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Sun Life Personal Health Insurance Enrolment

Please fill out the information below and click on the Apply Now button. You can also call us at 1-800-474-4474 to enroll over the phone.
Once we receive your application we will:
  1. Check for errors and populate an application form for you.
  2. Contact you to obtain any additional information that might be required.
  3. Send you the PDF application for your signature.
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* not required
Part A - General Information
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Please note: the co-applicant is an insured spouse/partner (if applicable).
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(if unknown leave blank)
Part B - Dependants
Part C - Beneficiary Designation
- Beneficiaries are for Accidental Death and Dismemberment (AD&D) if applicable -
- if you are not sure about this you can skip Part C for now -

Applicant Beneficiary:
Note: if you appoint a beneficiary under the age of 18, benefits will be paid into court or to Public Trustee unless a trustee is appointed below.
Applicant Trustee:
Co-Applicant Beneficiary:
Note: if you appoint a beneficiary under the age of 18, benefits will be paid into court or to Public Trustee unless a trustee is appointed below.
Co-Applicant Trustee:
Part D - Plan Information
Part E - Payment Information
Initial Payment:
Subsequent Payments:
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