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NOTE: ALL FORMS MUST BE SIGNED AND SUBMITTED TO THE BENEFITS OFFICE VIA EMAIL.

This page is for the employees eligible for Group Benefits and Pension Plan. Please contact your Benefit Representative first for any inquiry.

EMPLOYEE FORMS

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NEW EMPLOYEES

NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Benefits Representative is responsible for submitting the completed and signed forms to the Benefits Administration Office. DO NOT MAIL the original signed documents to our office unless requested.

New Employees eligible for Group Benefits and/or Pension

If you are a new employee with at least a ONE-YEAR contract and working 20 hours/week, you must be enrolled on the Benefits.

ALL eligible employees MUST be enrolled on Group Benefits.

NOTES:

      1. The Benefits Administration Office assigns the certificate number – please leave it blank.
      2. The Pension Division/subgroup is always 01 – DO NOT enter your local division number.
      3. The employee and employer MUST sign the Application for Group Coverage form.
      4. Email the completed form to benefits@cisva.bc.ca


Other Voluntary/Optional Group Benefits your are eligible

UPDATE/CHANGE in MEMBER’S INFORMATION

NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Benefits Representative is responsible for submitting the completed and signed forms to the Benefits Administration Office. DO NOT MAIL the original signed documents to our office unless requested.

Reminder: ALL updates must be reported within 31 days from the date of the change. NO EXCEPTION!

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):

Updating Coverage and/or 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:

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

Complete the following form(s):

Updating Life and/or Pension Beneficiary/Contingent Beneficiary

Complete the following form(s):

FOR LIFE INSURANCE BENEFICIARY/CONTINGENT BENEFICIARY:

FOR PENSION BENEFICIARY/CONTINGENT BENEFICIARY:

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

Complete the following form(s):

UPDATE RPP OR VOLUNTARY RPP CONTRIBUTION

NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Benefits Representative is responsible for submitting the completed and signed forms 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 RPP level from 3% to 7% or vice versa, add/update/remove voluntary pension contribution, please complete complete the form below:

Pension level increase by approval

Are you eligible to increase your pension contribution to 8% (15th year of service) or 9% (20th year of service)?

Fill out the following form(s):

MATERNITY LEAVE

NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Benefits Representative is responsible for submitting the completed and signed forms 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 gave 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.ca

    • Email your employee and attending physician statements to your school to be submitted to the Benefits Administration Office (only if you are comfortable doing so)     

    • Email your employee and attending physician statements to the Benefits Administration Office; or                                                     

NOTE: Please note that once you had submitted the scanned copy of the STD form(s), there’s no need to mail the original form(s).

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

Things to remember before, during and after the Maternity Leave

Things to remember:

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

*You can keep your Life Insurance, AD&D, STD, LTD, and Critical Illness and choose to waive the extended health and dental

**You will not be eligible for the Maternity STD benefits if you choose to waive your Disability Benefits.

***You can start receiving maternity benefits as early as 12 weeks before your due date or the date you give birth. You cannot receive these benefits more than 17 weeks after your due date or the date you gave birth, whichever is later.

Employment Insurance – Maternity/Parental Benefits
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APPLYING FOR DISABILITY

NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Benefits Representative is responsible for submitting the completed and signed forms to the Benefits Administration 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 the disability benefits. You must complete the EMPLOYEE STATEMENT and have your doctor complete the PHYSICIAN STATEMENT.

If you are claiming a COVID-19 STD benefit, please fill out this form. Please inform your employer that you are applying for a COVID-19 related STD as the employer will have to provide our office with the employer 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
    • Email it to your school to be submitted to the Benefits Administration Office (only if you are comfortable doing so); or
    • Email your forms to the Benefits Administration Office

NOTE: While you are on disability, your match pension contribution will be suspended. It will be re-instated on the day that you return to work full-time (pre-disability regular hours and duties).

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

ADD EXTENDED HEALTH AND/OR DENTAL (Late Applicant)

NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Benefits Representative is responsible for submitting the completed and signed forms 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 to have dual coverage (not losing the spousal coverage)?
  • Or did you missed the 31 days grace period and had not added your spouse or child under your plan?

Canada Life will now consider you a late applicant and have to be subjected 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 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 DEPENDENTS (aged 22 UP)

NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Benefits Representative is responsible for submitting the completed and signed forms 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 and attending full-time in-class post-secondary school?

Coverage application for over-aged disabled dependent

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

RETIREMENT OR TERMINATING EMPLOYMENT

NOTE: Employees MUST submit the completed form to their employer’s Benefits Representative. The Benefits Representative is responsible for submitting the completed and signed forms to the Benefits Administration Office. Email the completed form to benefits@cisva.bc.ca. DO NOT MAIL the original signed documents to our office unless requested.

RETIREMENT OR TERMINATING EMPLOYMENT

FILL-UP the following forms as follows :

Other Information

LOST or STOLEN CARDS
Health and Dental Cards Replacement

How to request a new card(s)? Who should we contact?

  1. Please contact your Benefits Representative first if you need a replacement card.
  2. Your Benefit Representative will send a request to benefits@cisva.bc.ca
  3. Once we receive the request, we will order your new cards.
  4. Please allow 3 to 4 working weeks to receive a new card(s).

NOTE: Due to the current situation, it might take longer for you to receive your cards; we highly recommend that you register online and download your electronic cards.

ADDITIONAL INFORMATION AND FORMS

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

FILL OUT ONLINE, THEN SIGN THE FORM AND SUBMIT IT TO YOUR EMPLOYER. THE EMPLOYER MUST Email the completed form to benefits@cisva.bc.ca.

The Welcome Plan is a temporary supplementary group plan of insurance that provides essential basic healthcare coverage for temporary, new and 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 as long as the employee meets all eligibility requirements. To be eligible under the Welcome Plan, the employee 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

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 are automatically covered for $10,000 of Basic Critical Illness Insurance. If you or your spouse require more than the Basic Insurance amount, you can each 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 only, you have an opportunity to 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 cognizant 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 for direct, online applications. Please feel free to visit their site for additional information on this benefit narrative, rates, the application process, etc. INDUSTRIAL ALLIANCE – VOLUNTARY CRITICAL ILLNESS INFORMATION

Additional Voluntary Critical Illness
ADDITIONAL VOLUNTARY CRITICAL ILLNESS APPLICATION
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, and not the CISVA Benefits plan, pays for drug costs after your new deductible has been reached, making each benefit dollar go farther. Send this form directly to Fair PharmaCare for processing. All B.C. residents who have 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 register for Fair PharmaCare. To register or obtain further information regarding Fair PharmaCare, please visit their website at BC Fair PharmaCare.

PENSION, RRSP, and TFSA

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 own retirement.  It will include:

      • where you can get more information on your plan
      • steps on how to calculate how much you need
      • what your investment options are
      • how to select your investments; and
      • the applications you would need to complete to enrol in the plan. You can also preview the online services and information on GRS Access at www.grsaccess.com before joining your plan 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 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 claim of Spouse to Interest in Member’s Pension of the Family Relations Act to inform the Plan that she/he has 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 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

On the occasion that 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.

GROUP BENEFITS AND REGISTERED PENSION / RRSP / TFSA / RESOURCES
PLAN OVERVIEW/GROUP COVERAGE

GROUP BENEFITS MEMBER PORTAL ONLINE SERVICES - GROUPNET:

REGISTERED PENSION INFORMATION:

PENSION PLAN VIDEO MATERIALS:

Employee Assistance Program
EE Assistance Program (EAP)

PREMIUM RATES
Welcome Plan