Managing employee benefits doesn’t have to be complicated. Whether you’re adding new employees, making updates for life changes, or handling opt-outs, this Plan Administrator Cheat Sheet provides the essential information you need to keep your group benefits running smoothly and in compliance with the Chambers Plan.
Who Is Eligible?
Employees and their dependents must meet the following criteria to qualify for coverage:
Employees: Canadian residents under the age of 75, working a minimum of eight months per year and not less than 15 hours per week.
Spouses: Married spouses or common-law partners the employee has lived with for at least 12 consecutive months.
Children: Dependent children under 21 years old, or up to 25 years old if they are full-time students.
Children with Disabilities: Children of any age are eligible if they are disabled and dependent on the employee.
Note: For firms enrolled prior to March 1, 2024, where part-time employees were not previously included, eligibility requires employees to be full-time and working a minimum of 20 hours per week.
Opting Out of Coverage
Employees and their families can opt out of health and dental benefits if they already have coverage elsewhere. Proof of alternative insurance is required. However, participation is mandatory for all other benefits, such as:
Life Insurance
Critical Illness (CI)
Employee Assistance Program (EAP)
When to Add a New Employee
The best time to add new employees to your benefits plan is as soon as they are hired. By enrolling them immediately, their coverage will start after your firm’s designated waiting period. Failing to enroll an employee within this period could result in them being classified as a Late Entrant, which may delay or limit their coverage.
Major Life Changes
Life events often require updates to employee benefit profiles. Be sure to make changes within 60 days of the event to avoid additional requirements. Common updates include:
Marriage
Birth or adoption of a child
Divorce or separation
Medical or maternity leave
Loss of duplicate coverage from another plan
Change of residence to another province
If updates aren’t made within the required timeframe, employees may need to complete a Dependent Statement of Health for approval.
Understanding Late Entrants
A Late Entrant is any eligible employee who didn’t apply for coverage within 30 days of the waiting period. In these cases:
A Statement of Health is required for the employee and their dependents.
Coverage will only begin once the application is approved.
A $250 dental benefit maximum applies during the first 12 months of coverage.
How to Add a New Employee
Adding a new employee is quick and easy through my-benefits®:
Log in and click Add New Employee.
Follow the on-screen steps to complete the process.
For online enrolment, click Employees in the left-hand menu. Both you and the employee can fill out the form online.
How to Remove an Employee
To remove an employee from the plan:
Log in to my-benefits®.
Click Employee Coverage Changes and then Employment Change.
Provide the last day of work and the reason for the change.
Simplify Plan Administration
Keeping your employee benefits accurate and up to date ensures your team has uninterrupted access to the coverage they need while protecting your business from unnecessary complications. For further support or assistance with administering your plan, reach out to your Chambers Plan advisor.
