Use this claim form to file for gym membership reimbursement (up to $18/month) if you are enrolled in an LISD Medical Plan.
Include a log of 10 gym visits for one month, a receipt or contract showing gym membership payment and the completed claim form.
Use this form to file for a hospital stay or up to $18 per month gym membership reimbursement if you are enrolled in major medical elsewhere.
Use this form to file a claim with BCBS when your provider did not. (Out-of-Network)
Spanish Language version
A Qualifying Life Event is a birth/adoption, death, spouse/dependent employment change or coverage loss.
Changes outside of a regular open enrollment period are made inside a 31-day window with the appropriate documentation/forms.
For New Hires interested in Sun Life Optional enrollment within 31-days of the first day on the job.
Or online at https://login.sunlifeconnect.com/commonlogin/#/registration/createaccount
for secure online submission. Notifications come through email on approval status.