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Is group coverage currently in force?* Yes No
If so, who is the carrier?*
What is the renewal date? 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 202020212022202320242025
If your firm currently has group coverage in force, the following documents are required to prepare a quote:
Employer contribution to total premium (min. 25%):
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Must the plan cover employees from other companies? Yes No
Are any employees presently absent from work on disability, parental of other authorized leave? Yes No
Are the employees and owners covered by CNESST? Yes No
Do you intend on making employer contributions to the plan? Yes No
Do you have employees outside the Province of Quebec? Yes No
Do you currently have a group retirement savings plan in place? Yes No
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