Claims Experience on Terminated Group Report

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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