Enrolment

• Application for drug and health insurance (Under age 65) (PDF 291k)
• Report of insurability (To be completed if you are applying for the drug and health insurance COMPLETE plan) (PDF 233k)
• Application for disability insurance (PDF 225k)
• Declaration of dependant children (PDF 36k)
• Disability Insurance - Re-entry form (PDF 24k)
  
• Application for term life group insurance (PDF 401k)
  Please return the form(s) to Sogemec Assurances
  C.P. 217, Succ. Desjardins, Montreal (Quebec) H5B 1G9
• Application for critical illness insurance (PDF 104k)
  Please return the form(s) to Sogemec Assurances
  C.P. 217, Succ. Desjardins, Montreal (Quebec) H5B 1G9

Claims

• Application for health insurance benefits (PDF 115k)
  Please return the form(s) to:
  Desjardins Financial Security, Box 3950, Lévis, Québec G6V 8C6

Payment authorization

• Payment by credit card (PDF 115k)
  Please complete the form if you would like to pay your drug and health insurance by credit card and return it to Sogemec Assurances inc.
• Pre-authorized withdrawals (health) (PDF 139k)
  Please complete the form if you would like to pay your bill(s) by pre-authorized withdrawals and return it to Sogemec Assurances inc.
  
• Pre-authorized withdrawals (disability) (PDF 134k)
  Please complete the form if you would like to pay your bill(s) by pre-authorized withdrawals and return it to Sogemec Assurances inc.
  

Exemption

• Exemption request (PDF 262k)
  For Insureds covered under the Comprehensive plan - Drug and Health Insurance only. To be used to suspend your protection.

Modifications

• Change of bank account (health) (PDF 139k)
  Please complete the form if there has been a change to your bank account and return it to Sogemec Assurances inc.
• Change of bank account (disability) (PDF 134k)
  Please complete the form if there has been a change to your bank account and return it to Sogemec Assurances inc.

Address change 
Please complete the form if there has been a change to your address.

• Modification request - Renewal (PDF 35k)
  To be used if you wish to modify or cancel your protection for drug and health insurance.