FORMS

• Health Care Forms
• Pension Plan Forms

Here are copies of the forms most commonly used with the health care plan and the pension plan.

Health Care Forms

• Group Insurance Application – TRIO Comprehensive Plan

• Group Insurance Application – TRIO Small Town Plan
  Use these forms to enrol new participants in a corresponding existing plan

• Sun Life Statement of Health
  Used to provide evidence of insurability for the following:

  • New Enrolment – Effective Date
  • Increased Coverage
  • Late Applicant (enrolled after 31 days)
  • Re-application (previously declined)
  • Annual Enrolment – effective date

• Extended Health Care Claim Form

• Exception/Special Authorization Application Form
  Use this form to apply for special authorization of a prescription drug not covered by your benefit list

• Dental Claim – If your Dentist does not allow assignment of the benefit, you must pay in full and submit a completed Standard Dental Claim Form (available at your Dentist's office) to Sun Life Financial, PO Box 11010, Stn CV, Montreal, QC, H3C 4T9.

  Group Insurance Notice of Change Form
  Use this form to amend personal information already on file

• Voluntary AD&D Application form

Pension Plan Forms

• Use these two forms to enrol a new employee into the pension plan:
  Pension Enrolment Form
  Spouse or Cohabiting Partner & Beneficiary Designation Form

• Use this form to change a spouse, cohabiting partner, or beneficiary designation:
  Spouse or Cohabiting Partner & Beneficiary Designation Form

• Use this form to change any personal information on record:
  Notice of Change in Member Information

• Use this form to notify Mercer of a termination of employment, retirement, or death:
  Notice of Change in Member Status

• Use the following form to transfer pension credits between the TRIO Pension Plan and the Newfoundland and Labrador Public Service Pension Plan:
  Pension Transfer Application - Part A

• Use the following form to transfer pension credits between two municipalities, both of which are participating employers in the TRIO pension plan
  Pension Transfer Application (Municipal) – Part A