Group size

• Minimum of two lives up to ten lives with organic growth to 25 lives
• Groups of one are not eligible (including association groups)

Eligible business

• Business must be established and active for a minimum of 6 months
• Some industries require carrier review (see product rules)
• Trucking companies do not require underwriting approval (owner/operator scenarios: carrier review)
• All employees must be actively at work and able to perform essential duties of their occupation
• Must have a Canadian signing officer
• Groups of 2 require underwriting approval for LTD coverage

Eligible individuals

• Canadian residents in Ontario and Atlantic Canada under age 75 covered by their provincial health plan
• Full-time permanent employees actively working at least 20 hours/week
• If part-time becomes full-time, waiting period starts when full-time begins
• Seasonal and contract employees may be eligible
• Self-employed and contractual employees are not eligible for LTD

Applicable provinces

This plan design applies to businesses in Ontario and Atlantic Canada. A separate plan design is available for Quebec based on provincial guidelines.

Participation basis

Mandatory

Family content

• Must be a true employer–employee relationship
• Groups with LTD must have less than 50% family content

Waiting periods

3 months for all new employees. No waiting period for those actively at work on the date the group’s coverage commences.

Evidence of insurability

Not required for core benefits.

Deductible

None

Late entrants

Evidence of insurability required. $250 dental benefit maximum in first 12 months of coverage.

Waiver of premium

Entry: None

Essential & Enhanced: only applicable if LTD is selected and if totally disabled. Life, AD&D and LTD premiums waived after expiry of LTD elimination period.

Spousal waivers

Yes — Health and Dental only. Group must have a minimum of two covered lives for health and dental benefits.

Survivor coverage

Yes — Health and Dental only, 12 months, no premium.

Annual billing

No

Benefit flexibility

Optional Benefits, Health Spending Account, Personal Wellness Account

Cost share

Employer must pay at least 25% of the premium. LTD is 100% employee paid.

Grandfathering of coverage

No

Rate guarantee

12–23 months

Renewal date

June 1, annually

Renewal modification notice period

At least 31 days

Right to convert

Standard conversion rights apply

Premium payment method

Pre-authorized debit (PAD) only

Plan changes inside pool

Move up or down one level at renewal only, with 24-month lock-in from date of change.

Plan changes outside pool

Cannot return to this plan after moving to a non-pooled product.

White labelling

Not available with this product

Processing time

5 business days (upon receipt of complete information)

Termination age

Earlier of retirement or age 75, unless otherwise specified