It’s not a sexy conversation, but essential knowledge none-the-less…did you know before a plan member can be eligible to be on the benefit plan, they MUST be covered by their provincial health care plan?
This information is value if your company hires temporary foreign workers.
Extended Health Care provided under a private group insurance plan is meant to supplement coverage provided under a publicly-funded provincial or federal health care plan. In this way, plan members have financial assistance for many of their regular and catastrophic medical expenses from both the public plan and their private group insurance plan.
From time to time, insurance carriers are made aware via an out-of-Canada medical emergency claim that a plan members doesn’t have provincial health care coverage in place, but are nonetheless enrolled under an employer-sponsored Extended Health Care program. To be eligible for coverage, plan members must be continuously covered under a provincial or federal health care plan.
Insurance carriers need to be notified if employees are listed for coverage under the benefit plan, but yet are not actively covered by their provincial/federal plan, or whose coverage has lapsed.
In this event, their Extended Health Care coverage should be discontinued. They are eligible for all other benefits.
Please note, if there is an employee who is in the waiting period for their provincial plan, but have not yet qualified for coverage, many insurance providers have options for coverage until they are approved and can join the regular plan.
For this and other administrative information, feel free to contact us today with any questions or concerns.
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