You are considered a smoker for price purposes if you used any form of tobacco such as; cigarettes, cigars, cigarillos, pipes, chewing tobacco, e- cigarettes, vaporizers or any smoking cessation products (such as Nicorette gum or nicotine patch) in the last 12 months or used any marijuana or hashish on a frequent basis in the last 12 months. Use on a frequent basis of marijuana or hashish means use on a daily basis.

I hereby apply for coverage under the Canadian Taxpayers Federation Group Critical Illness and Full Employee Assistance Program (EAP), Second Medical Opinion Consultation and Eldercare and Caregiving Case Management and Support Insurance Plan. I further authorize the deduction and remittance of premiums from my bank account by Canadian Benefit Administrators Ltd., as I have indicated above, for my contribution toward the cost of these benefits. I further consent to disclosure, collection, and use of any information required to administer the plan and receive issues and updates from the Canadian Taxpayers Federation via email. I understand that there is no cost for these emails and that I may unsubscribe at any time.

Effective Date of Coverage will commence on the date in which the e-signature has been confirmed by the applicant and the “Application for Group Coverage” is received by Canadian Benefit Administrators.