Pension@work pension and death
You may sign the completed forms and return them to AG Employee Benefits, for the attention of the administrator of your plan, at
Beneficiary(ies) in the event of death
Designation/change of beneficiary(ies) in the event of death (2nd pillar)
The affiliate must fill in and sign the form. It must then be sent directly to AG Employee Benefits at the address provided on the form.
FR - NL
Waiver of the application of Article 110/1 LCAT (2nd pillar)
FR - NL
Waiver of the application of Article 110/1 LCAT (3rd pillar)
FR - NL
Notification of departure from a plan
Use the Departure form if the employment contract of your affiliate is terminated for a reason other than retirement, early retirement or death.
EN - FR - NL - DE
Use the Notification of Liquidation if your affiliate retires or takes early retirement.
Use the Notification of death form if you have to report the death of an affiliate.
Print the form and complete the section about you.
Ask the beneficiary to complete the section about them, sign the form and send it to you with:
an extract of the death certificate including the place and date of the death,
a photocopy of the front and back of the identity and SIS cards of the beneficiary(ies),
a notarial certificate, if the beneficiary(ies) (other than the spouse) (was)were not designated by name. The certificate should provide the last names, first names, dates of birth, civil status and addresses of the legal heirs of the affiliate,
if one or more beneficiaries is(are) (a) minor(s) and no longer have a mother or father: the special authorisation of the judge of the peace authorising the tutor to collect the funds,
if the services provided by the contract must be converted into an annuity: a certificate of life of the beneficiary(ies),
if the affiliate's tax residence or the location of their wealth is abroad: a tax certificate. You must provide the “tax residence or location of wealth abroad” document in the language of the country in question for this purpose.
Pre-financing information document
The pre-financing information document must be provided by the employer to all of their insured employees and whenever a new person is hired. This ensures that the employer fulfils his information obligation under the Verwilghen Act. Given the severe sanctions, it is recommended that an acknowledgement of receipt be signed by the employees.
For group hospitalisation insurance, the employer must also provide the AG Care Vision form.
AG Care Vision form
AG Care Vision is an individual hospitalisation insurance plan which meets the legislator’s objective of encouraging pre-financing.
Employers who take out group hospitalisation insurance for their employees must provide them with the AG Care Vision form and the pre-financing information document.
EN - FR - NL
Request for individual continuation coverage
This document must be provided to the employee at the latest 30 days after the end of affiliation or the loss of group healthcare insurance or income protection coverage. The document consists of two parts:
The first must be completed by the employer.
The second is for the employee requesting individual continuation coverage.
The two documents must be sent to the employee.
EN - FR - NL - DE