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. For information on how to set up your Bridge account, check our our New Employee page.

1. These forms are to enroll into the Univeristy group benefits plan with Alberta Blue Cross. Alberta Blue Cross  is the Univeristy of Lethbridge carrier for Extended Health Care and Dental Plans. Your benefits start on the first day of work. However, it can take up to two weeks to get your card from Alberta Blue Cross. To submit a claim, you will have to register for access to the Alberta Blue Cross online services portal. While registering for your account, be sure to add your direct deposit information for reimbursement purposes. 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


2. This form is to sign up for your mandatory basic life insurance through Great West Life. 

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 to enroll in the Universities Academic Pension Plan -

PDF iconuapp_designation_of_spouse_and_non-spouse_beneficiary.pdf


5. 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.



New Employee Checklist 

Your Benefits at a Glance 

Full Alberta Blue Cross benefit Booklet

University of Lethbridge Academic Staff Collective Agreement