|June 2, 2020|
A new full-time employee should complete a Group Enrolment Form on the day he/she is hired. If the form is not received by the insurer within 31 days of the end of the waiting period, the employee is considered a late applicant.
Before submitting the enrollment application ensure that:
Once completed, the enrollment application should be mailed to the insurer immediately. You may fax a copy of the application form to expedite the application process; however, the original copy must be submitted. Please retain a copy of the application for your records. Insurance coverage will become effective when the employee has completed the eligibility-waiting period.
Please note that all information on these cards is necessary in order for the insurer to proceed with the enrollment.
Employees who have dental and/or extended health coverage through their spouse or common-law, may waive these benefits by indicating this in the enrollment application.
Each member of an employee’s family must be listed on the application form along with their date of birth in order for claims to be honoured.
The Plan Administrator should have the new employee complete the appropriate application for group coverage.
When the Plan Administrator provides the plan details to the employee, the employee has two options:
1. Enrol in the program for ALL benefits; or
2. Enrol in ALL benefits except health/dental only if comparable coverage is available through a spouse, an individual plan, or other group insurance plan(s).
An employee may waive dependent coverage for extended health and/or dental care only if the dependents are insured under the spouse’s plan for benefits equal to the benefits under your program. To waive dependent coverage during initial enrollment, complete Section #2 on the Group Enrolment Form. To waive dependent coverage after initial enrollment, use the Change Form. Mail the original copy of the applicable form to the insurer. You may fax the applicable form to (306) 347-6812 in order to expedite the change process, however, the original copy will also be required.
After the Expiration of the Waiting Period - "Late Applicant"
A new full-time employee who applies for coverage more than 31 days after the end of the waiting period is considered a Late Applicant. The employee must complete a Health Evidence Questionnaire Form immediately.
If a late entrant is also applying for dependent coverage, the 3rd and 4th page, or dependent's portion of the Health Evidence Questionnaire Form must also be completed.
Adding Coverage In Excess Of The Non-Evidence Maximum (Excess Coverage)
Many life and long term disability plan structures include a “Non-Evidence Maximum” (NEM) clause which sets a ceiling for the maximum amount of coverage an employee can be covered for without submitting medical evidence. If the employee is eligible for an amount of coverage in excess of the NEM based on his or her salary, the employee is required to submit evidence of insurability, detailing his or her medical past and current health status. Should the employee wish to apply for excess coverage, please ask him/her to complete a Health Evidence Questionnaire Form and submit the original to the insurer.
If you have any further questions, please contact us; we'll be glad to help you.