“Never put off until tomorrow that which you can do today.” –Benjamin Franklin
People seldom enjoy being late. Even more so if being late results in unforeseen consequences. It is easy to procrastinate what is difficult to understand. This strikes especially true when it involves insurance.
WHAT IT IS
Late entrants are employees (and their dependants), who withdrew from a plan or did not enrol in a plan, when they were initially eligible for coverage.
At a later date:
1. They decide to join the plan
2. They request a re-instatement of coverage
3. Their spouse/partner had coverage else where, no longer has it, and needs it
HOW IT WORKS
In the case of dental care plans, late application is often due to employees discovering that they, or their dependants, require dental treatment that will cost more than the premium contribution amount.
To become eligible for a plan, a late entrant must complete an Evidence of Insurability application. It is a document that must be completed by each family member (including the employee) to prove good health. It is then reviewed by the insurance provider, and they decide whether to offer the benefit to the employee or their family. Sometimes the provider will significantly reduce benefits for the first 12 months, though the cost to the employee is the same as full benefits.
For example, if the provider usually covers dental up to $1,500 annually, it is reduced to $250 annually, and only if coverage is not denied.
We do not recommend late enrolment to any one that has group benefits. It is costly and can have negative effects on individuals and their families.
We have numerous group clients that are happy with their coverage, and their staff are well looked after.
Periodically, we have group clients and their employees that become late enrollments/entrants. We try our best to explain that this is not good practice for themselves or their employees. It helps to understand that 30 days following an employee’s probationary period is all the time they have, to complete and send in the application for benefits. If they miss this deadline, the employee falls into ‘Late Applicant Status.’ They may no longer qualify for benefits. This is a difficult situation, for all parties involved.
To avoid this, it is best to complete the application at the newly hired date. Send it into the provider early. When the probationary period is over, the provider will automatically initiate enrolment. If the employee does not make the probationary period, the employer lets the provider know. Then, the employee and their family’s enrolment are removed from the active listing.
Have a question? Or need clarification?
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