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Note: ALL Group Benefits forms must be completed electronically by the employer.

This page is for employees eligible for Group Benefits and Pension Plans.

Please get in touch with your Benefits Representative first for any inquiries.

EMPLOYEE FORMS

FOR NEW EMPLOYEES

NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative.

The Benefits Representative MUST check and submit the completed and signed documents to the Benefits Administration Office. Do not mail the original signed documents to our office unless requested.

Open all Group Benefits Forms on a PDF reader. 

NEW EMPLOYEES eligible for Group Benefits and Pension

You must enroll in the benefits program if you have a ONE-YEAR contract and work 20 hours/week.
ALL eligible employees MUST enroll in Group Benefits.

  • Group Benefits ONLY:
    • APPLICATION FOR GROUP COVERAGE (TO BE COMPLETED BY THE EMPLOYER. USE THE BENEFIT REP PAGE FOR THE ONLINE APPLICATION)
    • RPP WAIVER OF PARTICIPATION

NOTES:

  • The Benefits Administration Office assigns the certificate number – please leave it blank.
  • The Pension Division/subgroup is always 01 – DO NOT enter your local division number.
  • The employee and employer MUST sign the Application for Group Coverage form.
  • Send the completed form to the Benefits Office through the secure folder.

WELCOME PLAN

The Welcome Plan is temporary supplementary insurance that provides essential basic healthcare coverage for temporary, new, or returning Canadian residents and their families when they do not qualify for provincial health plan coverage in their province or territory.
Welcome Plan benefits are available if the employee meets all eligibility requirements:

  • The employee and their dependent(s) must be covered under the Extended Health Plan
  • They must legally reside in a Canadian province or territory and are not eligible for coverage under a federal or provincial government health plan (e.g., MSP) because they do not satisfy the residency requirement in their province or territory of residence.
Other Voluntary/Optional Group Benefits, you are eligible
  • Guaranteed Approval Voluntary Critical Illness (must be completed within 60 days after the benefits eligibility date)
  • Optional Life Insurance
  • Voluntary RRSP
  • Tax-Free Savings Account

    • TO UPDATE/CHANGE YOUR INFORMATION

    NOTE: The Employer’s Representative completes and signs the Group Change form and submits it to the Benefits Administration Office.. Do not mail the original signed documents to our office unless requested.

    Reminder: Report ALL updates within 31 days from the change date. NO EXCEPTION!

    EXISTING EMPLOYEE JOINING THE PENSION PLAN

    Existing employees who had opted out of the pension plan can join the plan. The employee MUST complete the following forms:

    Updating Member Information

    Do you need to change any of the following:

    • Contact Information (Address, Phone number, email address)
    • Legal Name

    Complete the following form(s):

    • GROUP COVERAGE CHANGE FORM
    • CHANGE OF MEMBER INFORMATION (ONLY if you have PENSION) – Open as a Read-only file, enter the required information, print, and sign.

    Updating Dependent(s)

    Do you need to:

    • Add the extended health and dental coverage (loss of the spousal insurance coverage)
    • Add your spouse (newly married – within 31 days from the date of marriage
    • Add/Remove dependent

    Complete the following form:

    • GROUP COVERAGE CHANGE FORM

    Salary Update (Salary, hours per week, weeks per year change AFTER THE RE-ENROLLMENT PERIOD)

    Complete the following form(s):

    • GROUP COVERAGE CHANGE FORM

    Updating Life and/or Pension Beneficiary/Contingent Beneficiary

    Complete the following form(s):
    FOR LIFE INSURANCE BENEFICIARY/CONTINGENT BENEFICIARY:

    • GROUP COVERAGE CHANGE FORM

    FOR PENSION BENEFICIARY/CONTINGENT BENEFICIARY:

    Change in Employment Status (Termination, retirement, transfer of employment)

    Complete the following form(s):

    • GROUP COVERAGE CHANGE FORM

    TO UPDATE RPP, VOLUNTARY RPP, RRSP, OR TFSA CONTRIBUTION

    NOTE: The Employer’s Representative completes and signs the Group Change form and submits it to the Benefits Administration Office. Do not mail the original signed documents to our office unless requested.

    Increase/Decrease Pension contribution level

    To change/update the RPP level from 3%, 7%, 8%, or 9%, or add/update/remove voluntary pension, RRSP, or TFSA contribution, please complete the form below:

    • GROUP COVERAGE CHANGE FORM

    UPDATE INVESTMENT INSTRUCTION

    To change/update your investment portfolio, please complete the form below:

    GOING ON MATERNITY LEAVE

    NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Benefits Representative MUST check and submit the completed and signed documents to the Benefits Administration Office. Do not mail the original signed documents to our office unless requested.

