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Document Category: Service forms

Group Benefit Solutions – Refusal of Coverage Form

Both the employer and employee must complete this form if the employee does not wish to enrol in short and/or long term disability coverage offered under their employer’s non-mandatory plan.

Forward the original form to:
RBC Life Insurance Company
Refer to grid.
Retain a copy for your records

Maternity/Parental Leave of Absence – Opting Out of coverage

Both the employer and employee must complete this form if the employee elects to discontinue his/her coverage’s offered under their employer’s mandatory plan while on Maternity/Parental leave of absence.

Forward a copy of this form to RBC Insurance Customer Service, Refer to grid.
Retain the original form for your records.

Life Conversion Application – Group Benefit Solutions

If an employee has recently been terminated or their life coverage was reduced, they may be eligible to apply for conversion and become insured under the Group Life Conversion Policy. Learn about its benefits and how to apply.

Forward this form to RBC Life Insurance Company
Attn: Group Billing Support
PO Box 1840
Mississauga ON L4Y 4H0

Group LTD Conversion Facts

If your plan has a conversion option and an employee who has been covered for long term disability benefits under a group long term disability plan for at least 12 months, has recently terminated employment, that employee may be eligible to apply for conversion and become insured under the Group LTD Conversion Policy. Learn about its benefits and how to apply.