Staffing changes and your benefit plan – PLEASE READ

Clients and Friends,

I want to start by saying that we are here for you in these challenging times.  Thanks to another 12 days in self isolation (due to returning to Canada from a sailing trip) we will be in the office and available to you (now more than ever).

We are starting to get requests from clients about how they should handle benefits in the midst of laying off staff, reducing hours, having them work from home, and the other options you may be considering for the first time.  The short answer is that each insurer/ TPA is facing this for the first time too.  There is no standard answer.  Canada Life (was GWL) will be sending out the info below to advisors and clients very shortly.  This provides and aid to remember the various things we need to consider, but your provider may handle things quite differently. (CL/GWL is the first insurer to offer these options).

if you are laying off staff (with or without benefits) we need to ensure that it fits with the contract and that the insurer is notified.  if you are reducing hours, or rotating staff, then the minimum hours worked to be eligible for coverage may be affected, we need to let them know this too.

If you are in a critical position and need benefits suspended, or are considering the cancellation of your plan, it may make more sense to terminate coverage during the layoff, but maintaining coverage for a bare bones staff so that the coverage can be reinstated when staff are recalled.  Talk to us and we can work through possible solutions.


Canada Life (GWL) Communication

Canada Life (GWL) Renewals

To alleviate pressure on Canadian businesses during this time, effective immediately we will consider deferring, if requested by the plan sponsor, all non-finalized April, May and June renewals for 60 days each for all Selectpac and Regular, non-refund mid-market clients.  This will be done on a case by case basis.

Canada Life (GWL) Premium arrears handling

Effective immediately, we will stop sending letters or suspending claims at the 30-day mark and instead will move these activities to the 60-day mark. As with all other processes, this will be in effect for the next 2 months.

Canada Life (GWL) Reduction of work hours

Determining eligibility:

Minimum hours worked requirements for plan member eligibility under the contract will not be applied by the Enrolment, Life Claims and Disability teams from now until May 31.

If a plan sponsor would like to remove coverage for someone not meeting minimum hours, they need to submit a change request to have the employee terminated from the plan.

Canada Life (GWL) Covered benefit amounts:

Unless instructed otherwise by plan sponsors, benefits that are based on salary will be adjudicated based on the coverage for which the premium is being paid. Employer and employee premium rates will remain unchanged as we have committed to covering the higher benefit amounts.

Plans sponsors would need to request a salary reduction for employees working less hours if they do not want those employees to be covered for their standard life and LTD benefits.

This will only be temporary and is only an administrative handling practice so no formal changes to contracts will be made.

Canada Life (GWL) Temporary layoffs and leaves of absence

As you’re aware, our standard handling is to offer up to 31 days of coverage for short-term disability and long-term disability and up to 6 months for all other benefits.

Effective immediately, as a requested exception we will allow up to 60 days of short-term disability and long-term disability coverage and maintain the 6-month maximum for all other benefits.

As per usual process, even if a person satisfies their waiting period while on temporary layoff or leave of absence, disability benefits would not be payable until the employee’s declared return to work date as indicated by a recall letter from their employer.

Canada Life (GWL) Suspension of benefit plans

We will allow plans to suspend all coverage (premium and claims) for a maximum of 60 days with no penalty for reinstating. Plan Sponsors are accountable for communicating the impact of changes to coverage to their Plan Members.

Extremely important, if a disability was incurred during the time the plan was suspended, it will not be covered. Claims will only be covered if incurred while coverage was in force, or after the plan is reinstated. For the reason above, it’s recommended that life and long-term-disability remain in-force, while terminating less-essential benefits such as dental or vision. However, we are providing the full plan suspension offer for clients that really need it and enter into the agreement with full knowledge of the consequences.

Please note for Quebec, if long-term disability is offered on the plan, drugs cannot be terminated.

Canada Life (GWL) Out of Country Trip Limit increases

As per the most recent communication, “If you’re medically directed to quarantine by a physician or public health officials in advance of reaching your trip limitation and that results in surpassing the day limit, coverage would be temporarily extended to allow for potential coverage of a medical emergency until the end of the quarantine period upon which you could return home.”

We will consider, case-by-case, an exception up to 90 days for any individual circumstances that require exception handling based on compassionate grounds. An example of this may be someone who is unable to return home due to flight challenges.

Mainstay, Covid 19 and you!

I write this from a hotel room in St. Martin at the end of a great sailing holiday around what was once a beautiful island.  It’s not messed up by Covid-19 (there are NO cases here), but by hurricanes Irma and Maria almost 2 and a half years ago.  Some properties have recovered, others have sprung up from the rubble, but far too many are awaiting new zoning rules (French sides government delays) before they can begin the re-construction.  It’s amazing to see how far, and for how long the repercussions of events can last.

