Below, you’ll find all of our Member forms organized by type. The forms on this page are for administrative and claims purposes, and in most cases, will include requisite instructions and corresponding mailing addresses.
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.
All ENROLLMENT forms must be mailed to NEBS
NORTHERN EMPLOYEE BENEFITS SERVICES
#700, 5201- 50TH AVENUE, NORTHWEST TOWER
YELLOWKNIFE NT X1A 3S9
All DENTAL, VISION AND EXTENDED HEALTH CLAIMS forms should be mailed to the Co-operators or submitted online via the link in the sidebar
Co-operators Life Insurance Company
Extended Health Care Claims
1920 College Avenue
Regina, SK S4P 1C4