Eligibility & Commencement

Employee Eligibility

An Employee is eligible for insurance:

  1. on the EFFECTIVE DATE, if they meet the Eligibility Requirements specified in the Benefit Schedule; or
  2. after the EFFECTIVE DATE, on the date on which they meet the Eligibility Requirements specified in the Benefit Schedule.

A Participant whose insurance under the policy terminated due to termination of employment and who is re-hired by the Employer within 6 months immediately following the termination of their insurance will be eligible for the reinstatement of their insurance on the date they resume employment, provided application for reinstatement is made within 31 days of eligibility.

Insurance Application

An eligible Participant must complete an application or an application for exemption for themselves and for their Dependents, if any, for applicable benefits, within 31 days of the date on which they become eligible.

Evidence of Insurability

Evidence of insurability means any declaration relating to an individual’s physical health or to other factual information that could have a bearing on the acceptance of the risk. Only declarations that are provided on the forms approved by the Insurer will be accepted. There may be instances where evidence of insurability is required, such as,  if eligible participants under the plan are considered late applicants.

Commencement of Participant Insurance

The insurance of any Employee will become effective on the latest of the following dates, provided that Employee is Actively At Work on such date:

  • The Effective Date of the policy,

  • The date on which the employee first becomes eligible, provided their written application, completed using the form required by the Insurer, is received by the Insurer within 180 days of their date of eligibility,

  • The date on which the insurability of the Employee is approved by the Insurer, if the application of the Employee for insurance is received by the Insurer more than 180 days after the date of their eligibility.

  • If an Employee is not Actively At Work on the date their insurance would have otherwise commenced, such insurance will commence on the first day they are subsequently Actively At Work.

  • If the Employee is not Actively At Work on the date their insurance would have otherwise commenced due solely to a paid leave or a statutory holiday, then they will be considered Actively At Work on such date.

  • If a Participant requests an amount of insurance that exceeds the maximum amount the Insurer will provide without evidence of insurability, as specified in the Benefit Schedule, this excess amount will become effective on the latest of the dates specified in the preceding provision or on the date on which the insurability of the Participant is approved, if later.