Before we take a look at what late benefits applicants are and how to avoid them, it is easier to understand if you know why the concept exists in the first place.
For most benefit plans, insurance carriers abide by a 30-day rule that requires employees and their dependents enroll for group benefits no later than 30 days of becoming eligible for coverage.
If this is not the case and employees were given the option to join your benefits plan whenever it suited them, they would likely only join when they needed to submit a claim. Not only would this be a risk to the insurance company, but the cost of your group plan would skyrocket as the ratio of claims costs to premiums paid would become very out of balance.
They become classified as a late applicant. This does not mean that the enrolment or the change is no longer possible, but it does mean at the least:
If the carrier denies coverage, there is little recourse for the employee. They will not be insured with your group plan and will be excluded from this part of their compensation package. This could open up your organization to various liabilities, so being on top of your benefits administration should be high on your priority list.
Remember those timelines! For employees, their eligibility window closes 30 days from the end of a waiting period and for dependents, it's 30 days from the life-change or event: 30 days from birth, marriage, cohabitation anniversary, etc.
If you think you have a late applicant case or if you have any questions about eligibility or timeframes, contact us, and one of our benefits support specialists will be happy to help! See Humi Benefits
Subscribe to the newsletter and stay up to date with HR, Payroll, and Benefits.
Subscribe and stay up to date with COVID-19 related policies
There's widespread confusion about the Canadian wage subsidies, and as a Canadian payroll company, we've done our research to make sure we're ready to equip companies with the knowledge and confidence to benefit from this federal support. Join us on April 9th to learn everything you need to know from our payroll experts themselves.
Due to popular demand, we're hosting a part two for this webinar. We'll be covering all the uncovered topics and unanswered questions from the last webinar.
COVID-19 has completely altered the working landscape, and almost every Canadian business has undergone massive operational changes in the last seven days.