Forms - Retirees

Print this page

Email the link

Use the free Adobe Acrobat Reader to download the form you need. Send the signed form to:

OPSEU Pension Trust
1 Adelaide Street East, Suite 2900
Toronto, ON M5C 3A7
Fax: (416) 681-6175

Download the form you require by choosing one of topics below:

Beneficiaries and survivor benefits

Declaration of Attendance at a Secondary or Post-Secondary Institution (OPTrust 1031) form
Retiree Spousal Information and Beneficiary Designation (OPTrust 1015R) form
Application for Post-Retirement Spouse Survivor Pension (OPTrust 1016R) form

Personal Information

Medical

Marital status

Statement of Marital Status (OPTrust 3007) form
- How to Prove Your Spousal Relationship fact sheet

Insured benefits

Dentalcare claim
- Retired before 2017
  Pensioner Legacy Plan A1 (Policy 157838) - Original plan
- Retired after 2016
  Pensioner Legacy Plan A2 (Policy 169494) – Co-pay plan
  Pensioner Alternative Plan B1 (Policy 169974) – Government-paid plan
Healthcare claim
- Retired before 2017
  Pensioner Legacy Plan A1 (Policy 157838) - Original plan
- Retired after 2016
  Pensioner Legacy Plan A2 (Policy 169494) – Co-pay plan
  Pensioner Alternative Plan B1 (Policy 169974) – Government-paid plan
PRB Optional Upgrade
Canada Life Insured Benefits Change (OPTrust 3011) form
LCBO Employees - Canada Life Insured Benefits Change (OPTrust 3011 - LCBO) form
Waiver to Opt Out of Basic Life Insurance Coverage (LIFINS)

Taxes

Some of these forms require additional documentation as proof, such as a birth certificate or information establishing your spousal relationship. Gather all of the relevant pieces of documentation and send them to OPTrust.