Want to apply for the TLA Benefit Plan? Click here to contact us and request a quote for your company. Our expert benefits administrators will be touch to get you started on a plan for you and your business.

If you need to enroll or update an employees information, or other declarations, download the appropriate TLA Benefits form below. If you have any questions or issues with a form, contact TeamBlue@icbabenefits.ca for more information.

TLA Benefits Essential Forms

Use this form to enrol a new employee to your plan.

Click here to download the form.

Use this form to update a covered employee’s information. Examples: Add new family members, change names, update salary, terminate coverage, etc.

Click here to download the form.

Use this form:

  • To designate your beneficiaries for Basic Life/Accidental Death, and/or Optional Life/Optional Accidental Death insurance
  • At time of initial enrolment if you want to designate more than 3 primary beneficiaries
  • To change your existing beneficiary(ies). The beneficiary(ies) listed here will replace your previous beneficiary designation

Click here to download the form.

To continue coverage on your Extended Health and/or Dental plan beyond age 21 and up to the maximum age on your plan, your child must be:

  • Unmarried / not living in a common-law relationship, and-Attending school on a full-time basis, as defined by Canada Revenue Agency, or-Disabled and incapable of sustaining employment – Contact us for instructions.

If your child is about to turn or has recently turned 21, is not married or living in a common-law relationship, and is a full-time student, please complete this Declaration (one per child) and return to us to continue coverage on your plan.

Click here to download the form. 

Complete this form to provide confirmation that you are registered for BC Fair PharmaCare.  

Click here to download the form.