1stchoice Benefits Plan
Information & Forms

Forms not available on-line can be obtained by contacting Public Service Commission at 780-408-8464.

Common to All 1stchoice Plans

Handbook
1stchoice Benefits HandbookPDF icon
Form
Benefit Partner Statutory Declaration PDF icon
Form
Enrolment/Change Form PDF icon
Insert
Premium Rates PDF icon
Form
Statutory Declaration PDF icon

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Group Life Insurance Plan

Handbook
Group Life Insurance Plan PDF icon
Form
Application and Declaration for Non-Smoker Rate PDF icon
Form
Application for Advance Payment of Group Life Insurance PDF icon
Form
Application for Conversion PDF icon
Form
Application for Paid Up Life Insurance (For Payroll Use Only) PDF icon
Form
Attending Physician's Statement PDF icon
Form
Certificate of Attending Physician Dismemberment of Loss PDF icon
Form
Claim for Accidental Dismemberment or Loss PDF icon
Form
Designation of Beneficiary PDF icon
Form
Evidence of Insurability PDF icon
Form
Group Life Claimant Statement PDF iconExternal link
Form
Group Life Plan Sponsor Statement PDF iconExternal link

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Dental Plan

Handbook
Dental Plan PDF icon
Form
Alberta Blue Cross Dental Claim Form PDF icon

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Extended Medical Benefits Plan

Handbook
Extended Medical Benefits Plan PDF icon
Form
Alberta Blue Cross Health Services Claim Form PDF icon

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Prescription Drug Plan

Handbook
Prescription Drug Plan PDF icon
Form
Alberta Blue Cross Health Services Claim Form PDF icon

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Long Term Disability Plan

Handbook
Long Term Disability Plan PDF icon
LTD 1
Employee's StatementWORD icon
LTD 2
Employer's StatementWORD icon
Brochure
Long Term Disability Income Continuance Plan BrochurePDF icon
Contacts
Long Term Disability (LTD) Contacts
LTD 3
Notice of AppealWORD icon

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Employee and Family Assistance Program

Brochure
EFAP (Employee and Family Assistance Program)

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Special Accidental Death and Dismemberment Insurance

Form
Appointment of Beneficiary Form PDF icon

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Last Review / Update: 2019-02-28

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