Use this form to enrol your employees and their dependents in your company’s group benefits plan. An employee becomes eligible for benefits coverage in accordance with the eligibility requirements and the waiting period(s) outlined in your group policies. To be eligible, an employee must be in an eligible class, work a minimum hours per week, have completed the waiting period (if applicable), be “actively at work” on the eligibility date.

If an employee enrols in the benefits plan later than 31 days ofbecoming eligible, he/she will be treated as a Late Applicant. An employee who is considered a Late Applicant must provide satisfactory medical evidence of insurability to the Insurer and be formally approved prior to becoming eligible for coverage. Some limitations/restrictions may apply as per your group policy.

Use the Change Form to report to Johnstone’s work changes, including:

  • change of salary
  • change of position
  • transfer between classes and/or divisions
  • leave of absence for more than 31 days
  • disability
  • termination of employment, including retirement

And changes due to life events, including:

  • addition of spouse and/or dependent child(ren) due to marriage, including common-law, or birth of a child
  • deletion of spouse and/or dependent child(ren) due to legal separation, or divorce
  • death of employee, spouse or dependent child
  • dependent child becoming overage as per your policy
  • spouse gains benefits coverage, or spouse loses benefits coverage
  • home address change

Additional Life Insurance coverage is available for employee and their spouse, to supplement the amount of insurance provided under the Basic Life insurance plan. Use this form to apply for Optional Life Insurance.

Employees may wish to add an additional layer of protection to the group benefits package with optional accidental death & dismemberment (AD&D) coverage. Use this form to apply for optional group AD&D insurance.

Use this form whenever evidence of insurability is requested by your group insurance carrier.

Clients are welcome to set up premium and other payments payable to Johnstone’s directly from their financial institution by completing this form.

Tips for
Administrator Forms

Click on the type of form title to expand the section.

Then, select the appropriate form to link to the actual electronic form or the forms directory on the insurer’s website.

Each form will have specific instructions on how to complete the claim form.

Contact Johnstone’s Benefits if you require further information or guidance, if you are unable to access the required form, or if the desired form is not listed.