    An employee going on Maternity Leave of Absence

    Applying for STD Maternity Benefits

    All women in our system with disability coverage are entitled to the STD Maternity Benefit once they give birth. You must complete the following forms:

    Options on how to submit your claim:

      • Email your employee and attending physician statements directly to Canada Life via email at langley.dmso@canadalife.com
      • Email it to your school to be forwarded to the Benefits Administration Office (only if you are comfortable doing so), or
      • Upload your forms to the Benefits Administration Office

    NOTES:

    • ONLY APPLIES TO MEDICAL DISABILITY: While on disability, you cannot contribute to the matched pension. It will be re-instated when you return to work full-time (pre-disability regular hours and duties).
    • Employees on Post-Delivery STD (MATERNITY STD) have the option to contribute to the employer-matched pension. 

    IF YOU ARE THE EMPLOYER OR REPRESENTING THE EMPLOYER, PLEASE GO TO THE BENEFIT REPS PAGE TO ACCESS THE EMPLOYER STATEMENT.
    NOTE: Once you have submitted the scanned copy of the STD form(s), there’s no need to mail the original form(s).

    Things to remember before, during and after the Maternity Leave

    Things to remember:

      • Decide if you want to take 12 months or 18 months’ leave (there are no choices in between)
      • Decide if you want to keep or waive your *Group Benefits and Pension (as per Federal Law, employees can now waive their Group Benefits while on Maternity. Employees can also choose to continue contributing to the match pension while on Maternity Leave)
      • Arrange the Maternity leave agreement with your employer/PEC
      • Request for your Record of Employment (ROE)
      • Apply for Employment Insurance (EI) Maternity and Parental Benefits**
      • Apply for Maternity STD Benefit***
      • If you are a CISVA employee, provide the Maternity Medical report to your employer for top-up calculation.
      • Add your baby under your plan (the latest date that you can provide this information is 31 days after your child is born)
      • Prepare post-dated cheques to cover your Group Benefits and Pension employee contribution (if you are keeping your benefits and pension)

    *The Group Benefits are life insurance, AD&D, STD, LTD, Critical Illness, Extended Health, and Dental.
    **You can start receiving maternity benefits as early as 12 weeks before your due date. You cannot accept these benefits more than 17 weeks after your due date or the date you gave birth, whichever is later.
    ***You can apply for STD Maternity Benefits if you keep your Group Benefits while on Maternity Leave.

    Employment Insurance – Maternity/Parental Benefits
    Print This Information

    APPLYING FOR DISABILITY

    NOTE: The completed form should be submitted to their employer’s Benefits Representative (optional) or the Canada Life Disability Office. Do not mail the original signed documents to our office unless requested.

    Employee applying for Disability

    If you are away from work due to illness or injury for seven consecutive days (including weekends and statutory holidays), you must apply for disability benefits. You must complete the EMPLOYEE STATEMENT and have your doctor complete the PHYSICIAN STATEMENT.

    Options on how to submit your claim: 

    • Email your employee and attending physician statements directly to Canada Life via email at langley.dmso@canadalife.com
    • Submit to your school to be forwarded to the Benefits Administration Office (only if you are comfortable doing so) or
    • Upload your forms to the Benefits Administration Office

    NOTE: While on disability, you cannot contribute to the matched pension. It will be re-instated when you return to work full-time (pre-disability regular hours and duties).

    IF YOU ARE THE EMPLOYER OR REPRESENTING THE EMPLOYER, PLEASE GO TO THE BENEFIT REPS PAGE TO ACCESS THE EMPLOYER STATEMENT.

    ADD EHB AND/OR DENTAL (Late Applicant)

    NOTE: The Employer’s Representative completes and signs the Group Change form and submits it to the Benefits Administration Office. Do not mail the original signed documents to our office unless requested.

    LATE APPLICANT

    Did you:

    • Previously waived your extended health or dental coverage and now would like dual coverage (not losing the spousal coverage)?
    • Or did you miss the 31-day grace period and not add your spouse or child to your plan?

    Canada Life will now consider you a late applicant subject to their coverage approval.

    As a Late Applicant, you must complete the following forms:

    NOTE:

    Dental coverage for an approved late applicant will be limited.

    • Once approved, the employee and dependents have limited coverage of $250 for the first 12 months after the approval date.

    Extended health coverage for an approved late applicant is effective immediately after the approval date, BUT:

    • Approval for extended health coverage is not guaranteed.
    • Canada Life will approve the application based on the employee and the dependents’ medical insurability.

