Enrollment Form(s) and documentation required to be completed:
| ALL New Enrollments: | Form #20 Pension & Disability Income Plan Enrollment Form (When an employee joins the Pension Plan, they are automatically enrolled in the Disability Income Plan (DIP), unless the Employer does not participate in this plan.) |
| Form #25 Pension Plan – Beneficiary Designation and Change Form | |
| PROOF OF AGE A copy of proof of age is required for ALL employees at the time of enrollment. Refer to the “Proof of Age” section for acceptable documents. | |
| Group Insurance Participants also complete: | Manitoba Blue Cross/MEBP – Individual Application for Group Insurance Plan |
| Manitoba Blue Cross/MEBP - Group Life Insurance Beneficiary Designation Form (this form is only to be completed should the employee wish to apply for Optional Life and have a different beneficiary designation than the one entered for their Basic Life coverage on the App form above. Make sure Optional Life is checked off) | |
| Form #78 Application /Change-Voluntary Accidental Death & Dismemberment Insurance (Voluntary AD&D) - this form must be completed even if the new employee does not want to participate, as it verifies awareness of the program. |
Enrollment forms are to be completed and originals forwarded to the MEBP Administration Office immediately after the member has joined the Program. Please DO NOT send forms directly to Blue Cross. DO NOT HOLD ANY FORMS UNTIL THE END OF THE YEAR. When the Enrollment forms are received by the MEBP Administration Office, they will be checked and verified, and an account will be set up for the employee.