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Forms

Form 161 - Past service purchase application form (Supplemental Plan) pdf

  • Use this form to get a cost quote for purchasing Supplemental Plan past service.

Form 162- Pre-authorized debit form (Supplemental Plan)pdf

  • Use this form to change your existing Supplemental Plan past service pre-authorized debit instructions.

Form 301 - Request for a Supplemental Plan cost estimate (for Police, Fire or Paramedic Union or Association use only)pdf

  • Use this form to request a Supplemental Plan cost estimate when it is not obtainable through the employer.
Supplemental Plan benefits are not automatically provided. Employers can set up Supplemental Plan coverage for a class or classes of members in the police sector, firefighters and paramedics.