1 888 711 1119 ATTN: SERVICE PROVIDERS SUBMITTING ONLINE CLAIMS • • • PREFIX MUST BE ENTERED WITH STUDENT NUMBER DEPENDENTS (OLDEST TO YOUNGES 01 02 03 04 Use of this card authorizes the provider to submit personal information to Green Shield Canada necessary for claims adjudication. This card is not transferable. Unauthorized use of this card constitutes fraud. Coverage eligibility is subject to ʦ outlined in the contract and premiums paid. student.greenshield.ca 24-HOUR TRAVEL EMERGENCY MEDICAL 1.800.936.6226 Toll-free (Canada & USA) 0.519.742.3556 Collect (other countries) You must call WITHIN 48 HOURS of commencement of treatment. GSC TRAVEL # 5492

1 888 711 1119 ATTN: SERVICE PROVIDERS SUBMITTING … · Unauthorized use of this card constitutes fraud. Coverage eligibility is subject to benefits outlined in the contract and

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Page 1: 1 888 711 1119 ATTN: SERVICE PROVIDERS SUBMITTING … · Unauthorized use of this card constitutes fraud. Coverage eligibility is subject to benefits outlined in the contract and

1 888 711 1119 ATTN: SERVICE PROVIDERS SUBMITTING ONLINE CLAIMS

• • • PREFIX MUST BE ENTERED WITH STUDENT NUMBER

DEPENDENTS (OLDEST TO YOUNGEST)

Use of this card authorizes the provider to submit personal information to Green Shield Canada necessary for claims adjudication. This card is not transferable. Unauthorized use of this card constitutes

fraud. Coverage eligibility is subject to benefits outlined in the contract and premiums paid. student.greenshield.ca

24-HOUR TRAVELEMERGENCY MEDICAL

1.800.936.6226Toll-free (Canada & USA)

0.519.742.3556Collect (other countries)You must call WITHIN 48 HOURSof commencement of treatment.

GSC TRAVEL # 5492