For the most part, when you enter into a group benefits plan, your benefits will also be available for your dependents. However, there are rules for dependents that are important to know how and when they’re covered.
Who qualifies as a dependent?
A “dependent” is defined as a person, especially a family member, who relies on another for financial support. Within group benefits plans, this refers specifically to your spouse and children. Parents, grandparents, and cousins for example, are not eligible dependents in a group benefits plan.
Your spouse may be your legally married partner, or your common-law partner who is publicly represented as your spouse and usually has resided with you for 12 months.
Your children may be your natural, adopted, or step children typically under the age of 21, though it’s important to note that if they are unmarried and attending full-time college or university, they may also be eligible until age 25. These benefits may also extend for children over age 21 with a disability and who are dependent on your financial support.
The specifics on who qualifies as a dependent and qualifying life events can vary slightly by insurer, so please refer to your benefits coverage booklet with your insurance carrier for the details of your specific plan. Also keep in mind that while most group benefits plans do cover their plan members’ dependents, there are plans that are created to cover the individual plan member only.
When can your dependents be added to the plan?
Your dependents can be added on the date that you become eligible for your plan.
If you have been on your plan for some time individually, your dependents can be added easily within 31 days of a qualifying live event.
What is a life event?
A life event refers to an event causing a change in your personal life situation, allowing you to adjust your single/family coverage without the requirement to provide evidence of good health.
The most common valid life events for insurers are:
- Entering a common-law relationship
- Ending a common-law relationship
- Having a child
- Adopting a child
- The death of your spouse
- The death of your child
- Your dependent gaining insurance coverage
- Your dependent losing insurance coverage
- Your province of residence changing
It is vital that you keep your coverage up to date to ensure that your dependents will be eligible. Your dependents must be added within 31 days of their eligibility date (start of the plan or date of the life event) to guarantee them coverage. Following this deadline, your dependents will be treated as a late applicant and evidence of insurability (EOI) that is satisfactory to the insurer will be required for them to be covered. For more information on what this process looks like, see our article on Evidence of Insurability (EOI).
If you would like to review how your dependents are covered, or look at enhancing your benefits offering, contact our benefits team at firstname.lastname@example.org!
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