Apply for a non-smoker rate on your portable benefits coverage
Have you added portable benefits coverage to your workplace plan? You’re in the right place.
Download this form and print it, or fill it out in Adobe Reader XI or higherOpens a new website in a new window - Opens in a new window (not your browser) and save.
When you’ve completed your forms, you can submit them to us by email at firstname.lastname@example.orgOpens in a new window or fax to (416) 552-3373.