Extension and Request to add dependents


This form is for students who wish to add dependents and/or extend their coverage. Requests for changes to AETELUQ coverage must be received no later than 30 days after coverage begins.

IMPORTANT: Major Plan reserves the right to verify and validate eligible documents proving the status of your dependents. Please ensure that you have these documents and can provide them to us within 10 business days. If the supporting documents are not received within this timeframe, your request to add dependents may be refused and cancelled. Also, be sure to contact Major Plan to find out the cost of the contribution that applies to your situation.
In order to add dependents, you must extend your current AETELUQ coverage (add 8 months) and add your children or spouse for a period of 12 months.

Cost of the contribution for an extension of coverage: $198 for 12 months of coverage (extension of 8 additional months to the initial 4 months)

Cost of the contribution for adding dependent children* OR add a spouse: $297 for 12 months of coverage

Cost of the contribution for adding dependent children* AND add a spouse: $594 for 12 months of coverage

*Unlimited number of children



1. Complete and sign the form.
2. Send the form to student@majorplan.ca.
3. Our team will then analyze your application and contact you within 5 working days. Please wait for confirmation from a member of our
team as to the amount of the membership fee to be paid, and the payment terms and conditions.
4. Once payment has been made, an e-mail confirmation will be sent to you within 7 working days, confirming that your application
has been registered. Keep this e-mail.

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