Bursary Application
ScholarshipThe goal of the Carmen Principato Scholarship Trust Fund is to assist the children of Local 506 Members in obtaining high-quality post-secondary education.
To members contributing into the Carmen Principato Scholarship Trust Fund.
Dental Care
Claim FormClaim for all dental care expenses.
Member / Spouse / Dependent Children
Dependent with a Disability Coverage
AdministrationBenefit coverage application for over-aged dependents that are unable to support themselves.
Dependent Children
Direct Deposit Form
AdministrationComplete a direct deposit form to have your claim cheques deposited directly into your bank account.
Member Only
Emergency Out of Province Medical
Claim FormClaim a medical emergency while travelling.
Member / Spouse / Dependent Children
Extended Healthcare
Claim FormClaim for all heath care expenses which includes prescription drugs.
Member / Spouse / Dependent Children
Group Legal Claim Form
Claim FormClaim for your legal needs.
Member Only
Group Legal Enrollment Form
AdministrationGroup Legal Plan Enrollment form prior to claiming for all your legal needs.
Member Only
Hospital Cash Benefit
Claim FormBeen hospitalized? Claim for a daily cash benefit for the duration of your hospital stay to cover for parking, room amenities, etc.
Member / Spouse / Dependent Children
Life Insurance Claim Form
Claim FormClaim in the event of a death.
Member / Spouse / Dependent Children
Medical Cannabis Prior Authorization Form
AdministrationComplete this Prior-Authorization form prior to claiming for medicinal cannabis.
Member / Spouse / Dependent Children
Member Change of Address Form
AdministrationMoving and looking to change your home address? Complete the Member Change of Address Form.
Member Only
Member Enrollment/Application Card
AdministrationNew Member Enrollment / Application card or to add / change existing dependents and beneficiaries.
Member Only
Nursing Care
Claim FormIf you require out of hospital home nursing.
Member / Spouse / Dependent Children
Replacement Benefit Card Application
AdministrationLost / Misplaced your Member Advantage Benefit Card? Complete the Replacement Benefit Card Application to request a new card.
Member Only
Retiree Benefit Application Package
AdministrationMembers in Good Standing with LiUNA Local 506 retiring and want to enrol into the Retiree Benefit Plan? Complete the Retiree Benefit Application Package.
Member Only
Retiree Program Withdraw Notification
AdministrationThe Retiree Program Withdraw Notification is for current Retirees that wish to withdraw from the Retiree Benefit Program.
Member Only
Speech Therapy Medical Questionnaire
AdministrationPhysician to complete the Speech Therapy Medical Questionnaire for dependent children prior to incurring speech therapy claims. Benefit available to dependent children only.
Dependent Children Only
Vision Care
Claim FormClaim for all vision care expenses.
Member / Spouse / Dependent Children