    Please refer to our booklet for coverage information.

    DO NOT SEND THE FORMS TO CANADA LIFE DIRECTLY. SUBMIT THE COMPLETED FORM TO THE BENEFITS ADMINISTRATION OFFICE.

    FAILURE TO FOLLOW WILL CAUSE A DELAY IN THE PROCESSING OF YOUR APPLICATION.

    OVERAGED DEPENDENT (aged 22 UP)

    NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Benefits Representative checks and submits the completed and signed documents to the Benefits Administration Office. Do not mail the original signed documents to our office unless requested.

    Student Recertification - for dependent child 22 and over ONLY

    Is your dependent child turning 22 years old?

    Coverage application for over-aged disabled dependent

    Do you need coverage for your dependent child over age 22 who has a disability, please complete the following:

    RETIREMENT

    NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Benefits Representative checks and submits the completed and signed documents to the Benefits Administration Office. Do not mail the original signed documents to our office unless requested.

    RETIREMENT OR TERMINATING EMPLOYMENT

    How to become eligible for the retiree plan:

    “When an employee ceases work, to be eligible to join Benefits Class 5, the Retirees Division, the employee must:

    (a) formally declare their intent to retire (not just change employers) and
    (b) be over the age of 55 years at the time of retirement.”

    FILL-UP the following forms as follows :

    REMINDER: If you have enrolled in Voluntary Critical Illness, please contact Industrial Alliance to cancel the coverage and premium deduction.

    Other Information

    TERMINATION

    NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Employer’s Representative completes and signs the Group Change form and submits it to the Benefits Administration Office.. Do not mail the original signed documents to our office unless requested.

    TERMINATING EMPLOYMENT

    For termination/resignation, complete the forms below.

    FILL-UP the following forms as follows :

    REMINDER: If you have enrolled in Voluntary Critical Illness, please contact Industrial Alliance to cancel the coverage and premium deduction.

    Other Information

    ADDITIONAL INFORMATION AND FORMS

    PENSION, RRSP, and TFSA RESOURCES

    Enrolment Guide
    This enrollment guide provides you with information to help you understand what your plan offers and how you can play an active role in preparing and investing in your retirement. It will include:

    • where you can get more information on your plan
    • steps on how to calculate how much you need
    • what are your investment options are
    • how to select your investments; and
    • The applications you would need to complete to enroll in the plan. Before joining your plan, you can also preview the online services and information on GRS Access at www.grsaccess.com using this guest Access ID: ARCHDIOCESE Password:  Archdiocese_123Attach – Soft Copy enrolment guide individual applications are found in the respective plan sections on this page.- Registered Pension Plan Application (RPP) – Registered Retirement Savings Plan (RRSP) & Tax-Free Savings Account (TFSA)

    Group Asset Performance

    Registered Pension Plan - LUMP-SUM CONTRIBUTION
    Registered Retirement Savings Plan

    RRSP Forms

    Tax - Free Savings Account

    Tax-Free Savings Account (TFSA) form

    Marriage Breakdown: What is Form 1?

    Form 1 – An ex-spouse completes a claim of Spouse to Interest in Member’s Pension of the Family Relations Act to inform the plan that they have a claim of interest in a member’s account. Once the plan receives this notice, the plan is under an obligation to:

    REMINDER: Please note NO FUNDS are transferred upon receipt of Form 1.

    When can funds be split?
    The following forms must be completed and presented to the Benefits Administration Office (BAO) before Canada Life will make any payment :

    • Court Order or Separation Agreement. The order or agreement should direct the Plan member to make payments by naming the eligible former spouse and indicating the amount to be paid. The order or agreement must be specific as the BAO is not empowered to decide the details of the order or agreement.
    • Form 3 – Request for Transfer from Unmatured Defined Contribution Plan – of the Family Relations Act. This form is completed by the spouse or former spouse of a member who wants to transfer their pension entitlement to their RRSP or RPP.

    Request for transfer from unmatured DC Plan

    Upon receipt of all the necessary forms from an eligible former spouse, the Benefits Administration Office must send the Plan member Form 6 – Notice of Receipt. This form informs the member that our office has received completed forms from the eligible former spouse and that the plan will be processing the transfer of funds.

    Pension - Notice of death claim form

    If a member of the Archdiocese of Vancouver/CISVA Registered Pension Plan dies, the attached document must be completed by the beneficiary and sent directly to the Benefits Administration Office. There are additional documents that need to accompany this attachment. Therefore, DO NOT FORWARD this claim directly to Canada life, Group Retirement Services, as indicated at the top of the claim form. Once this step has been completed, Canada Life Group Retirement Services will contact the beneficiary to summarise available options.

