Enrollment Forms

It is necessary for all applicants enrolling in the Fellowship Group Insurance Plan to complete the following forms and return them to the office for processing. Downloads of the various forms can be found at the end of each form description.

Application for Group Benefits
This form gives our office information about you and your family. Note: the employee Identification Number will be your Social Insurance number. All applicants enrolling in the Fellowship Group Insurance Plan must complete this form.
Download (104KB)
Group Benefits Info Sheet
While we know most of the pastors in the Fellowship we do not know church secretaries, custodians, day care workers and teachers, all of which could be participating in the plan. In case we have questions regarding your application we will be readily able to contact you. All applicants enrolling in the Fellowship Group Insurance Plan must complete this form.
Download (69KB)
Social Insurance Number Authorization
This form allows us to use your social insurance number for identification purposes. All applicants enrolling in the Fellowship Group Insurance Plan must complete this form.
Download (67KB)
AD&D Beneficiary Designation
This form is the designation for the $200,000 AD&D insurance through ACE insurance on the Fellowship's basic plan. All other insurance is through Great-West Life.
Download (62KB)
Voluntary Accident Insurance Application
If you would like to purchase additional accident insurance please complete this form. If you do not want the additional optional coverage we will need you to sign the form and to check off the declination of coverage.
Download (72KB)
Long Term Disability - Salary Calculation
Please let us know your income and your housing allowance to help us accurately calculate your long term disability coverage. All applicants enrolling in the Fellowship Group Insurance Plan must complete this form.
Download (78KB)
Supplementary UI Application Form
If your church has not signed up for the SUB plan, we recommend that you register so there is no lapse of income should a disability claim arise.
Download (85KB)
Evidence of Insurability
This application is for those who are applying as late applicants (longer than 30 days after the first day worked) or those wanting optional life insurance through Great-West Life.
Download (277KB)