Java script has been disabled in your browser, please check if the URL in address bar is '/en/common/administration/terminating.asp' Terminating Coverage

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Terminating Employee Coverage

Terminating Employment

  1. Plan Administrator completes Section 1, 2 and 3 of the Change Form
  2. 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
  3. Retain the original for your files. We recommend that you keep the application for a period of one year following the termination date
  4. Ensure the Plan Member's pay-direct drug/id card is returned and destroyed on the effective date of termination