FAQ’s
Note: The following is for information purposes only. It is a summary of the provisions of the Group Policy. In the event of a discrepancy between this document and the Policy, the terms of the Group Policy will prevail.
General Provisions
Is joining the benefit plan optional for each Franchise?
Yes. Each Franchise may choose whether or not to participate in the plan.
For participating Franchises, is it mandatory that all eligible members enroll?
Yes. All owners and Full-time Support Staff working a minimum of 20 hours per week must join the plan.
Do members have to elect coverage for all benefits under the plan?
Yes. All “Core” and “Optional Benefits” are mandatory (except Health and Dental coverage, which may be waived where similar benefits are provided through a spousal plan).
Are there any Voluntary Benefits?
Yes. Additional Life Insurance called Voluntary Life may be purchased for the member, spouse or children. Please see the Voluntary Benefits in the Plan Details tab.
What are the Core Benefits?
Life Insurance, Accidental Death and Dismemberment, Dependent Life Insurance and Long Term Disability. Please see the Core Benefits in the Plan Details tab.
[spoiler title=”What are the Optional Benefits?“]Extended Health Care and Dental Benefits.
How long do I have to remain in any one Plan before I can choose another?
You must be covered under the same Plan for 1 year.
What is the definition of ‘salary’ as it pertains to Life, Accidental Death & Dismemberment and Long Term Disability Insurance?
For employees, salary is defined as current earnings as reported to the insurance company from time to time by your employer.
Eligibility
Who is eligible to join The Royal LePage Broker/Owner Group Insurance Plan?
All Royal LePage Franchise Owners and Royal LePage Corporate Brokerage Managers plus all Full-time Support Staff working a minimum of 20 hours per week.
Can anyone opt out of the Broker/Owner plan?
No. All eligible members of a participating Franchise must participate in the plan.
Are all benefits mandatory?
Yes. Members must enroll in all benefits (except Extended Health and Dental Care coverage where similar benefits are provided through a spousal plan).
Do common-law or same sex relationships qualify for family Health and Dental benefits?
Yes, however, you must have lived together for at least one year prior to applying for coverage.
Is there a waiting period before I can join the plan?
For members who are part of a particular Franchise and joining the plan for the first time, there is no waiting period. For all new hires, there is a 3-month waiting period.
Are there any penalties for Late Applicants?
Yes, a new member must enroll within 31 days of the eligibility date or late applicant penalties will apply. Medical evidence may be required and Dental coverage will be limited for the first year.
Waiting Periods
What is the waiting period?
The waiting period refers to the 90 days between your date of hire and the date you became eligible for group benefits.
Do I automatically get enrolled in the benefits program?
No, you must complete and submit your enrollment form within 31 days of becoming eligible for coverage. If you do not submit your Enrollment Form within 31 days you will be subject to late applicant penalties and evidence of insurability may be required.
I am a late applicant, what procedures must I follow to join the group benefits program?
You will be required to complete and submit an Enrollment Form along with a Equitable Life Evidence of Insurability Form.
Enrollment
How does a Franchise enroll in the new benefits program?
By completing a Franchise Application. Your Broker/Owner will need to complete a Franchise Application. Please contact Corporate Benefit Consultants Ltd. for more detailed requirements. Carla.kennedy@corporatebenefits.ca.
How does a member enroll?
By completing a Member Enrollment Application, which can be obtained by your Plan Administrator.
Is there a separate Enrollment Application for Voluntary Life?
Yes. Please obtain the application from your Plan Administrator.
Is medical evidence required for Voluntary Life?
You will be required to complete and submit an Enrolment Form along with a Equitable Life Evidence of Insurability form. Both of these can be obtained from your Plan Administrator.
Is there a waiting period that must be satisfied before I am eligible for coverage?
Yes, you must complete 3 months of full-time employment before you are eligible to join the plan.
Do I have to enroll within a specific period of time?
Yes. Your enrollment card must be completed within 31 days of your eligibility date or late applicant penalties will apply. Please see ‘Eligibility’ for more details.
If I experience a lifestyle change (i.e.; marriage, divorce; loss/gain of spousal coverage) can I make a change to my coverage for Health and Dental benefits?
Yes, however, Equitable Life must be notified of any change in coverage within 31 days from the date the lifestyle change takes place to avoid late applicant penalties. Please advise your Plan Administrator as soon as possible and the appropriate form will be provided to you.
Core Benefits
Life Insurance
How much coverage am I eligible for ?
You are eligible for an amount equal to 1 times your annual salary to a maximum of $250,000.
Do I have to provide the insurer any medical evidence to get life insurance?
No, all amounts of coverage are provided without medical evidence.
Is the Life Insurance benefit itself tax free?
