Forms

Welcome to the UBC Benefits Forms resource centre, where you can download a copy of any benefits-related form to help you file a paper claim, enrol for a benefit or update your coverage.

Find a Form

• Dental
• Extended Health
• Medical Services Plan (MSP)
• Employee Family Assistance Program (EFAP)
• Tuition Fee Waivers
• Life Insurance (Basic, Optional, and Optional Accidental Death & Dismemberment)
• Disability Benefit Plan (DBP)/Income Replacement Plan (IRP)
• Fair PharmaCare
• Retirement & Survivor Benefits Plan
• Payroll

For quicker processing and payment, consider submitting your UBC Dental or UBC Extended Health claims online. You can also register to have your reimbursement deposited directly into your bank account. Both are easy to do and kinder to the environment. Login to the Sun Life Members website to file your e-claim, or visit the Claims section of the UBC Benefits website for step-by-step instructions.

You can enrol for your benefits online by using UBC Benefits Sign-on.

For those without access to a computer, or if you are required to submit original receipts, you can file a paper claim by clicking on the appropriate form below.

Mailing Addresses for Completed UBC Benefits Forms

Vancouver Campuses

Attention: Payroll Services
Financial Services
General Services Administration Building
305 – 2075 Wesbrook Mall
Vancouver, BC V6T 1Z1
Phone: 604-822-2187
Fax: 604-822-9233

Okanagan Campus

Attention: Payroll
Financial Services
ADM 002 – 3333 University Way
Kelowna, BC V1V 1V7
Phone: 250-807-8616
Fax: 250-807-9354

Note: Your Fair PharmaCare Registration Form must be sent directly to Fair PharmaCare.

Dental

For information about UBC Dental Benefits, click here.

• Information on how to make a claim
• Dental Claim Form (pdf) Faculty and Staff, with the exception of Management & Professional and IUOE 882
• Combined Dental + HSA (pdf) Management & Professional Staff and IUOE 882 only (click here for information about the HSA)
• Enrol for dental benefits
• Change your address or update your dependants
• Enrol a newborn or adopted child to your benefits coverage
• Cancel your dental coverage

Extended Health

For information about UBC Extended Health Benefits, including prescription drugs, vision care and massage therapy sessions, click here.

• Information on how to make a claim
• Extended Health Claim Form (pdf) Faculty and Staff, with the exception of Management & Professional and IUOE 882
• Extended Health + HSA (pdf) Management & Professional Staff and IUOE 882 only (click here for information about the HSA)
• Extended Health claim form (pdf) Retirement and Survivor Benefits members only
• Enrol for extended health benefits
• Change your address or update your dependants
• Enrol a newborn or adopted child to your benefits coverage
• Cancel your extended health coverage

Please note: Only vision care and paramedical claims may be submitted online.  Prescription drug claims that have not been processed using your pay-direct drug card may also be submitted online.

Non-UBC Management & Professional Staff (i.e. Paymaster employers) – please use the regular (not combined HSA) claim form.

Mail your completed paper claim forms to:

Sun Life Assurance Company of Canada
PO Box 2010 Stn Waterloo
Waterloo ON N2J 0A6

Medical Services Plan (MSP)

For information about the B.C’s provincial medical insurance plan, click here.

Note: Enrolment in MSP is mandatory for all residents of British Columbia. However, enrolment through UBC’s group plan is not necessary if you have MSP coverage through another benefits plan.

• Enrol for MSP
• Change your address, update your personal information or update dependants
• Enrol a newborn or adopted child to your benefits coverage
• Cancel your MSP coverage

Employee Family Assistance Program (EFAP)

For information about EFAP, click here.

Note: You can opt out of UBC EFAP if you have similar coverage through another benefit plan.

• Enrol for EFAP or update your dependants
• Opt out of UBC EFAP
• Enrol a newborn or adopted child to your benefits coverage

Tuition Fee Waiver

• Information about UBC tuition fee waivers and other professional development-related benefits
• Apply for Tuition Fee Waivers online

Basic Group Life Insurance

For information about UBC’s Basic Group Life Insurance plan, click here.

Note: Enrolment is mandatory for all UBC staff and faculty. Your spouse and/or dependent children are not covered under this plan.

• Information about Life Insurance Claims
• Enrol for Basic Group Life Insurance (pdf)
• Update or change your beneficiary information (pdf)

Optional Life Insurance & Optional Accidental Death & Dismemberment

For information about UBC’s Optional Life Insurance plan and Optional Accidental Death & Dismemberment coverage, click here.

Note: Download and complete the form(s) applicable to your UBC employee group.

For UBC Staff (if you are Faculty or Management & Professional/M&P, see below)

• Enrol or increase coverage
• Change your coverage (other than increase)
• Update or change your beneficiary information (Optional Employee Life Insurance)
• Update or change your beneficiary information (Optional Spousal Life Insurance)

For Faculty and Management & Professional

• Enrol or increase coverage
• Change your coverage (other than increase)
• Update or change your beneficiary information (Optional Employee Life Insurance)
• Update or change your beneficiary information (Optional Spousal Life Insurance)

Disability Benefit Plan (DBP)/Income Replacement Plan (IRP)

For information about UBC’s long-term disability benefits, click here. For information on making a claim, click here.

Note: To apply for IRP/DBP benefits, you must be disabled under the plan and making a claim.

• Sunlife Disability Claim Form (Member)

Please note that the Disability Claim Form replaces the old Member Statement Form and Physician Statement Form.

To enrol in the IRP/DBP: Download and complete the following form applicable to your UBC employee group.

• Faculty form (IRP): Faculty, Academic Executives, Administrative Executives considered High Earners, Staff High Earners
• Other form (DBP): Administrative Executives (non-High Earners), Management & Professional, BCGEU Okanagan, IUOE 882, Non-union Technicians/Research Assistants, Executive Administrative, BCGEU Childcare, CUPE 2278, CUPE 2950, CUPE 116

Fair PharmaCare Forms

For information about Fair PharmaCare, click here.

Note: Remember to confirm your Fair PharmaCare registration with Sun Life. If you have yet to enrol in the Fair Pharmacare program, the quickest way is to register online. For those who prefer to submit a paper form, please download and complete the Fair PharmaCare Registration form and send the completed form to:

Health Insurance BC
Attention: PharmaCare Services
PO Box 9655 Stn Prov Govt
Victoria, BC V8W 9P2

Retirement and Survivor Benefits Plan Forms

• Information on making RSB claims
• RSB enrolment form
• Extended Health claim form
• Dental claim form
• Sun Life Medi-Passport Card (emergency travel card)

Extended Health and Dental claims forms can also be downloaded from the Sun Life member website, using your access ID and password.

Payroll Forms

Faculty and staff can update and view their personal and payroll information quickly and securely through the UBC Faculty & Staff Self-Service web portal. Simply access the portal using your Campus Wide Login (CWL).

For those without access to a computer, you can submit a paper payroll form for the following:

• Enrol in Direct Deposit
• Update or cancel your Payroll Direct Deposit information
• Update or change your personal information
• Update your TD1 Federal Tax Form
• Update your TD1BC Provincial Tax Form

Need Help?

If you have questions or need assistance completing a form, please contact UBC Benefits.