We are hoping to fly out on Tuesday (one of the last flights before the airport here is closed) and will then look at facing 2 weeks of self isolation (for being out of country).  As a result, our service levels may be a bit different.

If we have meetings scheduled with you, we’ll be in touch to reschedule, or to arrange to do them via Zoom.  Zoom is a great app that you can (but don’t need to) download to video conference, view files (like your renewal report etc) and meet virtually.  You can view and communicate all through a web browser and call in via phone if you don’t have a camera and microphone attached to your system.

I will also be postponing our Calgary and Vancouver industry educational events until the fall, as well as doing fewer speaking events over the next couple months.  As a result, I’m hoping to have more time to support our great clients, CGIB members, family and friends.

I hope that you, your families and staff are all okay during these challenging times.  I’ve already had friends step up and offer to get us groceries, friends of my son offer to get him from university and offer a place to stay so he doesn’t need to be alone (or locked up with us) and others offer to help.  We are truly lucky for having great people all around us..

This is a great time for everyone to help out friends, neighbours and absolute strangers and show how great humans can be.  Stay well.

Dave

GREAT NEWS – Dental Fee guide Increase LOWER than Expected.

Each year the Ontario Dental Association (ODA) sets their dental fee guide for the coming year.  This guide is used by many dentists to set their prices (though they can charge above or below this). Insurers tend to use these numbers as the “reasonable & customary” limitation for claims.

Last year the Ontario increase was 4.19% on average, which was the highest we’d seen in well over a decade.  The average over that time period was about 2.2%/ year.  The 1.27% increase for 2020 is a bit of a nice break and much lower than we’d been led to expect.

What this means to employers is that if your employees all submitted the exact same claims this year, as they did last year, then the cost charged would be 1.27% higher.  In reality, there are also trend and utilization numbers that are added to this (because we don’t do the same thing every year), but that said, this means a bit of relief in the rate creep we had been dreading.  (Other insurers will be similar to the levels shown below)

Interested in attending an benefits focussed educational event?

If you’re a current client of Mainstay Insurance Brokerage (or are considering being one), then know that you are always welcome to CGIB events at my expense.

CGIB is an association that holds several educational events each year.  The seminars are intended for a benefit advisor audience, to help them to educate their clients.  If you attend, you’ll be getting the message direct from the horses mouth.

Our next event is March 4th in Vaughan and all the details are here… http://www.cvent.com/d/ghqrt4

Just drop me a note if you’d like to attend and we’ll book you a spot.

Tax Tip – If your employees share the health and dental premium

As employers prepare T4’s, they can make like a bit easier for staff.  By reporting the employees contributions to the health and dental premium in Box 85, you are helping staff make sure they get the medical Expense Tax Credit (METC) where available.

This avoids employees being audited for proof of contributions (and you having to write out letters for them).  You can find more on the CRA site below or ask your accountant.

READ MORE

Why Bother With All These Forms For My Employees?

An interesting article, by a law firm, on the importance of getting staff to complete insurer forms.  We deal with this several times a year for different reasons, usually concerning staff not completing forms for excess Life and LTD coverage.  it is imperative that staff complete and submit these in a timely manner in order to get the coverage the employer offers.


Throughout an employee’s time with an employer, there are many occasions where the employer will be required to have the employee complete forms or other documents for third parties, or where the employer must complete forms themselves for third parties. We have encountered employers who either delay or completely disregard these requirements. Failing to meet these requirements are risky and potentially costly oversights! Below we will identify the consequences for the employer if these documents are not completed, completed inaccurately, or are not completed in a timely manner.

READ ARTICLE

 

How to avoid a massive holiday health care bill when OHIP out-of-country coverage ends

We’ve had several calls by clients about the OHIP removal of out of country coverage and if it posed a problem.  In actuality, the cut has made it easier to have claims paid with the group coverage by almost every carrier (no waiting for the province to pay first).  This article provides some context around it and also great questions to ask if people are not covered by group plans and plan on buying coverage.


If you are an Ontario resident planning to travel outside of Canada over the holidays and will be out of the country after Jan. 1, make sure you have adequate travel health insurance coverage or risk dealing with a crippling medical bill should a medical emergency arise.

READ MORE https://www.ctvnews.ca/canada/how-to-avoid-a-massive-holiday-health-care-bill-when-ohip-out-of-country-coverage-ends-1.4721528

Workplace Policies That All Businesses Need

A very short list of the policies that you MUST have (and those that you SHOULD have) in Ontario.


Ontario employers are required by law to have certain workplace policies in place at work. The policies that employers must have include the following:

  1. Workplace Health and Safety Policy;
  2. Workplace Violence and Harassment Policy;
  3. an Accessibility Policy; and
  4. Pay Equity Plan (employers with 10 or more employees).

Failure to have these policies in place is a violation of Ontario law and may result in the imposition of statutory fines and penalties.

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