Sign up for pre-authorized debit for health coverage premiums

Send us a form to sign up for pre-authorized debit to pay your extended health care and/or dental premiums directly from your bank account.


Submit the form

  1. Print the form
  2. Complete, sign and date the form
  3. Attach a sample cheque marked VOID or provide information about your financial institution and bank account on the form
  4. Submit the form to BC's College Pension Plan

Eligibility

You can submit this form to pay Green Shield Canada directly through pre-authorized debit if:

  • your pension payment does not cover your retirement health coverage premiums
Required information

You will need to do one of the following:

  • Attach a void cheque to your application
  • Provide information about your financial institution and bank account on the form

External links for applying for retirement health coverage

Read the Green Shield Canada My Benefit Plan booklet

Green Shield Canada

Medical Services Plan of BC

Related content for applying for retirement health coverage

Retirement health coverage premiums