Forms
Form 161 - Past service purchase application form (Supplemental Plan)
- Use this form to get a cost quote for purchasing Supplemental Plan past service.
Form 162- Pre-authorized debit form (Supplemental Plan)![]()
- Use this form to change your existing Supplemental Plan past service pre-authorized debit instructions.
- Use this form to request a Supplemental Plan cost estimate when it is not obtainable through the employer.

