Benefits By Design (BBD)
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For your convenience, we have provided a list of documents and forms below. All are available for downloading.

BBD Forms

Adhésion à L'Assurance Groupe (Fillable)

Reinstatement of Waived Benefits (Fillable)

Over-Age Dependent (Fillable)

Changement de Bénéficiaire (Fillable)

Beneficiary Designation (Fillable) Original signature required at BBD offices.

Change of Name

Group Insurance Enrollment (Fillable) Original signature required at BBD offices.

Key Points to completing the Enrollment Form

Pre-Authorized Payment Plan Form

Employee Report Form

Cost Plus Reimbursement

Dependent Status Change (Fillable)

Partial Waiver (Fillable)

Cost Plus Service Agreement

Evidence of Insurability (Fillable)

Insurers

Green Shield

Green Shield Mondial Claim Form for Emergency Medical Expense (Fillable)

Green Shield General Claim Submission Form (Fillable)

Green Shield Health Care Spending Account Claim Submission Form (Fillable)

Green Shield Community Giving Application Instructions

Green Shield Community Giving Application Form

Industrial Alliance Pacific Insurance and Financial Services Inc

Critical Illness Claimant's Statement

Certificate of Employer or Superior Officer (Fillable)

Green Shield Informational Wallet Card

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