Cost Plus Claim Form

Special claims reimbursement form. Employer must complete form and return to RBC Insurance.

Forward original form along with payment to:
RBC Life Insurance Company
PO Box 1600
8677 Anchor Drive
Windsor, Ontario
N9A 0B3
Attention: Client Administration

Claims Experience on Terminated Group Report

Note: To open this PDF, you will need to copy the PDF link and paste it into the Open File dialogue box in Adobe.

Beneficiary Designation Form

Employees purchasing life insurance are required to provide RBC Insurance with a beneficiary designation card to keep on file with the insurance plan. This is only necessary if you have not completed a Group Enrollment Form. Employees must fill out and sign this card in order to appoint a trustee for a minor beneficiary.

Forward a copy of this form to RBC Insurance Customer Service, Refer to grid.

Retain the original form for your records.

Appointment of Administrator(s) under the Access Agreement for Plan Sponsor

Application for Accident Insurance Conversion
Employees complete this application in conjunction with the Group Accident Insurance Conversion Notice to exercise their Conversion Privilege under the Group AD&D Insurance Policy. It provides an opportunity for those persons leaving the Group, who are under the age of 70 years and a resident of Canada, to convert to an individual accident insurance policy.

Send complete form to:

RBC Life Insurance Company
PO Box 1800 Stn B
Mississauga, ON.
L4Y 3W6
(ID Customer Service)

Annual Allocation of Health and Wellness Spending Account