- Plan Administrator completes Section 1 of the Notice of Change Form
- Fax a copy of this form to your nearest Morneau Shepell office
- 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 (if applicable)
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Last updated on: Tuesday, May 29, 2012 Page:
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