Group Benefits forms are available below, as well as on EquitableHealth.ca.

The fastest, most secure way to submit forms and supporting documents is our Document Submission Tool. Login to EquitableHealth.ca, then select My Resources > Document Submission. Uploaded forms are instantly sent to our teams.

Submitting a claim?

Health and Dental Claims

Submit claims anytime and get faster claim payments with Equitable EZClaim®

We’ve made submitting health and dental claims fast, easy and secure with Equitable EZClaim. Most eligible claims are paid within three business days; some in as little as 24 hours!

Learn how to use EZClaim to submit claims on your computer or mobile device.

If you need help submitting a claim, please contact our claims teams.

Disability Claims

To submit a disability claim, print, complete and submit the appropriate form to Equitable. If your plan requires your group plan administrator to provide an authorizing signature, be sure to obtain the signature before submitting your claim.

If the form you need doesn't appear below, please log in to EquitableHealth.ca, click on "My Resources" and select "Forms" from the drop-down menu.

Submit your disability forms instantly using our Document Submission Tool. Login to EquitableHealth.ca, then select My Resources > Document Submission.

No. Name
564 Long Term Disability Plan Member Claim Form Disability Claims
1617 Activities of Daily Living Questionnaire Disability Claims
427 Annual Long Term Disability Update Disability Claims
441 Application for Coverage for Dependent Child over 21 Administration Forms
563EN Attending Physician Statement Disability Benefits Disability Claims
188 Attending Physician Statement General Disability Claims
2044 Consent to Communicate with an Authorized Person Form Disability Claims
573 Coverage2go Application Administration Forms
Other
Group Admin
Marketing Materials
2015 Group Life & Disability Claim Plan Member Guide Disability Claims
1781 Group Life and Disability Claims Guide - PA Disability Claims
684 Group Life Claimant Claim Form Disability Claims
210 Group Life Plan Sponsor Claim Form Disability Claims
197 Job Description - Plan Sponsor Claim Form Disability Claims
Group Admin
238 Long Term Disability Plan Sponsor Claim Form Disability Claims
509 Optional Life Insurance Application and Statement of Health Administration Forms
2070 Over the Non-Evidence Limit for Plan Members Notification Group Admin
456 Plan Member Group Life and AD&D Insurance Beneficiary Designation Administration Forms
2068 QuickAssess Terms and Conditions Disability Claims
421APS Short Term Disability Attending Physician Claim Form Disability Claims
421FULL Short Term Disability Claim Form - Full Disability Claims
421PM Short term disability Plan member claim form Disability Claims
421PS Short Term Disability Plan Sponsor Claim Form Disability Claims
452 Statement of Health for Group Insurance Administration Forms