Application – Ontario Blue Cross® – Express Monthly Indemnity Accident & Illness

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Application

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Plan Details

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Disclosure

This insurance application will not be submitted to the insurance company until you have received formal email confirmation from your Red Helm Insurance advisor. Do not submit this application if you have not reviewed plans with and/or have been contacted by a Red Helm Insurance representative. Any information submitted within this application may be shared with the insurance company in question for the purpose of underwriting the insurance coverage you are applying for. If you have any questions or concerns, contact us at 1.866.230.5565.

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