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AMM Employee Benefits Forms

All Administrative forms can be sent back to Western Financial Group via email of fax to your Insurance Advisors. No originals required.

All Blue Cross claim forms can be sent directly to Manitoba Blue Cross.

Administration Forms

Application for Employee Benefits

Waiver (Refusal) of Group Benefits

Application for Retiree Benefits

Waiver (Refusal) of Family Coverage

Declaration of Health

Application for Change

Overage Dependent

Beneficiary Designation

Overage Disabled Dependent

Claim Forms

Dental Care Claim Form

Orthotics, Orthopedic Shoes, and Modifications Claim Form

Extended Health Care Claim Form

Out of Country Medical and Hospital Services Form

Vision Care Claim Form

Group Travel Health Claim Form

Manitoba Pharmacare Form