Industrielle Alliance, Insurance and Financial Services


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Group Insurance



Contract administration


How do I enrol a new member?

How do I change a member's personal information and benefits?

How do I handle late-entrants enrolments?

In the case of a termination, when do benefits cease?

When are premiums due?

How are prorated adjustments calculated?

Whom should I contact if I have questions or concerns?


Definitions


What is meant by “eligibility period"?

What is meant by “non-evidence maximum"?

What is meant by a “late entrant"?


Contract administration


How do I enrol a new member?

To enrol a new member, provide the employee with the Enrolment Request (PDF - 236 KB) form, and have the employee complete the required sections and sign the Plan Member Confirmation/Authorization section. As plan administrator, you must complete the first part in full and ensure that the form is signed and submitted to the following address, according to your administrative centre, within 31 days of the employee's eligibility date:

Toronto

Industrial Alliance Insurance and Financial Services
Administration Department, Group Insurance
522 University Avenue, Suite 400
Toronto, Ontario M5G 1Y7

Montreal

Industrial Alliance Insurance and Financial Services
Administration Department, Group Insurance
PO Box 790, Station B
Montreal, Quebec  H3B 3K6



 



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How do I change a member's personal information and benefits?

For terminations, salary changes or changes in member categories, you must complete the Notice of Change (PDF - 122 KB) form. It is very important to indicate the effective date of the change.

For benefits changes, name changes, changes of beneficiary, changes in a family situation, or to add dependents, you must complete the Change Request (PDF - 239 KB) form and return it to the following address, according to your administrative centre:

Toronto

Industrial Alliance Insurance and Financial Services
Administration department, Group Insurance
522 University Avenue, Suite 400
Toronto, Ontario M5G 1Y7

Montreal

Industrial Alliance Insurance and Financial Services
Administration Department, Group Insurance
PO Box 790, Station B
Montreal, Quebec  H3B 3K6



 



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How do I handle late-entrants enrolments?

If the enrolment request is submitted after the eligibility period, the coverage on the member, spouse and dependent children is conditional on approval of the evidence of insurability. You must return the Evidence of Insurability (PDF - 111 KB) form duly completed and signed by the member and dependents, if applicable, together with the Change Request (PDF - 239 KB) form and return it to the following address, according to your administrative centre:

Toronto

Industrial Alliance Insurance and Financial Services
Administration department, Group Insurance
522 University Avenue, Suite 400
Toronto, Ontario M5G 1Y7

Montreal

Industrial Alliance Insurance and Financial Services
Administration Department, Group Insurance
PO Box 790, Station B
Montreal, Quebec  H3B 3K6

 

Note: Industrial Alliance must receive all the forms and information required before it can approve requests for coverage to late entrants.
However, for Quebec residents, we grant health insurance coverage as of the date of receipt of the Enrolment Request (PDF - 236 KB) form.

 



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In the case of a termination, when do benefits cease?

In the case of a termination, all benefits cease on the member's last day of work. It is therefore important that you indicate the member's last day of work as the termination date.



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When are premiums due?

Industrial Alliance offers you three options for paying your monthly premium: pre-authorized withdrawals (PAW), Internet or cheque.

The table below gives the statement issue dates and the payment due dates for 2014 depending on the payment method you selected. Only plans administered at Industrial Alliance will receive the statements.

 Internet or Cheque

Pre-Authorized
Withdrawal(2)

Billing
Month

Statement
Issue Date

Payment
Due Date(1)

Statement Issue Date

 January

 December 14, 2013

 January 1, 2014

 December 17, 2013

 February

 January 18, 2014

 February 1, 2014

 January 21, 2014

 March

 February 15, 2014

 March 1, 2014

 February 18, 2014

 April

 March 22, 2014

 April 1, 2014

 March 25, 2014

 May

 April 19, 2014

 May 1, 2014

 April 22, 2014

 June

 May 24, 2014

 June 1, 2014

 May 27, 2014

 July

 June 21, 2014

 July 1, 2014

 June 24, 2014

 August

 July 19, 2014

 August 1, 2014

 July 22, 2014

 September

 August 23, 2014

 September 1, 2014

 August 26, 2014

 October

 September 20, 2014

 October 1, 2014

 September 23, 2014

 November

 October 18, 2014

 November 1, 2014

 October 21, 2014

 December

 November 22, 2014

 December 1, 2014

 November 25, 2014

 January

 December 13, 2014

 January 1, 2015

 December 16, 2014

(1)If you opt for Internet or cheque payment methods, premiums are due on the first day of the month after your statement is generated.

