Smartin Benefits Plan Owner Enrolment Form

Enrolling your Company with Smartin Benefits, makes you the Plan Owner.

Employee Details:

Use mailing address to send refunds to (cheque method)
Use email to send refunds to (Interac e-transfer method)
Please provide the Employee's Annual $ Limit or Class

Authorization and Confirmation:

Note: The act of inputting your name below serves as a general electronic signature and is legally binding. Please read the applicable statements below:

  • Plan Administrator / Employee: I acknowledge (by typing my name below) that the information contained in this application is accurate and true to my knowledge.
  • Plan Administrator: I have the permission of the Employee to share the information and that the Employee was informed and is eligible to participate in the Smartin Benefits Plan.
  • Employee: I confirm participation and eligibility to participate in the Smartin Benefits Plan.

Last Step:

Once you completed all the required fields, click on the Enroll Employee button:

  1. We will review and capture the information into our system.
  2. We will update the Company's Plan Administrator with a new Plan Member Number.