I have always believed that the most important work that I do starts if and when any of my clients need to make a claim on their coverage; at that point, I go to work fully, completely.  I feel that now is an important time for me to increase communications with my clients and others who may feel concerns about how their Extended Group/Employee Benefits coverage fits into the current state of affairs, and to let you know that I am here to help you and your employees.

We learned today that effective March 15th, 2020, the Canadian Federal Government has implemented important employment supports for workers and employers, including waiving the 1-week waiting period on Employment Insurance (EI) for those individuals in imposed quarantine.  Much more detail on this here. 

This morning, I received a great question from a valued client who owns a civil excavation company, employs roughly 40 workers.  Specifically, my client’s question is:

This issue is very important to him and his employees, and I have communicated my answer to him directly.  I have also taken this opportunity to share this and a couple other pertinent issues & questions that have arisen today to all my Business Owner and Extended Benefits Clients.

Employees laid off – Extended Benefits Remaining In-Force:

• If someone is laid off, the employer has the option of keeping the employee’s (Plan Member and Dependents) Health, Dental, Critical Illness, and Life Insurance benefits in-force for up to six months from the last day worked prior to lay-off.

• If included in the benefits plan, Short & Long-Term Disability Benefits cease once an employee is no longer working.  

• Regarding payment of premiums for Health & Dental benefits remaining for laid-off employees, this can be negotiated between the employee and employer (if there is a cost share arrangement in place).  There are two general options in this regard:

  • To continue a cost-share for up to six months while an employee is on leave (EI or otherwise), the employee could provide the employer with post-dated cheques in the amount of their share of the benefits.  Since the employee is no longer on payroll, there may be other options as well for the method of reimbursement to the employer.

  • Alternatively, the employer could choose to fund the employee’s share at 100%.

• To begin this arrangement, the employer needs to inform the insurance carrier of the Plan Member names and/or Plan ID numbers, along with the effective date of the layoff, so that this can be reflected on the billing.

In addition to the above details, I thought I would add other questions that may have come up in your business over the past few days.  A note that each carrier’s policies may differ and that these are general guidelines.

Out-of-Country Travel:

• On this topic, we are experiencing extremely fast-moving border restrictions and quarantines.

• Claims related to COVID-19 that occurred during travel out of Canada may be assessed like any other claim under your plan.  Plan coverages vary, so that’s why every claim will be handled on a case-by-case basis.

• Out of country coverage generally covers eligible expenses when you have symptoms from a medical emergency and you require treatment.  These include medical evacuation if suitable care isn’t available, family assistance, and lodging.

Short-Term Disability (STD / Weekly Indemnity) Claims Related to Quarantine:

• Income replacement coverage (such as short and long-term disability) is important coverage that provides income replacement where a person can’t work due to illness/disease or injury.

• If the benefits plan includes Short-Term disability, Plan Members are eligible for benefits from the start of the quarantine period, if they are displaying symptoms consistent with COVID-19, have tested positive, and are unable to work.

• If plan members have symptoms that prevent them from working, but testing does not confirm COVID-19, they should submit a claim.

The health and well-being of your employees and their families is more top of mind nowadays than at any time in our recent history.  If your company does not have an Extended Benefits Plan in place yet, perhaps now is a good time to start the process.  It would be my pleasure to have this conversation with you.

I encourage all my friends, colleagues and clients to send me any questions you may have, and I am prepared to do my best to communicate clear responses as quickly as possible.