Enrolment

• Application for drug and health insurance (PDF 218k)
• Application for group insurance (PDF 211k)
• Report of insurability
  To be completed if you are applying for group insurance coverage (PDF 233k)
• Declaration of dependant children (PDF 122k)
• Application for guaranteed insurability option (PDF 137k)
  Please return the form(s) to Sogemec Assurances inc.

Claims

• Application for health insurance benefits (PDF 56k)
  Please return the form(s) to:
  Desjardins Financial Security, Box 3950, Lévis, Québec G6V 8C6
• Application for benefits following total disability (PDF 66k)
  Please return the form(s) to Sogemec Assurances inc.
• Physical and/or psychological illness (Original request) (PDF 104k)
  Please return the form(s) to Sogemec Assurances inc.
• Physical and/or psychological illness (Additional report) (PDF 84k)
  Please return the form(s) to Sogemec Assurances inc.
• Detailed statement of overhead exprnses and income earned - Partial Disability (PDF 67k)
• Claim of reimbursement of overhead expenses - Total Disability (PDF 64k)

Payment authorization

• Payment by credit card (PDF 116k)
  Please complete the form if you would like to pay your bill(s) by credit card and return it to Sogemec Assurances inc.
• Pre-authorized withdrawals (PDF 139k)
  Please complete the form if you would like to pay your bill(s) by pre-authorized withdrawals and return it to Sogemec Assurances inc.
  

Exemption

• Exemption request (PDF 262k)

Modifications

• Change of bank account (PDF 139k)
  Please complete the form if there has been a change to your bank account and return it to Sogemec Assurances inc.

Address change 
Please complete the form if there has been a change to your address.

• Modification form/cancellation - Life, accident and Disability Insurance(PDF 53k)
• Modification form - Group Insurance (Drug, Health and Dental Care Insurance) (PDF 37k)