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faq

Am I really guaranteed coverage regardless of my medical history?

Yes. You and your family members are guaranteed the Essential level of coverage for Extended Health Care regardless your health and the health of your dependents and regardless of hours worked, time of application or place of employment. Those applicants actively working for a participating organization and in a 60 Day Window, will be guaranteed the Complete level of coverage.

Can I keep my coverage if I am no longer employed at a hospital?

You may keep some, but not necessarily all. Your core benefits, for example, will terminate. However, provided that you and/or your spouse are under 65, your employee life insurance (and/or your spouse’s life insurance if applicable) can be converted into an individual policy with Co-operators Life. This conversion can be done without providing evidence of good health but the premiums may change. Conversions must be done within 31 days of the group coverage terminating. Your health and dental coverage will continue under your current plan option until such time that you attain age 65. Then you will be enrolled in the appropriate Plan 65+ level.

Do I have to cancel my coverage if I am no longer employed at a hospital?

No. We have coverage that is both portable and flexible. Should you cease to be employed at a hospital, your health and dental coverage will continue under your current plan option until such time that you attain age 65. Then you will be enrolled in the appropriate Plan 65+ level. If your plan includes Life insurance you would have to make changes to that coverage. Provided that you and/or your spouse are under 65, your employee life insurance (and/or your spouse’s life insurance if applicable) could be converted to an individual policy with the Co-operators and so long as the application for conversation was made within 31 days of the group Life coverage terminating, the conversion can be completed without providing evidence of good health. (NOTE: monthly premiums are subject to change). If your plan includes LTD and ADD&D you would have to cancel those benefits.

How do I know if I work for an endorsing hospital?

You can confirm that you work in an endorsing hospital by using the search function at the top of the web page or by clicking here to view the list of endorsing hospitals. Or you may call our office at 1.866.768.1477 to speak to one of our representatives.

I am a temporary part time employee; does the Plan have anything for me?

Definitely. Regardless of hours worked in a week, you are eligible to apply for Plan 2, which offers Extended Health Care and (optional) Dental coverage.

I have Extended Health Care and Dental benefits through my spouse’s group plan. Is there anything in this plan for me?

Absolutely! Your spousal group coverage does not insure your income! If you are working more than 18 hours per week on average in a hospital and have spousal coverage you are entitled to apply for our Plan 1A. This plan provides you with Long Term Disability coverage. It also includes Employee Life Insurance and Accidental Death, Disease and Dismemberment insurance. If you apply for this coverage in a 60-day window, and you later lose the benefits under your spouse’s plan for any reason, we guarantee to offer you and your dependents at that time, the Complete Level of our Extended Health Care benefits. This guarantee will be in place regardless of your health and without medical evidence. The only condition is that you must apply for our Extended Health Care benefits within 60 days of losing the benefits under your spouse’s plan.

If I enroll in a Plan that includes Core benefits what happens when I reach age 65?

If you are enrolled in our plan that includes the core benefits, your Life insurance and ADD&D coverage will terminate when you turn 65, and your Long Term Disability coverage will terminate 4 months prior to your 65th birthday.

If I enroll in the Plan, what happens to my Health and Dental coverage when I reach age 65?

At the end of the month in which you turn 65, the Health and Dental coverage under your current plan option will cease and you will automatically be enrolled in Plan 65+ with your then current dental coverage. If you had the Essential level of coverage then when you turn 65 your coverage will transfer to the 65+ Essential level. If you had the Complete or Optimum level of coverage, when you turn 65 your coverage will transfer to the 65+ Complete level. You may apply for the Optimum level at any time. However, this level of coverage is issued at the discretion of the insurer and is only available subject to full medical underwriting. The initial basis for the medical underwriting is the information provided in a completed Form 2 document.

What are core benefits?

The term ‘Core benefits’ refers to Life Insurance, Accidental Death Disease and Dismemberment Insurance and Long Term Disability Insurance.

What does “actively at work” mean?

In order to be considered actively at work, you must be a hospital employee that is scheduled to work.For example, You are not considered to be actively at work if you are on a disability or maternity leave.

What happens if there is a change in my employment status like retirement or reduction in hours?

This is your plan and is not administered by your employer. Therefore it is your responsibility to notify us of any change to your employment status. Depending on the status change you may no longer be eligible for the core benefits. Please note that changes in coverage will only be made the first of the month following the date our office is notified in writing. Changes in coverage will not be made retroactively.

What is a “60 Day Window”?

The term “60 Day Window” refers to a one time opportunity to receive guaranteed coverage, at the Complete level, in the plan for which an individual is eligible. 60 Day Window opportunities arise from the first of the following occurrences:

  • Initial hire date at the hospital
  • Losing group health coverage as a result of retirement from a full-time position
  • Losing group health coverage as a result of a transfer from full-time to part-time
  • Losing group health coverage as a result of turning age 65
  • FIRST offer from the hospital of non-temporary or non-contract employment

*60 day windows apply only to those employed at an endorsing hospital. Other specific circumstances may apply.

When I first came on to the plan I was working less than 18 hours but I am now working more than 18 hours per week. Does my coverage change?

It will not change "automatically" but you may be eligible to apply for the core benefits (Life, ADD&D & LTD). If you are a permanent part time or casual employee and are now working more than 18 hours per week on average, you need to contact our office to learn more about updating your coverage.