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June 5, 2019
As the Group Sponsor of your Employee Benefits Policy in Regina, you are responsible for ensuring your employees are enrolled in your plan. Those who are not registered on time jeopardize their eligibility and coverages available to them.
Most Group policies in Regina have a waiting period in place before coverage for employee benefits begin, this is typically 3 months. Check your policy wording to confirm your plan’s eligibility period. Insurers will require the application to be submitted within 31 days of becoming eligible, if you wait any longer you run the risk of a ‘late entrance’ scenario.
If employees are not added on time, they become late entrant. Late entrant employees are required to complete medical questionnaires on themselves and their dependents. This is then underwritten approval from your carrier to be added to your employee benefit plan. Depending on the answers, employees and dependents run the risk of being declined coverage. For employees who are granted coverage, they are often provided reduced coverage for the first 12 months on the employee benefit plan. This is done to protect the integrity of your policy. You want to ensure that all employees are participating in your plan at their appropriate eligibility time frame, and not just waiting to join the program when they have a need for the coverage.
To help protect yourself and your valuable employees, you can safeguard these proceedings, delays, and frustrations by having a procedure in place when it comes to completing the employee enrolments. The best practice is to have each new employee complete the enrolment day one. Send in the new application or add the member to the insurer’s online portal immediately, the insurance carrier will apply the internal waiting period, and coverage will begin once they are eligible. This way, you do not have to worry about trying to remember when someone is eligible and potentially miss someone at no fault of the member. If the employee does not make it through the plan waiting period, a simple note or online termination can be completed, and they are removed.
Similar to new employees, the same rules apply to changes once an employee is on the plan. Examples of these would include; changes to marital status, the birth of a child, beneficiary designation as well as spousal coverage being lost (coordination of benefits). It is so essential in any life-change situation the insurance company is notified, this communication will avoid the above ‘late entrant’ policy in the future. Your benefit plan is there to take care of your team members no matter their health history, everyone is welcome when you are enrolling members and making changes on time! For more information, contact us!