Carrier Forms

Benecaid

https://www.benecaid.com/claim.html

Manulife

http://groupbenefits.manulife.com/canada/GB_v2.nsf/Public/gb_mondial_cuba_intro
http://groupbenefits.manulife.com/canada/GB_v2.nsf/Public/pm_forms

Empire Life

http://www.empire.ca/consumer/en/group/planmember/formslibrary.html
Empire Life Cuba Out of Country

DesJardin

http://www.desjardinslifeinsurance.com/en/group-plans/Pages/group-plans.aspx?Navigation=nv_menu#

Equitable Life

http://www1.equitable.ca/en/products/group/forms.asp
http://www.equitablehealth.ca

For Out of Country Form email group-health-claims@equitable.ca or call 1-800-265-4556

MDM Insurance Services

https://secure.mdm-insurance.com/clients/Clients.cs

Great-West Life

http://www.greatwestlife.com/001/Client_Services/Group_Plan_Members/Forms/S7_001136

For Out of Country Form call 1-800-957-9777 and they will assist you

BBD

http://www.benefitsbydesign.ca/planadministrator-forms.html
http://www.greenshield.ca/English/PlanMembers/Forms/
Cuban Travel Requirements - Greenshield

Sirius

http://www.siriusbenefits.ca/news/cuba.pdf
http://www.siriusbenefits.ca/forms/index.htm

ClaimSecure

http://www.claimsecure.com/en/forms_member.asp

Sun Life

http://www.sunlife.ca/canada/v/index.jsp?vgnextoid=602604d2024ad010vgnprod1000067c7d09fRCRD&vgnLocale=en_CA

RWAM -EHC and Dental Claim Forms

http://www.rwam.com/files/forms/RC001_EHCClaim.pdf
http://www.rwam.com/files/forms/RC004_DentalClaim.pdf
http://www.rwam.com/files/forms/RA077_ChangeinStatus.pdf

Cuba-specific Information

The insured will need to refer to their Group Benefits Booklet, call their Plan Admin, or contact RWAM to confirm which Travel Assist Brochure is applicable.

http://www.rwam.com/files/news/RBI019_CubaOOCTravelInsRequirements.pdf(this one explains the Cuba travel documentation requirements)
http://www.rwam.com/files/news/Cuba_Confirmation_of_Recognized_Company_Mondial_Assistance.pdf
http://www.rwam.com/files/forms/TravelAssistBrochure_RA092_Referral.pdf
http://www.rwam.com/files/forms/TravelAssistBrochure_RA093_NonReferral.pdf


Please read the following update regarding travel to Cuba.