Supplemental Plan Forms

  • Form 161 - Past service purchase application form (Supplemental Plan) (673.0 KB)

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

  • Form 162 - Pre-authorized debit form (Supplemental Plan) (804.0 KB)

    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) (813.0 KB)

    Use this form to request a Supplemental Plan cost estimate when it is not obtainable through the employer.