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Losing Group Benefits

By | Employee Benefit Plans, Group Retirement Programs, Group Services, Individual Health Plans | No Comments
Important information for employees and employers to know whenever someone is leaving a group plan.

Whether it is due to leaving for a new venture, taking contract work, retirement, or other reasons, more and more people are going through changes that result in a loss of group benefits coverage. However, leaving an employer does not mean one has to leave this valuable coverage behind. The following is an explanation of some of the things that employees and employers should all understand in order to properly identify the options that are available at this critical point in time.

Health and Dental Coverage

There are 2 types of Health & Dental Plan options – Conversion Plans and Traditional Plans

The easiest solution to deal with the loss of health and dental coverage is to extend coverage using a Conversion Plan. Acceptance is guaranteed, and coverage is uninterrupted, as long as an application is made within 60 days of losing group coverage. These plans are available from several carriers, and each company offers different levels of coverage to choose from. There are no medical questions, and coverage can be provided for the same items that were provided on the group plan, and for anyone who was covered on the group plan.

The other type of Health Plan is referred to as a Traditional Plan. These plans require a medical questionnaire in order to be eligible, and they offer flexible and comprehensive coverage. In many cases, these plans will offer higher coverage limits than a Conversion Plan. Once a Conversion Plan has been secured, it may be worth investigating to see if a Traditional Plan is an option.

Conversion Plans
  • Guaranteed Coverage if you apply within 60 days of your group coverage terminating
  • No medical requirements
  • Pre-existing conditions are covered
  • Most plans include Prescription Drugs, Hospital Benefits, Vision Care, Paramedical Specialists, Dental Care, and more
  • Emergency Medical Travel Insurance may be available on some plans
Traditional Plans
  • A Medical Questionnaire is required in order to be eligible
  • Typically provides higher coverage limits
  • Flexible coverage to meet your needs
  • No restrictions based on employment status or prior coverage
  • Most plans include Prescription Drugs, Hospital Benefits, Vision Care, Paramedical Specialists, Dental Care, Travel Insurance and more

Group Retirement Plans

  • There are several options available at this point in time
  • A Group RRSP plan will offer an individual account that looks to mirror the existing investments where possible
  • You can transfer to an individual plan with another financial institution
  • You can transfer to another group plan if available
  • These transfers can be done between institutions, and without any tax implications
  • If you are leaving a Defined Benefit Pension Plan, you may require additional analysis in order to take advantage of your available options

Long Term Disability Insurance

  • There may be an option to extend coverage without a medical
  • Coverage would be extended for a period equal to any severance period
  • Financial underwriting and coverage limits based on former salary
  • There are specific terms and conditions which apply to these policies

Life Insurance & Critical Illness Insurance

If your plan included this coverage, it may be wise to investigate whether there is an option to convert any of this coverage

Application typically required within 30 days of losing coverage

Understanding your options is the first step to making a wise decision.

Identifying and selecting the right coverage for you and your family is a process that is based on many factors. By taking advantage of the conversion options available within your policy, you are in a stronger position to assess your situation, obtain the advice that you need in order to make the right decisions to protect yourself and your family.