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Forms - Active Plan

Access all essential forms for your Benefits of Film plan, including enrollment, claims, and updates—everything you need in one place.

Health Benefits Enrollment, Beneficiary & Change Forms

Over-Age Dependant Form

Complete this form to enroll a dependent disabled child over the age of 21.

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Group Change Form (Extended Health and Dental)

Use this form to report changes, including adding or removing a family member, if you enrolled in the group plan.

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Group Benefits Enrollment Form (Extended Health and Dental)

Fill out this form to enroll in the benefits plan.

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Life Insurance - Beneficiary Designation Information and Form

Use this form to designate or update your life insurance beneficiary.

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Extended Health & Dental

Healthcare Expenses Reimbursement

CL Out of Country Claim Process (to upload claims)

Upload your out-of-country medical claims directly through Canada Life’s secure online submission portal.

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Healthcare Expenses Reimbursement

Emergency Medical Claims

Submit claims for emergency medical expenses incurred while travelling outside Canada.

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Healthcare Expenses Reimbursement

Statement of Claim – Out of Country Expenses Form

Use this form to request reimbursement for eligible out-of-country medical expenses. (For claims prior to June 1, 2023, and all non-emergency claims.)

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Healthcare Expenses Reimbursement

Gender Affirmation Care & Procedure Application

Complete this form before your procedure to request coverage for gender affirmation care.

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Healthcare Expenses Reimbursement

Family Building Claim Form

Use this form to submit eligible expenses for fertility, surrogacy, and related family-building services.

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Healthcare Expenses Reimbursement

How to Submit Your Claim Online

A quick guide to help you submit your claim and required documents.

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Healthcare Expenses Reimbursement

Dentalcare Expenses Statement with HCSA M445D-HCSA-W

Submit claims for reimbursement of dental expenses (Active Group Number: 58197).

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Healthcare Expenses Reimbursement

Healthcare Expenses Statement with HCSA M635D-HCSA-W

Submit claims for reimbursement of health care expenses, including physiotherapy, massage therapy, chiropractic services, and more (Active Group Number: 58197)

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Short Term Disability

Disability and Illness Forms

Canada Life Disability Benefits Physician Statement

Have your physician complete the Canada Life Disability Benefits Physician Statement to provide the required medical information for your disability benefits application.

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Disability and Illness Forms

Canada Life Disability Benefits Employee Statement with Consent

When completing the form, please enter the following:
Employer name: IATSE 891 Employee Life and Health Trust
Group plan number: 58199

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Disability and Illness Forms

Disability Procedure Guide with Application Form link

Refer to this guide for the Short-term Disability procedure and access to application form links.

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Critical Illness

Allstate Insurance Critical Illness FAQ

Find answers to common questions about your Allstate Critical Illness Insurance coverage.

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Allstate Application for Critical Illness

Critical Illness Claim Form | Submit a claim for Critical Illness benefits. Use your “Union #” as the Certificate Number and “IATSE 891 ELHT” as the Employer Name when completing this form.

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How to submit a claim to Allstate

Follow the steps mentioned in the document to submit a claim to Allstate: online via myAllstate, by phone, or email.

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Drug Coverage

Prescription medication request form for brand name drug coverage

Request for Brand Name Drug Coverage

Complete this form to request coverage for a brand name medication when a generic version causes adverse reactions.

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