Premiums: Details on payment delays or relief

 

Small Case:

Flexibility on premium payments. Small businesses can be the most impacted by the current pandemic. If you can make your monthly premium payments, please continue remitting them as normal. If you have difficulty paying your premiums within the 31-day timeframe, we’ll continue your contract. You’ll then have up to 60 days to pay the premium from the date it’s due. If you have questions or need to make arrangements, please contact your Client Service Administrator at 1-877-786-7227.

 

Large Case:

Flexibility on premium payments. We want to support you in these difficult times. We know you may face challenges in paying your premiums on time. If you can make your monthly premium payments, please continue remitting them as normal. If you have difficulty paying your premiums within the 31-day timeframe, will continue your contract. You will then have up to 60 days to pay the premium from the date it’s due.


Employees in The Waiting Period: How is this handled?

 

Small & Large Case:

We have clarified our position on how we will apply waiting periods during lay-offs,

  • If someone satisfies the waiting period and can work from home – should be considered active and coverage should start (if the client is paying premiums)
  • If someone satisfies the waiting period and on lay-off – coverage should start if the client has other employees on lay-off in that group and has continued coverage (if the client is paying premiums) 
  • If the Client has not continued coverage, we’ll start counting the waiting period from the date the member returns to work.


Processing Layoffs: Administrative Steps Required


Small Case: Terminate coverage 

We strongly recommend that you maintain coverage to continue to protect the health of your employees. If your benefit plan allows you to terminate coverage during a temporary layoff, you must apply the decision equally to all employees within the same class. (These can be processed on the plan sponsor site, SBB.Central@sunlife.com or TPA.

 

 

Large Case: Terminate coverage 

We strongly recommend that you maintain coverage to continue to protect the health of your employees. If your benefit plan allows you to terminate coverage during a temporary layoff, you must apply the decision equally to all employees within the same class.

  • If terminating all benefits; the client should process member terminations via TPA or in Plan Sponsor site even if they are terminating all members.
  • If terminating disability only; the client should submit a special request 
  • For SSOL clients can reach out to the employee maintenance team for support  

 

Small Case: Suspending coverage 

Even if your benefit plan does not provide for a suspension of coverage, you can suspend coverage for all of your employees for up to three months. Suspending coverage means that employees won’t have access to any of their benefits. To suspend or terminate coverage, you can process member terminations in our Plan Sponsor Services website or on your administrative system. You can also contact your Client Service Administrator (SBB.Central@sunlife.com)


Large Case: Suspending coverage 

Even if your benefit plan does not provide for a suspension of coverage, you can suspend coverage for all of your employees for up to three months. Suspending coverage means that employees will not have access to any of their benefits.


Coverage, by Benefit and Extensions during Layoff

 

Small Case & Large: Maintain coverage

You may maintain coverage for all benefits (or all benefits, except disability) for up to three months. Your benefit plan may set out a different temporary lay-off period. If so, this period will apply. You must apply your coverage decision equally to all employees within the same class. We know that you may not be able to collect employee contributions at this time. In such cases, you should remit the full premium now. You can then collect employee contributions when employees are back at work. This will not affect benefit taxability.


Minimum Hours of Work

 

Small Case & Large Case: Minimum hour requirements

Some employees may be working reduced hours and fall under the minimum number of hours required in the contract. You can maintain coverage for employees on reduced hours, on a temporary basis, for up to three months. 

Salary Based Benefit Coverage Amounts


Small Case & Large Case

Do not reduce salary amounts in your administration system. We want to ensure employees are covered for their full benefit if they submit a claim.

Renewal Handling

 

Small Case: Deferred renewals. We are deferring May and June renewals by two months automatically. This means that May renewals will be effective in July and June renewals will be effective in August. We will not apply any retroactive adjustments

 

Large Case: If you have concerns about your upcoming renewals, please contact your Account Executive to work on an arrangement.


Health Care


Prescription Supply Amounts

 

We know that plan members want to ensure they have enough medication at home during the COVID-19 pandemic.  Pharmacy regulators, associations and health ministries are recommending that pharmacists provide a 30-day supply to Canadians. This helps ensure there are enough medications available for all Canadians during the pandemic.  We support pharmacists using their discretion in dispensing medications. A plan member might receive only a 30-day supply for their medication, even if their prescription is for more. If a plan member has previously filled a prescription, they may receive a different amount than the last time.


Virtual services providers as it relates to claims (Small and Large)

 

We know that in-person visits to many health-care providers may not be available during the COVID-19 pandemic. We want to ensure plan members continue to receive the health care they need. Now, we’ll cover virtual services for appointments where they do not need direct physical therapies. We’re extending claims coverage for virtual services performed by:

  • Audiologists
  • Chiropodists
  • Chiropractors
  • Naturopaths
  • Occupational Therapists
  • Osteopaths
  • Podiatrists
  • Psychologists
  • Psychotherapists
  • Physiotherapists
  • Registered Dieticians
  • Social Workers
  • Speech Therapists

The practitioner must be in Canada for us to pay claims. Existing coverage remains the same.

We continue to assess other potential virtual services. We’ll keep you informed of any changes.


Member Communications Plan (Small and Large)

 

To help educate plan members about COVID-19 and how it may impact them, we are continuously sharing information on the mySun Life mobile app, mysunlife.ca, and on sunlife.ca.

We have launched a dedicated page for plan members at sunlife.ca/covid-19 that we will continually update with the latest information.