October 14, 2019  
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New Plan Members

Once the Plan Administrator provides details on the plan to the Plan Member, the Plan Member has two options:

  1. Enrol in the program for ALL benefits; or,
  2. Enrol in ALL benefits except health/dental if comparable coverage is available through a spouse’s plan.

If the employee elects option b), a Waiver of Coverage Form must be completed. If there are situations that do not correspond to a) or b) above, contact your Morneau Shepell consultant for assistance.

During the Waiting Period (as stipulated in your group contract)

  1. Plan Administrator completes Part 1 of the Plan Member Enrolment Form
  2. Plan Member completes Parts 2, 3, and 4 of the Plan Member Enrolment Form
  3. Plan Administrator must review the form to ensure that:
    • All sections are complete
    • All dependent information is listed (i.e., names of spouse, children and all dates of birth). If any information is missing, these dependents will not be covered
    • The new hire has signed up for the correct benefits
    • The application is signed and dated
  4. The form must be completed and submitted within 31 days of the end of the Plan Member’s waiting period. If there is a discrepancy between this time period and the effective date, please attach a memo to the application card outlining the reason.
  5. Fax a copy to your nearest Morneau Shepell office
  6. Retain the original for your files
  7. Provide the Plan Member with a Employee Benefit Handbook

To ensure that this Plan Member is added on your next monthly premium statement, provide a copy of the completed Plan Member Enrolment Form to the nearest Morneau Shepell office prior to the 15th of the month.

After the Expiration of the Waiting Period - “Late Applicant”

Plan Members who do not complete and sign a Plan Member Enrolment Form within 31 days from their date of hire will be considered late applicants.

Plan Members who are considered late applicants must submit satisfactory medical evidence of insurability to Morneau Shepell. Morneau Shepell will then advise you of the insurer’s decision to grant or withhold coverage, or remit back premiums. Coverage commences only when formal written approval is received from the insurer carriers.

The same procedure for late enrolment of Plan Members applies for late enrolment of dependents. Plan Members must enrol their eligible dependents in the plan within 31 days from the date the dependents became eligible for dependent benefits (e.g., a newborn baby must be enroled within 31 days of his/her date of birth).

Enroling a Late Applicant

  1. Plan Administrator completes Part 1 of the Plan Member Enrolment Form and Plan Member completes Parts 2, 3, and 4 as detailed under “Adding a Plan Member During the Waiting Period”
  2. Have the Plan Member and, if applicable, eligible dependent(s) complete the insurer’s Evidence of Insurability form
  3. Send the original signed Evidence of Insurability Form and a photocopy of Plan Member Enrolment Form to Morneau Shepell
  4. You will receive a letter advising you of the insurer’s decision (approval or declination) and Morneau Shepell will make any changes necessary to your premium statement
  5. Once you have received confirmation of the approval date and verified that the Plan Member is on your premium billing statement, provide the Plan Member with an Employee Benefit Handbook

Note: The employee does not have coverage until you receive confirmation from Morneau Shepell.

Adding Coverage In Excess Of The Non-Evidence Maximum (“Excess Coverage”)

Many life and long term disability plan structures include a “Non-Evidence Maximum” (NEM) clause which defines the maximum amount of coverage a Plan Member can be covered for without submitting medical evidence. If the Plan Member is eligible for an amount of coverage in excess of the NEM based on his or her salary, the insurer requires the Plan Member to submit evidence of insurability, detailing his or her medical past and current health status. Should the Plan Member wish to apply for excess coverage, please ask him or her to complete and submit the original signed Evidence of Insurability Form and a photocopy of Plan Member Enrolment Form to Morneau Shepell.

Notes:

  • The Plan Member does not have excess coverage until you receive written notification from Morneau Shepell. Your Morneau Shepell consultant will advise if the Plan Member’s application was approved or declined by the insurer.
  • Excess coverage can be applied for upon hire or at a later date.
  • Plan Member is not obligated to apply for excess coverage.

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If you have any further questions, please contact us; we'll be glad to help you.


Last updated on:  Tuesday, July 10, 2012  Page: 

This information is not intended for use without professional advice. While we have attempted to make this site as accurate as possible, it is only a summary. For more information, see our disclaimer.

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