Skip to main content

The browser you’re using is no longer supported. For the best experience, please upgrade to the latest version of Google Chrome or Firefox.

Benefluent Logo
Logo of the Advisor Account
GSC (Green Shield Canada) Health Assist Logo

Apply Online

New Applicant

If you are a new customer and wish to apply online, please click the New Application button below. You will be prompted to answer a few easy questions to get a quote, then simply select a plan to start your application.

NEW APPLICATION

Returning Applicant

If we have already emailed you a quote or you have saved a partially completed application within the last 30 days, enter your confirmation number below to continue where you left off.

Apply Manually

If you would prefer to fill out a paper application and submit it by mail, please print the PDF provided below. You may need Adobe® Acrobat® Reader® to view the file.

Advisor Information

Please use the information below to complete the advisor fields. That way we’ll know who sent you to us.

ADVISOR CODE: 2711346
OFFICE CODE: HA331
MGA CODE: 1598

ADVISOR NAME: Sam Beales
OFFICE NAME: Kingston
MGA NAME: Benefits by Design Inc.

Application form (PDF)

Click here for ZONE. Click here for LINK.