    REGISTERED PENSION INFORMATION:

    PENSION PLAN VIDEO MATERIALS:

    • GRS Access website demo: Video

    GROUP BENEFITS RESOURCES
    PLAN OVERVIEW/GROUP COVERAGE

    BENEFITS BOOKLETS

    COVERAGE INCLUSIVE to EHC COVERAGE and EHC CLAIM FORMS

    GROUP BENEFITS MEMBER PORTAL ONLINE SERVICES - GROUPNET:

    OTHER GROUP BENEFIT and TAX FORMS
    Welcome Plan Application (re: Employees NEW to Canada equivalent to MSP)

    FILL OUT ONLINE, SIGN THE FORM, AND SUBMIT IT TO YOUR EMPLOYER. THE EMPLOYER MUST upload the completed and signed form to ADJUSTMENTS.

    The Welcome Plan is temporary supplementary insurance that provides essential basic healthcare coverage for temporary, new or returning Canadian residents and their families when they do not qualify for provincial health plan coverage in their province or territory.

    Welcome Plan benefits are available if the employee meets all eligibility requirements:

    • The employee and their dependent(s) must be covered under the Extended Health Plan
    • They must legally reside in a Canadian province or territory and not be eligible for coverage under a federal or provincial government health plan (i.e., MSP) because they do not satisfy the residency requirement in their province or territory of residence.

    CL Direct Deposit Form

    CL DIRECT DEPOSIT FORM
    Optional Life Insurance Application Form
    OPTIONAL LIFE APPLICATION FORM
    CISVAs optional insurance plan provides supplementary life insurance coverage for CISVA/RCAV employees. Please refer to the Optional Life Brochure within our CISVA Benefits Plan Overview section for further information regarding Optional Life rates.

    New Employee Guaranteed Acceptance Voluntary Critical Illness

    VOLUNTARY CRITICAL ILLNESS GUARANTEED ACCEPTANCE APPLICATION
    Note: available to eligible employees and dependent spouses enrolled in Benefit Class 1, 2, and 4. As a CISVA/RCAV employee, you covered $10,000 of Basic Critical Illness Insurance.

    Suppose you or your spouse require more than the Basic Insurance amount. In that case, you can apply for $25,000 to $300,000 of medically underwritten Critical Illness Insurance coverage under the CISVA Voluntary Critical Illness Insurance plan.

    For new employees to the benefits plan, within the first 60 days of employment, you can apply for the first $25,000 of Optional Critical Illness insurance without having to supply medical evidence. You are guaranteed approval for this voluntary coverage, regardless of your medical history (regardless of your pre-existing conditions).

    Please be aware of this strict timeline after the 60-day window; you are subject to medical evidence! Industrial Alliance Pacific (IAP) has updated its website to allow direct, online applications. Please visit their site for additional information on this benefit narrative, rates, the application process, etc. INDUSTRIAL ALLIANCE – VOLUNTARY CRITICAL ILLNESS INFORMATION

    REMINDER: If you do not want to continue your Voluntary Critical Illness coverage after termination or retirement, please get in touch with Industrial Alliance to cancel the coverage and premium deduction.

    Additional Voluntary Critical Illness
    ADDITIONAL VOLUNTARY CRITICAL ILLNESS APPLICATION

    REMINDER: If you do not want to continue your Voluntary Critical Illness coverage after termination or retirement, please get in touch with Industrial Alliance to cancel the coverage and premium deduction.

    TD1 (Federal)

    TD1 Federal Personal Tax Credits Return

    TD1BC (Province of British Columbia)
    TD1BC British Columbia Personal Tax Credits Return

    Fair PharmaCare Application

    Fair Pharmacare indexes your provincial deductible for prescriptions to your income.
    Registering ensures that the Fair Pharmacare plan, not the CISVA Benefits plan, pays for drug costs after your new deductible has been reached, making each benefit dollar go further.
    Send the form directly to Fair PharmaCare for processing.
    All BC residents with a CareCard from MSP should be registered for Fair PharmaCare.
    Please note that effective January 1, 2008, PharmaCare will no longer reimburse prescription or medical supply costs incurred before the date a family registers for Fair PharmaCare.
    To register or obtain further information regarding Fair PharmaCare, please visit BC Fair PharmaCare.

    Employee Assistance Program

    Telus Health will verify your employer/group plan – provide the Roman Catholic Archbishop of Vancouver or the RCAV as your plan sponsor/employer.