Retired Members  |  Forms

Retiree Program Withdraw Notification

Coverage Details

Description

The Retiree Program Withdraw Notification is for current Retirees that wish to withdraw from the Retiree Benefit Program.

Applicable for

Member Only

Submit your form online:

Step 1

Download, print and fill out the form.

Download Form
Step 2

Upload the form using our online submission form.

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Submit by mail:

LiUNAcare Local 183
200 Labourers Way
Vaughan, ON, L4H 5H9
Suite 2100

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