Employee and Retiree Responsibility

You should note that you have responsibilities to fulfill. Your responsibilities include, but are not limited to, the following:

• For ensuring that you have applied for the coverage you wish to have for yourself on your enrolment forms and your dependents within the appropriate time frames.
• To change your coverage from single to family within the appropriate time frame. If the coverage is not changed within 31 days of acquiring your first eligible dependent an Evidence of Insurability on Dependents is required for approval.
• To add a spouse to this plan in the event that he or she loses coverage under another plan within a 31 day period following the loss of coverage to avoid having to provide medical evidence.
• For examining payroll deductions for each pay period for all group insurance benefits. Examples would include family versus single coverage and optional benefit premiums particularly when you have requested changes in coverage and at the annual renewal date when the premiums are adjusted. This will ensure accuracy and allow for corrections on a timely basis. Coverage details can be confirmed through pay stubs, your plan administrator, employers online benefit statements (where available), and the insurance carrier (by visiting www.CanadaLife.com and signing into Groupnet for plan members or by calling 1-844-349-5656.
• For amending your coverage to delete any coverage you no longer require. Contributions which you have paid are not refundable if they were consistent with the application on file.
• For effecting conversion of the coverage eligible to be converted upon the earlier of termination of employment or at age 65.
• For accurately completing the necessary forms required for continuing benefits while on maternity leave, sick leave, special leave without pay, retirement, etc. It is extremely important these arrangements be made prior to commencing eligible leave. For continuation of group life and health insurance while on temporary lay-off or on unpaid leave you are responsible for the payment of the full premium amount (employer/employee contributions) and failure to remit will result in termination of coverage. You are also responsible for the payment of the full premium amount (employer/employee contributions) if you are a casual/hourly employee and you maintain benefits during a pay period when you have not worked and have not received pay. Failure to remit premiums will result in the termination of coverage.
• For providing appropriate claim information necessary to process LTD and/or Waiver of Premium claims as well as to ensure notice of claim/proof of claim where necessary has been provided within appropriate time frames as required under the contract.
• For providing appropriate medical information necessary to add a dependent as functionally impaired to continue their coverage beyond the age a dependent would otherwise terminate based on contract guidelines.
• For completing the appropriate forms accurately, completely, and within applicable timeframes for such things as change of address, addition or deletion of a dependent, and other significant matters that can change or otherwise affect your coverage.
• To register overage student dependents between age 21 and 25 at the beginning of each school year. Failure to do so may impact coverage.
• Reviewing the online employee benefit booklet, contacting the insurance carrier and/or your organization’s plan administrator to ensure you have a sound knowledge of the benefits available, extent of coverage, eligibility criteria, exclusions, restrictions, medical underwriting requirements, conversion options, continuation of benefits, predeterminations and other important requirements of the program.
• Providing proof of the purchase of pension service that may reduce LTD premiums. Premiums will only be adjusted when the plan administrator has been notified and received verification despite the date the purchase may have occurred.
• For notifying your plan administrator if the deletion of an overage dependent requires a change in your premiums from family to single coverage.

Eligibility for Group Insurance

• Permanent Full Time Employees are required to participate in the group insurance program from their first day of employment.
• Temporary Full Time Employees, if hired for a single period of three months plus one day, are required to participate in the group insurance program from their first day of their employment. Employees who are hired for a period of less than three months, who receive notice of extension equal to three months plus a day, are required to participate from the date of notification.
• Permanent Part Time Employees are required to participate in the group insurance program from their first day of employment. Permanent Part Time Employees must work at least 50% of the minimum hours for a full-time employee on a bi-weekly basis.
• Seasonal employees are covered under the plan during their term of active employment. During periods of lay-off, provided they do not work for another employer during such lay off, employees have the option to continue their coverage (coverage will not continue unless a “Continuation of Coverage” form is completed, signed, and given to your Administrator prior to your leaving).
• Temporary Call-In/Casual/Hourly employees are required to participate in the group insurance program on April 1 of each year provided they worked a minimum of 50% of full-time years in the preceding calendar year.