Contact Person: City: * Province: * - BC AB SK MB Phone Number: * Email Address: * Select Options Term Life (Mandatory): Lesser of 1 Times Annual Salary or 50,000 1 Times Annual Salary 2 Times Annual Salary 3 Times Annual Salary Long Term Disability (Mandatory): 75% of monthly salary 60% of monthly salary - 60% of monthly salary (benefit is non-taxable ? employee must pay 100% of premium) - 75% of monthly salary (benefit is taxable ? employer contributes to LTD premium) LTD Cap Benefit at $1000: Waiting Period Partners: 30 days 90 days 113 days Waiting Period CPAs: 113 days 180 days Waiting Period Employees: 113 days 180 days Dependent Life (Requires Term Life): ADD (Requires Term Life): Critical Illness: Extended Healthcare: - 80% Prescription Drugs/No Vision 100% Prescription Drugs/No Vision 80% Prescription Drugs/$200 Vision 100% Prescription Drugs/$200 Vision 80% Prescription Drugs/$350 Vision 100% Prescription Drugs/$350 Vision Dental Care: - 80% Basic 100% Basic 80% Basic/50% Major 100% Basic/50% Major 80% Basic/50% Major/Ortho 100% Basic/50% Major/Ortho Details of Employees Complete for each employee. Name Type Age Gender Annual Salary Smoker? Family? Premium - Partner CPA Employee - Male Female - Non-Smoker Smoker - Single Family $0.00 Policy Total $0.00 Add Employee How did you find us: - Newsletter CPA Pivot CPA InFocus CPA Dividends CPA Capitalize Conference Show Provincial Body Facebook LinkedIn Twitter Search Engine Sponsorship Another CPA IPW Client I Am An Existing Client Other Home About Insurance Quote Brochures Forms News FAQ Copyright 2020 CPA Insurance Plans West. All rights reserved.