Quick Contact
Ottawa office
466 Tremblay Road
Ottawa, ON K1G 3R1

Tel: 613-231-2266
Fax: 613-231-2345
Toll Free: 1-888-613-1234
Winnipeg office
1403 Kenaston Boulevard
Winnipeg, MB R3P 2T5

Tel: (204) 942-4438
Fax: (204) 943-5998
Toll Free: 1-888-204-1234


All eligible employees under the age of 70, who are actively covered under a Coughlin group insurance benefit, pension or individual plan are eligible to be covered under this plan. 

Click here to download the application.

Continuation of coverage  

Employees who are:  (1) laid-off on a temporary basis;  (2) temporarily absent from work due to short-term disability;  (3) on leave of absence;  (4) on maternity leave; or (5) continue to maintain an affinity with Coughlin through its group insurance, pension or individual plans, may continue to be covered under this program.

Spousal coverage available

All spouses under the age of 70 can be covered by Privileged Selection group term life insurance.  Just have him or her complete and sign the spousal portion of the application.

Click here to download the application.

employee benefits specialists
Important forms
Dental - Medical Claim Forms
Dental & medical claim forms
Pre-authorized deposit forms
Pre-authorized deposit forms
Pre-authorized payment forms (Ottawa only)
Pre-authorized payment forms (Ottawa only)
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Personal financial programs for you and your family.
What's new
March 31, 2020
UPDATE: COVID-19 Coughlin & Associates Ltd. is act...