In order to submit a claim, please fill out the appropriate claim form on-line, print, sign, attach your receipts and submit to:
Attn: HWT Department
Suite 1001, 3700 Steeles Avenue West
Woodbridge, Ontario L4L 8M9
Claim Forms
Claim Form (British Columbia only)
Claim Form (Alberta, Saskatchewan, Manitoba)
Claim Form (Ontario only)
Claim Form (Atlantic Canada)
Stop Loss / Travel Medical - In-province Claim Form
Stop Loss / Travel Medical - Claim Consent Form
Out of country - Stop Loss / Travel Medical Claim Form
In order to apply for a Flexsave™ plan, the following forms need to be completed in full and submitted to the following address:
Attn: HWT Department
Suite 1001, 3700 Steeles Avenue West
Woodbridge, Ontario L4L 8M9
Set up Forms
REQUIRED
1a. Flexsave Trust Application Form - Self Employed / Unincorporated Applicants
1b. Flexsave Trust Application Form - Corporate Applicants
1c. Credit Card Payment Form (To accompany Trust Application if paying Set Up Fee by credit card)
2. Employee Enrollment Form
- each employee must complete which includes the business owner/sole proprietor
3. Stop-Loss/Travel Medical Form (requirement for unincorporated business)
- each applicable employee must complete along with business owner
3b. Stop-Loss/Travel Medical Form Change Form (To change any information pertaining to Stop-Loss policies)
OPTIONAL
4. Pre-authorized debit
- for companies that wish to pre-fund their Flexsave plan on a monthly basis
5. Pre-authorized debit for STOP/LOSS monthly premium
- for companies that wish to pay stop/loss insurance on a monthly basis
6. Request for Direct Deposit (EFT)