(2)If you opt for the pre-authorized withdrawal payment method, premiums will automatically be withdrawn from your bank account on the date you selected on the Policyholder Pre-Authorized Withdrawals (PAW) (PDF - 56 KB) form.

Important: If the entire premium for your Group Policy is not received by the end of the allocated period, you will receive a letter reminding you that your premium payment is overdue. If the entire payment has still not been received within 45 days of the due date, health and dental claim reimbursements for all plan members under the Group Policy will be suspended. 



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How are prorated adjustments calculated?

Prorated adjustments at Industrial Alliance are calculated based on 30 days, regardless of the number of days in the month where the adjustment is effective.

Prorated adjustments are calculated differently in the case of a new member, a termination of member coverage or a change of coverage. Below are examples for each scenario.

1. New Plan Member

Coverage effective July 4, 2014. Processed on the July 2014 bill.

Monthly Health Premium: $125.82
Monthly Dental Premium: $95.29
Monthly Life Premium: $31.80

 How many days do we charge to the  client?

 30 days - 3 days = 27 days

 What is the prorated Health Premium  amount?

 $125.82 / 30 days x 27 days = $113.24

 What is the prorated Dental Premium  amount?

 $95.29 / 30 days x 27 days = $85.76

 What is the prorated Life Premium  amount?

 $31.80 / 30 days x 27 days = $28.62

 What is the total amount to be charged to  the client?

 $113.24 + $85.76 + $28.62 = $227.62

2. Termination of Member Coverage 

Termination effective February 7, 2014. Processed on the March 2014 bill.

Monthly Health Premium: $98.06
Monthly Dental Premium: $129.80

 How many days do we reimburse to the  client?

 30 days - 6 days = 24 days

 What is the prorated Health Premium  amount?

 $98.06 / 30 days x 24 days = $78.45

 What is the prorated Dental Premium  amount?

 $129.80 / 30 days x 24 days = $103.84

 What is the total amount to be reimbursed  to the client?

 $78.45 + $103.84 = $182.29

3. Change of Coverage 

Change of coverage from Single to Family effective June 21, 2014. Processed on the July 2014 bill.

Monthly Health Premium - Single Coverage: $55.76
Monthly Health Premium - Family Coverage: $156.54
Monthly Dental Premium - Single Coverage: $29.48
Monthly Dental Premium - Family Coverage: $73.74

N. B. Since June premium was already paid, the adjustment will only include the difference between the family and the single coverage premium.

 How many days do we charge to the  client?

 30 days - 20 days = 10 days

 What is the prorated Health Premium  amount?

 ($156.54 - $55.76) / 30 days x 10 days =  $33.59

 What is the prorated Dental Premium  amount?

 ($73.74 - $29.48) / 30 days x 10 days =  $14.75

 What is the total amount to be charged to  the client?

 $33.59 + $14.75 = $48.34



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Whom should I contact if I have questions or concerns?

Contact:

Industrial Alliance Insurance and Financial Services
Customer Service, Group Insurance
Toll-free Telephone: 1-877-422-6487
From the Toronto region: 416-585-8921
From the Montreal region: 514-499-3800
E-mail: groupinsurance@inalco.com



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Definitions


What is meant by “eligibility period"?

The eligibility period is the period of time an employee must be employed by you before becoming insured under your group insurance plan.



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What is meant by “non-evidence maximum"?

The non-evidence maximum is the amount of insurance offered to a member without any requirement that the member provides information about his or her state of health. If a member requests a coverage limit in excess of the non-evidence maximum, the member must complete the Evidence of Insurability (PDF - 111 KB) form, and the coverage will only become effective when Industrial Alliance has approved the evidence of insurability.



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What is meant by a “late entrant"?

A late entrant is any employee who does not complete an application for insurance within 31 days of his or her date of eligibility. These employees must be medically approved before they can become insured.



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