Please select from the list below to access the form you require.

 

All of the forms on OTIP Services are posted as PDF files. You will require a copy of Adobe Reader to access these files. Download your free copy. If you are unable to access these files, please contact us to have a copy of the form mailed to you.

Application for Insurance and Evidence of Insurability

When applying for coverage more than 31 days after becoming eligible, complete and submit this form along with your application. Plan members under the RTIP and ARM health plans will need to complete this form if they wish to change their coverage during the year. Plan changes made by RTIP and ARM health plan members on the renewal date (January 1) do not require evidence of insurability.

 

Change of Beneficiary Form

Plan members who have life coverage and wish to change their designated beneficiary must complete this form. This form must be signed and dated.

 

Full-Time Leave – All Benefits

Plan members whose plan allows for continuation of coverage during a leave of absence must complete this form whether or not they choose to maintain or discontinue coverage.

 

Part-Time Leave – Long Term Disability Insurance

Plan members approved for a part time leave of absence must complete this form to indicate whether they wish to maintain their long term disability insurance coverage based on their part or full time salary.

 

General Benefits Application

Complete this form if you are new member and wish to apply for coverage.

 

Health and Dental Change Form

Plan members who need to change their health and dental single/family coverage status, add or remove dependants must complete this form. This form must be signed and dated.

 

Overage Dependant Student Form

Plan members must complete this form annually for any dependant child who is over the maximum age and in full-time attendance at an accredited post-secondary education institution. A form must be submitted each year until the dependant child reaches the contract termination age or is no longer in full-time attendance at school.

 

Pre-Authorized Debit Authorization Form

Plan members may choose to have their premium deducted monthly from their bank account. Join our convenient, pre-authorized monthly payment plan by submitting a completed PAD authorization form and a personal cheque, marked VOID for verification purposes.

Standard Dental Claim Form

Claimants requiring reimbursement for dental care expenditures must have this form completed by their dentist or dental specialist. Original receipts and applicable supporting documentation must accompany all claim submissions.

 

Extended Health Benefit Claim Form

Claimants seeking reimbursement for extended health care benefits such as prescription drugs can complete this form and submit it by mail to the address listed on the form. Original receipts and applicable supporting documentation must accompany all claim submissions.

 

Vacation Supply Form - RTIP - ARM

RTIP and ARM health plan members will need to complete this form if they wish to purchase more than a three-month supply of prescription medication to take on their vacation.