefits terminated and detailing the type of benefits you were covered for
  
  OR
• A copy of your summary of benefits from the previous carrier and proof as to the last premium payments made or last billing invoice.
• Make certain that you and your spouse, if applicable, have both signed the authorization for pre-authorized payment, and have signed and dated the declaration and authorization sections on page 4.
• Please ensure that all sections of the medical and lifestyle Questionnaire have been completed for all applicants.

Your coverage will begin on the first of the month following the date that we receive your application and premium payment. A confirmation package will be mailed to you with your policy details, and any forms you may require.