Health / dental insurance plan



This form is for students who have permanently opted out of the complementary health and dental plan and who wish to reinstate the plan during the modification period at the beginning of the semester. If you need more information, please do not hesitate to contact us. We will be happy to answer your questions.

IMPORTANT : Be sure to include all the supporting documents needed to evaluate your file (proof of loss of coverage, account statement and other documents). If the supporting documentation is not received by the end of the modification period, your reinstatement request may be denied. Also, be sure to contact Major Plan to find out the cost of the reinstatement fee that applies to your situation.

Procedure :

1. Complete and sign the form.
2. Send the form to
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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