Below are links to commonly used Chambers of Commerce Insurance Plan forms.

Administrative Forms

Employee Application

Employee Change Request

Employee Statement of Health and Dependents Health

Firm Benefit Change Form

Claim Forms

Extended Health Claim Form

The Great West Life Assurance Company

Administrative Forms

Brochure of available coverage

Employee Application

Employee Change Request

Employee Statement of Health

Pre-Authorized Payment Form

Direct Deposit Brochure and Form

GroupNet Sign-up Information for Employees

Claim Forms

Healthcare Claim Form

Sun Life Financial

Administrative Forms

Employee Application

Health Questionnaire

Claim Forms

Extended Health Care Claim Form

The Empire Life Insurance Company

Administrative Forms

Employee Application

Employee Statement of Health

Change/Request Form

Manulife Financial

Administrative Forms

Employee Application

Employee Statement of Health

Health Services Navigator Application

Claims Forms

Extended Health Care Claim Form

For all Life and Disability claims, please contact our office.