Forms for Group Plan Administrators

Forms are also available through MSP’s Forms-by-Fax service, available 24 hours a day 7 days a week at (250) 356-9646.

Group Plan Registration Form

This form can be used to set up your group plan

Form # Form Name and Information

201

Register your company to begin administering a group plan.

 

Group Plan Administration Forms

These forms can be used to administer your group plan

Form # Form Name and Information

167

Add individuals to your group plan.

170

Report changes, including individuals' information updates, the addition or deletion of dependents, and group plan information updates.

1904

Notify group plan members who are being removed from the group plan about their status change and what they need to do to ensure continued MSP coverage.

 

Group Plan Cancellation Forms

This form can be used to request termination of your group plan with MSP.

Form # Form Name and Information

295

 Request MSP group plan termination

This form can be used to cancel group coverage for an employee/ pensioner and all dependants.

Form # Form Name and Information

217

Cancel group coverage for an employee, pensioner and all dependants

 

Supplies Order Form

This form can be used to order paper copies of MSP brochures and forms.

Form # Form Name and Information

173

Order paper copies of MSP brochures and forms.