Temporary Medical Insurance Opt Out Form

FOR THE PLAN YOU HAVE INDICATED YOU MUST PROVIDE PROOF OF ALTERNATIVE COVERAGE (PDF, JPG, GIF OR PNG FILES ALLOWED). ACCEPTABLE PROOF INCLUDES ONE OF THE FOLLOWING: BC SERVICE CARD, OR CONFIRMATION OF COVERAGE FROM HEALTH INSURANCE BC, OR BC MSP INVOICE FROM REVENUE SERVICES.
Files must be less than 2 MB.
Allowed file types: gif jpg png pdf.
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