Forms and contact details for Plan Administrators

The following forms are available online to make it easier to manage your group insurance plan.


  1. Certain forms require Word software, whereas for others you will need Acrobat software.
  2. Complete the selected form by clicking on each empty field.
  3. It may take a few seconds before the text appears onscreen, depending on your Internet connection.
  4. Save and print the form in order to sign it. Send us the original copy by mail.

Administrative Forms
Attention! Be sure to always keep a printed and signed copy on hand for your files, and also remember to provide a signed copy to the employee concerned.
If you use the ag@net extranet portal, it is not necessary to mail AGA Benefit Solutions an original signed copy.*
Concernant le formulaire Preuve d'assurabilité ou Déclaration d'assurabilité, les solutions de prévoyance AGA doivent recevoir l'original. Veuillez sélectionner le formulaire d'assurance approprié.
Insurers' Contact Details - Disability Insurance
As of January 1st, 2021, following the revision of the disability insurance service offer, you are invited to contact your insurer for any question related to a request for disability benefits, life insurance or serious illness.
  • Canada Life
(T) 1 888 878-6059


  • La Capitale
(T) 1 800 463-4856


  • Blue-Cross
(T) 1 877 849-8509


  • Desjardins Insurance
(T) 1 800 463-7843

Link: Online Form

  • Humania Assurance
(T) 1 800 818-7236


  • iA Financial Group (Industrial Alliance)
(T) 1 877 422-6487


  • iA Financial Group AD&D
(T) 1 800 266-5667


  • Manulife
(T) 1 866 236-6313


  • SSQ Insurance
(T) 1888 651-2307


  • UV Insurance (Union-Vie)
(T) 1 800 567-0988


Request for weekly benefits
We suggest you keep the originals for your records. All requests must be sent by fax or by email to

Situation A – If your weekly income replacement benefits are placed with one of the following insurers, please click on the appropriate link to directly access their claim form:

Situation B – If your weekly income replacement benefits is self-insured, please complete the appropriate AGA claim form among the following:

Long Term Disability Forms
We suggest you keep the originals for your records. Requests must be sent by fax or by email

Click on the appropriate link, according to the insurer with which your long term disability coverage is subscribed:

To complete your application, attach a copy of all medical certificates on file since the work stoppage , a copy of the job description in your company and a copy of the last two pre-disability pay statements.

If your insurance is subscribed with Assumption Life or Blue Cross insurers , please provide a birth certificate and a copy of your last payment slip from Employment Insurance .

Critical Illness Forms
We suggest that you keep the originals for your records. Requests should be sent to us by fax or email at

In the event of a diagnosis of critical illness, insurance against serious diseases provides a lump sum payment. To know the eligible health states and eligibility requirements, please consult the contract and / or brochure.

If your critical illness coverage is subscribed with one of the following insurers, please select the link of your insurer :