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Provincial health insurance: mandatory for plan member eligibility for group insurance

News Release

Did you know that plan members must be covered under the health insurance plan in their province of residence to be eligible for the employer’s group insurance plan?

Whether a business traveller or a foreign worker, there are many situations in which employees may become ineligible for their group insurance plan and these situations are becoming more and more common. While each case is unique, some situations in which employees or their dependents are at risk of losing their group insurance coverage are becoming more regular:

  • Overseas posting, expatriate or business traveller
    Employees who must leave the country for an extended period must first take the necessary steps to maintain their provincial health insurance coverage. If they don’t maintain it, they will not be covered under their group insurance plan. 
  • Foreign worker, inpatriate or work visa holder
    Newly hired newcomers must wait approximately three months before they are covered under their provincial health insurance plan. Therefore, during this period, they will not be covered under their group insurance plan.

Group insurance plan eligibility criteria
iA Financial Group (Industrial Alliance Insurance and Financial Services Inc.) determines group insurance plan eligibility based on four specific criteria. To be eligible, plan members must:

  1. Be covered under their province of residence’s health insurance plan
  2. Meet the definition of “full-time Canadian resident”
  3. Meet the definition of “Employee” under the group insurance contract
  4. Respect the eligibility period required by the employer 

Most employees already respect these criteria. Thus, there is no issue regarding their eligibility for group insurance coverage. However, the status of some employees or dependents may be uncertain. In these cases, simple verifications with the individuals in question or with the health insurance plan in their province of residence could help avoid countless problems. Additionally, an iA Financial Group advisor could also help identify alternatives available to the employer and plan members.

A communiqué will be sent to group insurance plan administrators on March 25, 2019, to inform them.

Read the French version of this communiqué.