Get your Group Benefits forms
Below, you’ll find our most used Group Benefits forms organized by product. If the form you need does not appear below, you can find it by logging on to Benefits Now®. Please download all the necessary forms to meet your needs and note that some forms are for the plan member, while others are for the plan sponsor or treating physician.
The forms on this page are for administrative and claims purposes, and in most cases will include instructions and the address to send them to.
How to use and submit forms
Save the forms to your computer. In some cases, you can fill them in directly before printing. Otherwise, print them out and complete them by hand before mailing to the address indicated on each form.
Extended Health Claim forms
Drug - Prior Authorization forms
View the list of drugs and access the necessary forms.
If you have been prescribed one of the listed drugs, have your prescribing physician complete the appropriate form and submit to The Co-operators. Any costs incurred for the completion of pre-authorization request forms are the responsibility of
the patient/plan
member.
Dental Claim forms
Emergency Out of Country
ContinYou GOLDEN - Retiree Product
Early Intervention
Long Term Disabilty
Short Term Disability
Life Claim forms
Living Assistance
AD&D Claim forms
Life Waiver of Premium
Physician's Statement
Physician's Statement - Dependent Children Covered Illness
If you would like to order more forms, please use the following link: