Faculty Benefit Enrollment Forms

Mandatory Forms 

Please fill out all 6 forms below and return them to Human Resources. If you have any questions with filling out the forms, please contact Helena Lang or Krystal Davis at human.resources@uleth.ca. If you have specific questions regarding your benefits, please contact Adriana Ota at adriana.ota@uleth.ca

1. These forms are to enroll into the Univeristy group benefits plan with Alberta Blue Cross.  Your benefits start on the first day of work; however, it can take about up to two weeks to get your card from Alberta Blue Cross. Please keep all receipts if you are using your benefits prior to getting your card. To see your benefits at a glance or to see the full benefit booklet, please see the Information section below.

PDF iconextended_health_and_dental_form.pdf

PDF iconalberta_blue_cross_direct_deposit_form.pdf


2. This form is to sign up for your mandatory basic life insurance through Great West Life. The rate sheet will be found in your welcome email. -

PDF iconbasic_life_insurance_form.pdf


3. These forms are to set up your payroll - 

PDF icondirect_deposit_form.pdf

PDF icontd1_alberta_form_2020.pdf

PDF icontd1_federal_form_2020.pdf


4. This form is only needed if you have a partner and/or you cannot find your marriage certificate.  

PDF icondomestic_partner_spousal_declaration_form.pdf


Optional Benefit Forms 

1. You have the option to purchase additional life insurance on top of the mandatory basic life insurance. For more information, please contact human.resources@uleth.ca.

2.  You have the option to purchase Accidental Death & Dismemberment Insurance. For more information, please contact human.resources@uleth.ca.



Your benefits at a glance:

Link to view full benefit booklet: https://www.uleth.ca/hr/pension-and-benefits/term-faculty

Setting up your Bridge Account:

University of Lethbridge Academic Staff Collective Agreement