CORPORATE CARE INC
 SIGN UP FORM for INCORPORATED BUSINESSES
PRIVATE HEALTH SERVICES and COST PLUS PLANS

740 CENTURY ST WINNIPEG MANITOBA R3H 0M1
Administrator's Fee: 5% OF ALL CLAIMS SUBMITTED (GST on Admin fee Extra) plus a $10.00 processing charge.*
Benefits Administrator: *
Please use our Employee Enrollment Form for each added user.
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I learned about Corporate Care from:
Emailing this form constitutes Agreement to the Terms and Conditions of Corporate Care's Private Health Services Plans and Cost Plus Plans.  I also agree to the following:
I will keep medical receipts on file for 7 years as per CRA guidelines.  
All medical receipts submitted will only be those from my own families expenses, and only amounts never reimbursed by this plan or other plans will be submitted.
 *