10
9) Please explain how the date of eligibility is used in a 0.5 LOA for a full-time
teacher where the leave lasts for five years.
Members on a long term LOA are eligible for coverage under the plan upon their RTW.
They are automatically enrolled in the LTD plan on November 1, 2013 for the portion of
their contract that they are working on November 1, 2013.
If they have not maintained coverage during their part-time LOA on their 1.0 FTE or had
more than 24 months of consecutive LOA, they will become insured under the plan and
subject to premium payment on the .5 FTE LOA portion of their contract when they
return to full-time teaching.
10) How will the November 1, 2013 implementation date affect members who are
currently on leave? How will these individuals be informed of the changes?
Members who have continued coverage during their LOA will be automatically
transferred to provincial plan coverage on November 1, 2013. Members who did not
maintain coverage during their LOA will be enrolled in the LTD plan upon their Return to
Work.
11) How will members pay premiums if they're on leave? Who collects premiums at
that time?
The Board will be required to bill and collect LTD premium during a LOA in the same
manner as they do if you are continuing your life, health or dental coverage.
12) If a member is on a leave and comes back early (e.g., back from a pregnancy leave
or an unpaid leave), how does that affect coverage?
An early return to work will not affect coverage if the leave commences after November
1, 2013. If the leave commences prior to November 1, 2013 and the member did not
continue coverage during their leave under their prior plan, they become members of the
provincial plan upon their RTW and any claim is subject to a pre-existing condition
limitation for the first 12 months of membership in the provincial plan.
13) What happens when someone on leave makes a disability claim? What kind of
coverage can they expect?
A member on an unpaid LOA makes a claim as if they were working and the waiting
period can be served during the LOA. Benefits are not payable until the member would
be scheduled to RTW as this would be the first day that they would be suffering an
actual income loss from not being at work.
14) What is the enforcement mechanism to ensure that members pay for coverage
during a leave? Who is expected to police this? What are the consequences of
members deliberately not paying for coverage (e.g., closing down a bank account
during their leave so the Board can't make deductions for LTD, or refusing to
provide post-dated cheques)?
The provincial plan requires continuous participation in the LTD plan during a LOA in
order to protect the ability of the member to make a claim for benefits if a medical