MSP Change

MSP Group Change Form


Use the MSP Group Change Form if you are covered for the Medical Services Plan of BC (MSP) through the Ironworkers Local 97 Health & Welfare Plan and you wish to add or delete a dependent from your MSP coverage.

Information Needed to Complete the Form

In addition to the Member’s personal information, additional information is required to complete the form, including:

  • Group number (4823381), which is pre-printed on the form,
  • Detailed information on any changes to your dependents (if applicable),
  • Residency information,
  • Signatures from both the Member’s and spouse.

Additional information to complete the form is listed on the second page of the form. Please follow the instructions on the form.


Questions on completing the form should be directed to the Plan Administrator.

Completed forms should be forwarded to the Plan Administrator.