Yes. Your beneficiary will receive the entire Life Insurance benefit tax free.
If my employer pays for the cost of my Life Insurance is the premium considered a taxable benefit to me?
Yes. Any portion of the Life Insurance premium that is paid by your employer would be considered a taxable benefit to you.
Is there a Waiver of Premium clause provided under this benefit?
Yes. Provided you were under age 65 and had been totally disabled for 4 consecutive months, the insurer would waive your Life Insurance premiums.
When does my Life Insurance benefit reduce/terminate?
Life Insurance reduces by 50% at age 65 and terminates the earlier of retirement or age 70, or when you are no longer an eligible participant under the plan.
What happens if my salary changes during the year?
As your Life Insurance is a reflection of your earnings, it is important that your employer report salary changes to the insurer as they occur.
When I terminate, is there a conversion option?
Yes. Existing amounts of Life Insurance up to $200,000 can be converted to a permanent policy without medical evidence. Please contact your Plan Administrator for more details.
Accidental Death and Dismemberment Insurance (AD&D)
What is the Accidental Death component of AD&D Insurance?
The Accidental Death component will pay your beneficiary a sum equal to your group life amount upon your death due to an accident.
What is the Dismemberment component of AD&D Insurance?
The Dismemberment component will pay you an amount between 1/8th and 2 times your basic life amount in the event you suffer an injury due to an accident.
How much coverage am I eligible for?
Your Accidental Death Benefit provides you with an amount equal to your life insurance benefit. Your Dismemberment benefit provides a portion of the face amount depending on your loss. Please see Accidental Death & Dismemberment Section in Plan Details for more information.
Do I have to provide the insurer any medical evidence to get AD&D Insurance?
No. All amounts of coverage are provided without medical evidence.
Is the Accidental Death benefit tax free?
Yes. Your beneficiary will receive the Accidental Death benefit tax free.[/spoiler]
[spoiler title=”Is the Dismemberment benefit tax free?“]Yes. You will receive the Dismemberment benefit tax free.
Can I top up my AD&D coverage?
No. This program does not offer Voluntary AD&D coverage.
If my employer pays for the cost of my AD&D Insurance is the premium considered a taxable benefit to me?
No. AD&D Insurance premium that is paid by your employer is not considered a taxable benefit.
Is there a Waiver of Premium clause provided under this benefit?
Yes. Provided you were under age 65 and had been totally disabled for 4 consecutive months, the insurer would waive your AD&D premiums.
When does my AD&D benefit reduce/terminate?
AD&D Insurance reduces by 50% at age 65 and terminates at the earlier of retirement or age 70, or when you are no longer an eligible participant under the program.
Dependant Life Insurance
Does the amount of coverage vary by dependant?
Yes. In the event of the death of your spouse you would receive $10,000; for each dependant child $5,000.
Is the Dependant Life benefit a tax free payment?
Yes. All life insurance amounts are received tax free.
As a single parent, do I qualify for Dependant Life coverage?
Yes. All members with eligible dependants will qualify for the Dependant Life benefit even if you waive, or elect single Health and Dental Coverage. However, you must indicate your coverage status at time of enrollment.
If my employer pays the premium for my Dependant Life Insurance is this considered a taxable benefit to me?
Yes. Any portion of the Dependant Life premium paid by your employer would be considered a taxable benefit to you.
When does my Dependant Life benefit reduce/terminate?
Your Dependant Life benefit terminates at the earlier of retirement or age 70, or when you are no longer an eligible participant under the program. There is no reduction of benefit.
Long Term Disability
Do I have to provide any medical evidence to qualify for Long Term Disability coverage?
No. All amounts of coverage are provided without medical evidence.
What is the maximum amount of coverage I can apply for?
That depends on your salary. The higher your income, the greater your coverage. Please see the Long Term Disability Section in Plan Details for more information.
What is the maximum amount of Long Term Disability coverage available?
The maximum amount of coverage is $7,000 per month.
Is there a waiting period before benefits would commence?
Yes. You must be totally and continuously disabled for 4 months before being eligible to receive benefits.
Why do I have to pay the premium for my Long Term Disability benefit?
In order for the benefit itself to be paid out tax free, you must pay 100% of the LTD premium.
I have my own individual disability coverage. Why must I pay the LTD as well?
In order to achieve the most favorable spread of risk, resulting in the lowest possible unit costs, all benefits are mandatory (including LTD) for all members of the group.
In the event of total disability, would my Group LTD benefits pay in addition to my individual plan?
Yes. Group benefits are not offset by any individual benefits you might receive.
How do I find out what my LTD premiums would be?
If your employer requested a personalized quotation for your Franchise, the information would be available through your Broker/Owner.
