Forms
Claim Forms
Claim forms are available from the Administrative Agent or downloaded online. The downloadable claim forms are for eligible active members and eligible dependents of the Local 3000 Members Benefit Fund as listed below.
Please be sure to complete them fully, attach necessary original paid in full invoices along with any other original documentation where applicable and keep a copy for your records to substantiate your claims, and submit to the following mailing address:
LiUNAcare Local 3000
90 Burnhamthorpe Road West
Suite 300, Mississauga, Ontario
L5B 3C3
Vision Claim Form
Policy 177882
Download FormDental Claim Form
Policy 177882
Download FormExtended Health & Drugs Claim Form
Policy 177882
Download Form