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    Individual Health Insurance Quotes

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    Manulife FlexCare Online Enrolment

    Please fill out the information below and click on the Apply Now button.You can also call us at 1-800-474-4474 to enroll over the phone.

    Once we receive your application we will:

    1. Check for errors and populate an application form for you.
    2. Contact you to obtain any additional information that might be required.
    3. Send you the PDF application for your signature.

    Part A: General Information

    Applicant Details

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    Part B: Dependants to be Covered

    Part C: Beneficiary Designation

    - Beneficiaries are for Accidental Death and Dismemberment (AD&D) if applicable -


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    Note: if you appoint a beneficiary under the age of 18, benefits will be paid into court or to Public Trustee unless a trustee is appointed below.

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    Part D: Payment Information


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