| FORM |
Remittance
Agency |
IAN |
PRI |
SIN |
Certificate
NO. |
| Public
Service Health Care Plan (PSHCP) |
CG |
|
|
|
|
- TBS-SCT 6491 Employee Application
|
|
|
X |
|
X |
- TBS-SCT 6492 Pensionner Application
|
|
|
X |
|
|
- PWGSC-TPSGC 2278 Contribution Remittance for Leave
Without Pay
|
|
|
X |
|
X |
- PWGSC-TPSGC 2397 Notice of Cancellation
|
|
|
X |
|
X |
- PWGSC-TPSGC 2028-8 Application for Designation of
Additional Dependants for Comprehensive Coverage
|
|
|
|
|
X |
| |
|
|
|
|
|
| Disability
Insurance (DI) |
CG |
|
|
|
|
- PWGSC-TPSGC 2026 Application for Full-time Employee
|
|
X |
|
|
|
- PWGSC-TPSGC 2026-1 Application for Part-time Employee
Only
|
|
X |
|
|
|
- PWGSC-TPSGC 2229 Declaration of Personal Insurability
|
|
X |
|
|
|
- TBS/SCT 330-302E Claim for Disability Insurance,
Employee's Statement
|
|
X |
|
X |
|
- TBS/SCT 330-304E Claim for Disability Insurance,
Employee's Medical Information and Attending Physician's
Statement
|
|
X |
|
|
|
- TBS/SCT 330-303E Claim for Disability Insurance,
Employer's Statement
|
|
X |
|
|
|
| |
|
|
|
|
|
| Public
Service Management Insurance Plan (PSMIP) |
CI |
|
|
|
|
- PWGSC-TPSGC 2027 LongTerm Disability (LTD) -- Application
for Full-time Employee
|
|
X |
|
|
|
- PWGSC-TPSGC 2027-1 LTD -- Application for Part-time
Employee Only
|
|
X |
|
|
|
- PWGSC-TPSGC 2028 PSMIP -- Application for Full-time
Employee
|
|
X |
|
|
|
- PWGSC-TPSGC 2028-5 PSMIP -- Application for Part-time
Employee Only
|
|
X |
|
|
|
- PWGSC-TPSGC 2028-1 PSMIP -- Change of Name or of
Beneficiary
|
|
X |
|
|
|
- PWGSC-TPSGC 2028-2 PSMIP -- Declaration of Health
|
|
X |
|
|
|
- PWGSC-TPSGC 2028-7 PSMIP -- Members Entitled to
Government-paid Coverage
|
|
X |
|
|
|
- TBS-SCT 5945 National Life Assurance Company of
Canada, Claim for Long Term Disability Benefit
|
|
X |
|
X |
|
- TBS-SCT 5946 National Life Assurance Company of
Canada, Claim for Long Term Disability Benefit
|
|
X |
|
|
|
| |
|
|
|
|
|
| Dental
Care Plan (DCP) |
CF |
|
|
|
|
- PWGSC-TPSGC 2278-1 Remittance of Dental Care Plan
Contributions for a Period of Leave Without Pay
|
|
|
X |
|
X |
| |
|
|
|
|
|
| COMMUNICATION
- SUPERANNUATION DIRECTORATE |
|
|
|
|
|
|
|
|
X |
X |
|
|
|
|
|
X |
X |
|
|
|
|
|
X |
X |
|
|
|
|
|
X |
X |
|
X |
| |
|
|
|
|
|
| COMMUNICATION
WITH: |
|
|
|
|
|
- Sun Life of Canada (PSHCP)
|
|
X |
|
|
X |
|
|
|
X
|
|
|
|
- National Life Assurance Company of Canada (PSMIP)
|
|
X
|
|
|
|
|
|
|
X
|
|
|
|
