Plan Administrator completes Section 1, 2 and 3 of the Change Form
Return a copy to: (Mail) Morneau Shepell, 895 Don Mills Road, CPAG, Toronto ON M3C 1W3 or (Fax) 1.877.464.0109 or scan and email to csc@morneaushepell.com.
Retain the original for your files. We recommend that you keep the application for a period of one year following the termination date
Ensure the Plan Member's pay-direct drug/id card is returned and destroyed on the effective date of termination