These updates are required as soon as possible to ensure that we process plan member claims correctly and that you are not covering ineligible dependents.
Important information you need to know:
- Your Sun Life booklet will identify the lower and upper age limit for dependents. You can find it in the ‘Who qualifies as your dependent’ section.
- If a dependent reaches the lower age limit in a plan, but isn’t a full-time student, their coverage ends.
- If a dependent is previously identified as a full-time student, but hasn’t reached the upper age limit, they’ll continue to have coverage unless we’re notified they are no longer a student.
How to update your over-age dependent information
First, you can identify dependents by running an over-age dependent listing on the Plan Sponsor services site. This report will allow you to input the upper and lower age limit to produce a list of dependents you need to validate.
Please ask employees to provide you with an updated proof of studies, for their dependent records and update any over-age dependent information.
Who is eligible for coverage?
To qualify, a dependent must:
- Meet all contractual requirements under your plan.
- Be under the upper age limit for your plan.
- If over the lower age limit, be attending an accredited institution as a full-time student. For a full listing of institutions accredited by the government, you can search for institutions in Canada and outside of Canada.
- Retain their provincial health-care coverage.
Coverage for full-time students who are over the lower age limit ends on the date that they are no longer enrolled as a full-time student (i.e. completed studies, dropped courses, taking time off from studies).
If a student completed their year and re-enrolls in the fall term, we continue coverage through the summer break. We may continue coverage beyond the age limits for a dependent who qualifies as a disabled dependent under the terms of your plan. Sun Life must receive notice within 31 days of the date that the dependent reaches the limiting age.
Students enrolled in apprenticeship programs – Often, students working full-time in apprenticeship programs are sent to school for various periods throughout their apprenticeship. If the dependent does not receive Employment Insurance (EI) benefits while in school, then they’ll remain an eligible dependent.
Students enrolled in co-op programs – Students enrolled in co-op programs are eligible for coverage, provided they are under the upper age limit.
Students studying outside of Canada – Full-time students attending an institution outside of Canada require prior approval for coverage by Sun Life. Please ensure you complete the Plan Sponsor Request to Continue Coverage smart form located on your Plan Sponsor Site, under Guides for Group Benefits Administrators.
Students who are studying outside of Canada need to apply for an extension of their provincial coverage before leaving the country. They must keep this provincial coverage in place during the length of their studies in order to qualify for coverage under the group insurance plan.
Important reminders for your employees
Claim submissions – The claim must indicate the student’s status for those dependents who are full-time students.
What if the dependent is covered under their student plan or their employer plan? Then that plan will be the first payor for any claims. Your benefit plan may pay any remaining balance, if eligible.
Confirming coverage – When the school needs confirmation of a dependent's coverage, the plan member can contact our Client Care Center at 1-800-361-6212.
Additional benefits cards for dependents
Plan members can print personalized emergency travel and Pay-direct drug cards through mysunlife.ca or access them through the my Sun Life mobile app.
Questions? We’re here to help.
For Clients with less than 50 employees, please contact your Client Service Administrator at 1-877-786-7227.
For Clients with more than 50 employees, please contact your Sun Life Group Benefits representative.