Enrollment form – Drug/Health/Dental CareImportant note
You can send your application using our secured page here or by fax at 514 350-5071 or by mail to our Montreal office.
The effective date of your coverage may not pre-date the date of the signature on the request for enrolment, except for enrolments that result from an end of exemption, in wich case, the applicant must prove that he/she was insured under a similar group insurance plan to the one he/she wishes to join.
The choice of plan must remain in effect for a minimum of two (2) years and no change is possible within such period.
For more details, please contact our Customer services team at 1 800 361-5303