Mandatory participation & opting out

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Your group benefits policy, guarantees universal enrolment. This means everyone is included, with 100% mandatory participation for all employees and their dependents (unless your contract with the insurance carrier says otherwise).

Universal enrolment lets employers like you provide and keep up coverage through your chosen insurance carrier. So, when an employee fits the eligibility requirements of your contract, they must be enrolled.

💡 Note

Just a heads up! The mandatory participation rule, which encompasses all the wonderful benefits in your package like Life, AD&D, Dependent Life, etc., is mandatory and can't be opted out of by any employee.

Exceptions to mandatory participation

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There are two exceptions when you can opt out of universal enrolment:

  1. Health and Dental Benefits
    An employee can opt out of health and dental benefits if they already have this coverage under their spouse/partner’s plan.

    Reminder:
    While the employee may receive Health and Dental coverage through a spouse/partner's plan, they are not covered by any other benefits that may be included in your plan, such as Life, AD&D, Dependent Life, and so on, and must still enrol in these other benefits.

  2. Optional Benefits
    Optional benefits, as the name implies, are excluded from universal benefit enrolment. If your plan includes optional benefits like Optional Life, Optional AD&D, and Optional CI, employees can select whether or not to enroll in these benefits.

    Note:
    All optional benefits are paid for by the employee, and depending on your insurance company, a medical questionnaire is typically required to qualify for coverage.

Employees are more likely to opt out of health and dental benefits if they are responsible for the monthly payments. But, good news! If the company takes care of these costs, they're usually more likely to jump on board. Plus, they could be covered by not just one but two plans - their employer's and their spouse's or partner's. This is a great way to coordinate benefits and get the most bang for their buck in terms of coverage.

 

Opting out of all coverage

We understand that there may be occasions when an employee refuses to enrol in the benefits plan. In this scenario, it is strongly recommended that a refusal form be completed to protect the company from any future liability.

The document should explicitly confirm the employee's choice to decline coverage and describe the late applicant's terms if they decide to enrol at a later date. Please contact our Benefits Support team for a free template of this refusal form for you to use.

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