A-29.01, r. 4 - Regulation respecting the basic prescription drug insurance plan

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7. Every person to whom paragraph 4 of section 15 of the Act respecting prescription drug insurance (chapter A-29.01) applies shall, to register in the basic prescription drug insurance plan, provide the Board with the following information:
(1)  his full name;
(2)  his sex;
(3)  his date of birth;
(4)  his health insurance number;
(5)  his social insurance number, where applicable;
(6)  his home address;
(6.1)  his employment status, the name of his employer, and his profession or habitual occupation;
(7)  in the case of a person referred to in the second paragraph of section 11, a statement according to which the group insurance contract or the employee benefit plan to which he is required to become a member on the basis of current or former employment status, profession or habitual occupation is applicable solely outside Québec;
(8)  a statement according to which he is not required to become a member of a group insurance contract or an employee benefit plan applicable to a group of persons determined on the basis of current or former employment status, profession or habitual occupation;
(9)  his civil status, whether he is single, married a common-law spouse, separated, divorced, widowed or a member of a religious order;
(9.1)  the employment status, the name of the employer, the profession or habitual occupation of his spouse, where applicable, and if the latter is not entered on the form of the person who registers, the spouse’s full name, date of birth and health insurance number;
(10)  a statement according to which his spouse is not obliged to ensure his coverage as a beneficiary taking into account that he is not himself required to become a member of a group insurance contract or an employee benefit plan applicable to a group of persons determined on the basis of current or former employment status, profession or habitual occupation, where applicable;
(11)  in the case of a person under 18 years of age, a statement according to which he is emancipated and the reason of the emancipation;
(12)  in the case of a person of 25 years of age or under who is duly registered as a student, a statement according to which he attends an educational institution on a part-time basis or that he has a spouse.
O.C. 1519-96, s. 7; O.C. 582-97, s. 1.