Downloadable Forms

Plan Sponsor Forms:

• Set Up and Claims Process ( To guide you with set up and claims )
• Administrative Services Agreement ( Contractual agreement between Plan Sponsor & Imax )
• Private Health Services Plan - Plan Design ( To instruct Imax what percentage and type of expenses you wish to cover )
• Employee Change Termination Form ( To inform Imax of any Plan member & Dependant coverage & contact status changes )
• Imax Solutions Deposit slip

Plan Member Forms:

• Employee Enrolment Form ( This is used to enrol employee's as a Plan Member in the Solutions plan and may be mailed, faxed or e-mailed )
• Claim Form : Pay As You Go ( This is used when funds are supplied with each claim and the form uses 5% GST. Please download the form and open with Adobe Acrobat Reader to edit )
• Claim Form : Funds On Deposit ( This is used for Plan Sponsors with funds on deposit to pay claims. Please download the form and open with Adobe Acrobat Reader to edit )
• Direct Deposit Request for Solutions Claims ( To deposit the claim cheque electronically in Plan Member's personal bank account )

Please e-mail forms to imax@shaw.ca.

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