Employee Benefits Administration Forms

	Addition of Firm Benefits		Overage Dependant
	Application for Change		Overage Disabled Dependent
	Applications for Optional Life		Prescription Drug Exceptions
	Beneficiary Designation		Extended Health Pre-Authorization
	Evidence of Insurability		Pre-Authorization Chequing Plan
	Employee Enrollment		Extended Heath & Dental Evidence of Insurability

Please send completed forms to HED Insurance and Risk Services:

HED Insurance and Risk Services
777 Portage Avenue
Winnipeg, MB  R3G 0N3

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