If I am totally disabled do I have to continue to pay my Long term Disability premiums?
No. After 4 months of total and continuous disability, the insurer would waive your premiums as long as you remain totally disabled.
If I was on claim for benefits and returned to work and was once again disabled for the same reason, would I have to re-satisfy the waiting period?
No. As long as it was a related disability and your relapse occurred within 6 months of returning to work.
Are there any coverage exclusions for Long Term Disability Benefits?
Yes. A standard ‘3/12’ exclusion exists. I.e.; If you received medical treatment, consultation, care or services, or took prescribed drugs in the 3 months just prior to the effective date of coverage and the disability began in the first 12 months of coverage, it would be considered a pre-existing condition.
Employee Assistance Program (EAP)
What is an Employee Assistance Program?
An EAP is an extensive employee support program, which assists individuals in managing all aspects of their work and family lives. This service offers you and your family support with any work or personal issue, including short-term professional counselling and connecting you to local resources to help you manage emotional, practical or physical needs.
Who provides our EAP program?
Employee support is provided by Workplace Options. The organization is staffed by professionals who are completely independent of your employer. They are bound by professional standards regarding confidentiality, and do not dis close details of individuals who have contacted the service. An y information you share is at your discretion and will not be shared with your employer.
- is free – no cost to you
- is confidential
- is available in your language
- can be accessed in multiple ways and is available 24 hours a day, 7 days a week, 365 days a year.
CONTACT:
TOLL FREE: 1 877 847 4525
UNIVERSAL TELEPHONE ACCESS: 1 416 956 2979
(Charges for the call are paid by the service)
SMS TEXTING: 647 624 2840
EMAIL: support@resourcesforyourlife.com
WEBSITE: http://wpoglobal.powerflexweb.com
COMPANY CODE:
What sort of issues do EAP counselors address?
They deal with current crisis resolution, including work-related issues, anger management, stress management, health/disability issues, separation/divorce, drug addiction, financial issues and many more
Optional Benefits
Extended Health Care
Do I need to provide medical evidence to be eligible for this coverage?
No. All coverages (including Extended Health Care) are provided without medical evidence, unless you are a late applicant. (Please see ‘Eligibility’ for more information on Late Applicants)
Are pre-existing medical conditions excluded from coverage?
No. All medical conditions are covered up to the limits of your contract.
What does it mean to be a late applicant?
Your enrollment card must be completed within 31 days of your eligibility date or late penalties will apply. Please see ‘Eligibility’ for more details.
What does the Extended Health Insurance Benefit cover?
This is a comprehensive health insurance program and covers many items not covered by your provincial health care program including prescription drugs, semi-private hospital and professional services. The degree of coverage varies by plan selected. For more details please see the Extended Health Care Section in Plan Details.
Who pays for the Extended Health Insurance Benefits?
Cost sharing arrangements are determined by each Franchise and may vary from one location to another. However, your employer must pay at least 50% of the cost of all benefits except Long Term Disability, which is entirely employee paid.
How do I find out how much the premiums are for the Extended Health Insurance Benefit?
If your employer has requested a personalized quotation for your Franchise, the information would be available through your Broker/Owner.
Why are there three different plans to choose from?
Each plan provides different coverage levels at different costs. This gives you the option of choosing a plan best suited to your individual or family needs.
Do I have to choose the same plan as my co-worker or employer?
No. You are free to choose the option that is best suited to your individual or family needs.
I am covered under my spouse’s Extended Health Care program; do I still need to be covered by this program?
No. You may waive health and/or dental coverage if you have similar coverage through a spousal plan.
How do I make a claim?
You will be issued a Pay Direct Drug Card for Prescriptions Drug claims. For all other Health related claims, you can submit them online through the Plan Member Portal or you can complete a claim form and mail it directly to Equitable Life.
How do I contact Equitable Life for Claims Questions?
Dental Claim inquiries 1.800.265.4556 X 601 group-dental-claims@equitable.ca
Health Claims inquiries 1.800.265.4556 X 606 group-health-claims@equitable.ca
When does this benefit terminate?
Your benefit will terminate at the earlier of retirement or age 80, or when you are no longer an eligible participant under the plan.
Dental Care
Do I need to provide medical evidence to be eligible for this coverage?”
No. All amounts of coverage are provided without medical evidence, unless you are a late applicant.
What does it mean to be a late applicant?
Your enrollment card must be completed within 31 days of your eligibility date or late applicant penalties will apply. Please see “Eligibility” for more details.
What is covered by the Dental Insurance benefit
Coverage varies by plan selected. For more details please see the Dental Care Section in Plan Details.
Who pays for the Dental Insurance Benefits?
