Extension of Benefits (Benefit Tips ® - © 2012)

Maternity or Pregnancy Leave

Job security is the primary reason for maternity leave legislation. Maternity leave is a right that employees have under federal and most provincial labour legislation. The leave is available regardless of hours worked per week.

The duration of the leave is at least 17-weeks and can commence within the 17-week period prior to the expected delivery date.

Employees may apply for "Maternity Benefits" from the Employment Insurance Program because employment earnings are suspended during parental leave.

In many jurisdictions, employees earn seniority and receive some benefits when on maternity leave.

Parental Leave

Job security is the primary reason for parental leave legislation. Parental leave is a right that employees have under federal and most provincial labour legislation. The leave is available regardless of gender or hours worked per week.

The duration of the leave is up to 37-weeks and can commence within the 52-week period following the birth or adoption of a child by the employee or their significant other.

Employees may apply for "Parental Benefits" from the Employment Insurance Program because employment earnings are suspended during parental leave.

In many jurisdictions, employees earn seniority and receive some benefits when on parental leave.

Duration of Leave

Job security and the extension of benefits, depend on which labour laws governing the employment relationship. Those within the federal jurisdiction receive benefits and job security for 54-weeks. The other end of the spectrum is Alberta, which provides job security for 18-weeks but no benefits.

Federal Jurisdiction

The Canada Labour Code governs federal Crown Corporations federal Special Operating Agencies marine shipping services (ships, ferry service, ports) air transportation (airports, aerodromes, airlines) railways road transportation (crossing provincial or international borders) canals, pipelines, tunnels and bridges (crossing provincial borders) telephone, telegraph and cable systems radio and television broadcasting (including cablevision) banks grain elevators and feed and seed mills uranium mining and processing business dealing with protection of fisheries as a natural resource many First Nations activities.

Termination of Employment

In most cases, employers must continue all benefits until the end of the period of employment. Many jurisdictions include the time equivalent of any lump sum payout such as vacation, sick-time and severance. It is important to receive the benefit provider’s approval prior to negotiating an extension of benefits since some insurers are not willing to extend high risk benefits beyond the statutory requirement. If the group insurer is not willing to provide coverage for the obligation an employer has then a special policy for transition benefits should be purchased from a specialty insurer. Either the employer or employee may purchase transition policies during the 30/60/90 day period following the termination of employment, depending on the benefit and insurer.

Conversion to Personal Coverage

Life insurance and sometimes other coverage like long-term disability insurance, critical illness insurance as well as health and dental benefits can be converted to personal coverage within the 31-day period following the termination of group coverage. This is a valuable feature for employees with health conditions that would otherwise prevent them from qualifying for personal policies. The conversion of group coverage to a personal policy requires prompt action on the part of the employee. The employee must obtain a quotation, complete an application and provide payment within the 31-day period following the termination of group coverage. It is prudent to refer to this benefit feature as described in the employee’s benefit booklet in an employee’s letter of termination. It is critical to document any employee requests for information regarding the conversion feature and how it was dealt with. This is a tumultuous time for the terminated employee and the employer, broker and insurer can assist or hinder the process.

Changing Insurers or Claims Administrators (Benefit Tips ® - © 1999)

Confirmation of Coverage

Don't cancel your existing coverage until you receive written confirmation by the new insurance company and you are sure that they have the details of all employees not actively at work.

Continuation of Coverage

Ensure that the new insurer will honour the continuation of benefits for leaves of absence, severance periods and survivors. Legislation exits in most provinces that stipulate that no employee may lose coverage solely as a result of a change in insurer.

The new insurer must not reduce existing volumes of life and disability insurance below the lesser of the prior coverage or the new schedule of insurance.

The suicide and pre-existing condition clauses must consider time served under the prior policy and new policy.

Notice of Claims

Advise your staff of the change in coverage and facilitate the submission of claims. Most polices require that claims be submitted no later than 90 days following the termination of the policy. Provide your existing carrier with a listing of all disabled employee and review their disability claim and waiver of life insurance premium claim.

Disabled Employees

Disabled employees should apply for a waiver of their life insurance premium with the insurer that provided coverage when they became disabled. This should be done as soon as they believe that their claim will satisfy the waiting period (usually four to six months), but no later than the last day of coverage by that insurer.

Integrity of Claim Maximums

Provide the new claims administrator with details on orthodontic dental claims to preserve the claim information needed to adjudicate the lifetime maximum. The annual deductible is often waived for the first partial calendar year in order to avoid the administration of entering claims information from the prior carrier.

The annual maximums and frequency limitations start over on the effective date of the new policy. This can significantly increase claim costs when changing claim administrators.