Updated December 1, 2020
We have standard pre-existing condition clauses in our contracts. This can affect a plan member’s eligibility for disability benefits if:
- the health conditions existed before a plan member’s coverage began, and
- the disability occurs within the timeframe set out in the contract
If there is a break in coverage, we typically use the coverage reinstatement date when applying the pre-existing provision. Earlier this year we changed our administrative process for COVID-19-related layoffs. We were using the previous date coverage began when applying the pre-existing provision. As of January 1, 2021, we’ll be returning to your standard contract terms for pre-existing conditions.
Pre-existing condition clause: statutory leaves
Many provinces have laws that protect the earnings and benefits of employees when returning from a statutory leave. This includes legislated emergency leaves.
If the plan sponsor must continue benefits coverage during a statutory leave, the plan member still has the option to waive it. Here is what happens when a plan member waives coverage during a statutory leave.
Pre-existing condition provision: We reinstate coverage when the plan member returns to work. We will use the previous date coverage began when applying the pre-existing condition provision