EmailMeForm
Benefits Concern Form
Please fill out this form completely to assist us in helping you resolve your claim.
Name
*
First
Last
Phone
*
###
-
###
-
####
Employee #
*
Email Address
*
Active/Retired
*
Please select
Active
Retired
Retired and Over 65yrs
Former Municipality
*
Please select
East York
Etobicoke
North York
Scarborough
Toronto
York
Active (Not Applicable)
Has your claim been submitted and denied?
*
Yes
No
Has your pre-estimate been denied. Either electronically or over the phone?
*
Yes
No
Briefly describe your issue. Please note that this information will be sent to the City Benefits staff to administer.
*
READ CAREFULLY: Please upload any supporting documentation that you believe will be useful. This field IS required. Please upload any relevant emails from TEAMS Central and Denials from the GS website. If you fail to submit these, it will delay the process.
*
Add File
