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Persons
Member
Spouse
Dependents
Inactive persons
Last name
First name
Gender
Birth date
Relationship
Payroll
DOE
JOHN
MALE
JAN 01 2001
SPOUSE
Manitoba Blue Cross
Last name
First name
Gender
Birth date
Relationship
Payroll
DOE
JANE
FEMALE
JAN 02 2002
SPOUSE
Manitoba Blue Cross
Last name
First name
Gender
Birth date
Relationship
Payroll
DOE
JOHN
MALE
JAN 01 2001
SPOUSE
Manitoba Blue Cross
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Termination date:

*Manitoba Blue Cross Information

Last name
First name
Gender
Birth date
Relationship
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Address
Mailing address (Street)
City
Province
info
Postal code
Payroll
123 EASY STREET
12345
MB
A1B 2C3
Manitoba Blue Cross
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Employment information
Date of Employment
Employee Number
Occupation
Payroll
Apr 12 2022
123
Teacher
Manitoba Blue Cross
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Salary
Type
Amount
Hours
Effective date
Payroll
Annual
$50,000.00
40
2010-01-01
Manitoba Blue Cross
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Coverage
Coverage
Name
Relationship
Effective date
Health
John Doe
Spouse
Mar 12 2022

No coverage data

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Beneficiary
Payroll
First name
Last name
Relationship
Percentage %
JANE
DOE
Spouse
Percentage
Manitoba Blue Cross
First name
Last name
Relationship
Percentage %

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Banking information
Transit number
Institution number
Account number
Payroll
12345
123
00123456789
Manitoba Blue Cross
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