Adding or Deleting Dependents
- Plan Administrator completes the “Reason for Completion” box and Part 1 of the Notice of Change Form by indicating the Plan Member's identification number, name, effective date of change etc.
- Plan Member completes applicable information in Section B of the Notice of Change Form
- Fax a copy of this form to your nearest Morneau Shepell office
- Retain the original for your files
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Last updated on: Tuesday, May 29, 2012 Page:
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