Reminder about enrolment forms

When enrolling new plan members onto your plan, it is important to make sure that enrolment forms are completed by the plan member and submitted on time. The insurer must receive applications within 31 days after a plan member becomes eligible to join the group plan.

When an enrolment form is not received on time, the plan member is considered a “late applicant” and must provide evidence of insurability, including the completion of a statement of health, in order to be considered for coverage under the plan. Even if they are approved for coverage, they may face additional limits on their dental coverage for 12 months.

This situation also applies when a plan member submits their forms to the plan administrator on time, but the administrator does not submit it to the insurer before the deadline. The policyholder’s liability could be substantial should a beneficiary or plan member initiate legal action as a result of inadequate insurance.

It is equally important to ensure you have a plan member’s completed and signed enrollment form before enrolling them. Enrolling a plan member without a completed and signed enrolment form can lead to problems, particularly since the form is used to designate the plan member’s beneficiary.

When a plan member passes away, the Insurer requires a copy of the signed enrollment form before a life claim can be processed. However, if an employee was enrolled on the plan without designating a beneficiary, payment of the death benefit would be paid according to applicable provincial legislation, usually to the estate of the plan member.

Since the form is also used to collect information about the plan member’s dependents, an incomplete form could result in dependents not being covered under the plan.

Here are some suggestions to avoid late applications and to help ensure plan members and their dependents are enrolled on time:

  1. Let plan members know the deadline for their application submission when you provide them with the enrolment forms.  Remind them to complete all required information and to include their dependents.

  2. Keep a list of your plan members’ submission deadlines and follow up if needed to ensure they submit the forms on time.

  3. Once you receive an enrollment form from a plan member, submit it to the insurer right away and notify the insurer on when the probation period is up or if the plan member is to be removed from the plan.

 

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