Cost sharing arrangements are determined by each Franchise and may vary from one location to another. However, your employer must pay at least 50% of the cost of all benefits except Long Term Disability, which is entirely employee paid.
How do I find out how much the premiums are for the Dental Insurance Benefit?
If your employer has requested a personalized quotation for your Franchise, the information would be available through your Broker/Owner.
Why are there three different plans to choose from?
Each plan provides different coverage levels at different costs. This gives you the option of choosing a plan best suited to your individual or family needs.
Do I have to choose the same plan as my co-worker or employer?
No. You are free to choose the option that is best suited to your individual or family needs.
I am covered under my spouse’s Dental Insurance Program; must I enroll in the Royal LePage program?
No. You may waive health and/or dental coverage if you have similar coverage through a spousal plan.
How often will I be able to go to the dentist?
This plan has a 6 month recall exam provision. This means that you can have your routine check-up every 6 months.
When does this benefit terminate?
Your benefit will terminate at the earlier of retirement or age 80, or when you are no longer an eligible participant under the plan.
Out-of Country Emergency Assistance
Download: Equitable Life Travel Assist Brochure
Voluntary Benefits
Voluntary Life Insurance
How much Voluntary Life Insurance coverage can I purchase?
You can purchase units of $10,000 up to a maximum of $500,000, for yourself, units of $5,000 up to a maximum of $250,000, for your spouse and, units of $2,000 up to a maximum of $10,000 for each dependent child.
Do I have to provide the insurer any medical evidence to get Voluntary Life Insurance?
Yes. You must submit an Evidence of Insurability from to purchase any Voluntary Life Insurance. The insurer will review information provided in your Evidence of Insurability form and either approve or decline your request for Voluntary Life Insurance. Please see your Plan Administrator to obtain the Evidence of Insurability form.
Is the Voluntary Life Insurance benefit tax free?
Yes. You or your beneficiary will receive the benefit tax free.
How do I find out how much Voluntary Life Insurance costs?
The Voluntary Life Insurance rates are split into age brackets and included smoker and non-smoker rates. Also, there are separate rates for your spouse and children. Please press here for the Voluntary Life rate table.
What is the definition of a smoker?
A smoker is anyone who has used tobacco products in the past 12 months, including cigarettes, cigars, or chewing tobacco.
Billing
How often am I billed and when are premiums due?
Premium statements are generated and mailed monthly. Premiums are due monthly in advance.
When are premiums considered overdue?
There is a 30 day grace period during which premium payments must be made. Failure to do so may result in claims payments being suspended by the insurer.
Do I have to remit premium taxes or provincial sales taxes directly to the government?
No. All necessary taxes will be calculated and included on your billing statement and the insurance company will remit them to the government on your behalf.
Which premiums are considered a taxable benefit to the employee?
Only employer-paid premiums for Life and Dependant Life Insurance (Except in Quebec, where all premiums paid by the employer are considered taxable benefits to the employee).
Why can’t the employer pay my Long Term Disability premiums?
In accordance with Canada Customs and Revenue Agency (now known as Canada Revenue Agency or CRA) guidelines, the employee must pay 100% of the LTD premium in order for the benefit itself to be considered non-taxable.
I have a question about how much money is being taken off of my pay for my benefit coverages; whom should I talk to?
You should contact your Human Resources Department if you have questions about payroll deductions.
Is there a minimum premium that the employer must pay towards the cost of the plan?
Yes. The employer must pay at least 50% of the cost of all benefits except Long Term Disability. Premium distribution may vary from Franchise to Franchise.
Getting a Quotation
Before selecting a Health and Dental Plan, I need to know how much each plan costs. How can I find out the price of each option?
If your employer has requested a personalized quotation for your Franchise, the information would be available through your Broker/Owner.
When do the rates change and for how long are they guaranteed?”
The rates are guaranteed for one year.
How do I get a quote for the total cost of all benefits, including Life Insurance and Long Term Disability?
A Franchise Owner may request a personalized quotation for all employees by completing a Confidential Employee Data Sheet. Please contact Carla Kennedy at Corporate Benefit Consultants Ltd. Carla.kennedy@corporatebenefits.ca 905-943-4450 Ext. 1.
Customer Service
Who should I call if I have a question about the status of a Health or Dental claim?
|
Dental Claim inquiries |
Health Claims inquiries group-health-claims@equitable.ca 1.800.265.4556 X 606 |
If I have any questions about my benefit coverages whom should I contact?
You should contact your Benefit Plan Administrator. Alternatively you can contact Carla Kennedy, Corporate Benefit Consultants Ltd. at 905-943-4450 Ext. 1. Or email Carla.kennedy@corporatebenefits.ca