What Happens When...

Certain events in your life may affect the benefits coverage you need and/or the benefits coverage you receive.

  • You get married or reach 12 months of living with your common law partner
  • You get divorced or your common-law relationship ends
  • You have a baby or adopt a child
  • Your spouse loses benefit coverage
  • You take a maternity or parental leave
  • You take an approved paid or unpaid leave of absence
  • You are approved for Long Term Disability benefits
  • You leave your employer
  • You retire
  • You die before retirement
  • Your spouse or child dies
     


You get Married or Reach 12 Months of Living with your Common Law Partner

If you get married or reach 12 months of living with your common law partner, you may wish to change your benefits coverage to include your spouse. Contact your Benefits Administrator within 60 days of your spouse becoming eligible for coverage if you wish to:

  • change your health and/or dental coverage from single to family;
  • purchase $50,000 evidence-free Optional Life Insurance for your spouse.

At any time you may also wish to:

  • change your Basic and/or Optional Life Insurance beneficiary designation;
  • purchase or increase Optional Life Insurance for yourself;
  • purchase more than $50,000 of Optional Life Insurance for your spouse;
  • change your Optional Accidental Death & Dismemberment (AD&D) Insurance coverage from single to family and/or purchase additional coverage;
  • change your Optional AD&D Insurance beneficiary designation;
  • purchase or increase Critical Illness coverage for yourself; or
  • purchase Critical Illness coverage for your spouse.
  • In some cases your spouse will need to provide medical evidence and be approved before coverage begins.

If you change from single to family dental coverage after 60 days of your first dependent becoming eligible for coverage, your dependent’s dental benefits will be limited to $125 for the first year of membership.


You get Divorced or your Common Law Relationship Ends

If you become divorced or your common law relationship ends, your spouse is no longer eligible for coverage under the Health Association benefit program.

Any coverage your spouse had under the program will end.

In the event of a divorce, the only way you may continue your spouse’s coverage for Health Association benefits is by having this decreed in the divorce agreement.

If you become separated, divorced or your common law relationship ends, you should contact your Benefits Administrator immediately to:

  • remove your spouse from health and/or dental coverage;
  • change your health and/or dental coverage from family to single (if applicable);
  • change your Basic and/or Optional Life Insurance beneficiary designation;
  • cancel Optional Life Insurance for your spouse;
  • change your Optional Accidental Death & Dismemberment (AD&D) Insurance coverage from family to single (if applicable);
  • change your Optional AD&D Insurance beneficiary designation; or
  • cancel Critical Illness coverage for your spouse.


You have a Baby or Adopt a Child

If you have a baby or adopt a child, you may change your benefits coverage to include that child. Contact your Benefits Administrator within 60 days of your child becoming eligible for coverage if you wish to:

  • add your child to your health and/or dental coverage;
  • purchase Optional Life Insurance for your dependent child;
  • purchase or increase Optional Accidental Death & Dismemberment (AD&D) Insurance;
  • purchase or increase Critical Illness coverage for your dependent child. 

Other things you might consider would be to:

  • change your Basic and/or Optional Life Insurance beneficiary designation;
  • purchase or increase Optional Life Insurance for yourself (proof of good health maybe be required);
  • purchase or increase Optional life Insurance for your spouse (proof of good health may be required);
  • purchase or increase Optional Accidental Death & Dismemberment (AD&D) Insurance;
  • change your Optional AD&D Insurance beneficiary designation;
  • purchase or increase Critical Illness coverage for yourself (proof of good health may be required); or
  • purchase or increase Critical Illness coverage for your spouse (proof of good health may be required).

 
Your Spouse Loses Benefit Coverage

If you had opted-out of the health and/or dental plans because you were covered under your spouse’s plan, you may join the Health Association plan within 60 days of losing your spouse’s coverage without medical evidence.

If your spouse loses benefit coverage, you may also wish to contact your Benefits Administrator to:

  • purchase or increase Optional Life Insurance for yourself;
  • purchase or increase Optional Life Insurance for your spouse;
  • purchase or increase your Optional Accidental Death & Dismemberment (AD&D) Insurance;
  • purchase or increase Optional Critical Illness coverage for yourself; or
  • purchase Optional Critical Illness coverage for your spouse.

You take a Maternity or Parental Leave

If you take a maternity/parental leave, you may choose to continue all of your Health Association benefits for the duration of your leave. The continuation of your Long Term Disability and/or Critical Illness coverage is limited to 24 months.


If you choose not to continue your benefits during your leave, you may re-apply for coverage within 60 days upon your return to work. You will need to:

  • satisfy the waiting periods for Health coverage, Dental coverage, and Critical Illness coverage regardless of your length of leave; and
  • satisfy a waiting period for Basic Life Insurance if your leave is longer than 12 months.

You will also be subject to the pre-existing condition restrictions for your Long Term Disability Insurance and your Critical Illness Insurance (if you choose to re-apply for this coverage).

 

You take an Approved Paid or Unpaid Leave of Absence

If you take an approved paid leave of absence, you may continue all of your benefits for up to 12 months (24 months for Long Term Disability and/or Critical Illness coverage). The existing cost-sharing arrangement prior to your leave will continue.

If you take an approved unpaid leave of absence, you may continue all of your benefits for up to 12 months (24 months for Long Term Disability and/or Critical Illness coverage) as long as you pay the full premiums.

If you choose not to continue your benefits during your leave, you may re-apply for coverage within 60 days upon your return to work. You will need to:

  • satisfy the waiting periods for Health coverage, Dental coverage, and Critical Illness coverage regardless of your length of leave; and
  • satisfy a waiting period for Basic Life Insurance if your leave is longer than 12 months.

You will also be subject to the pre-existing condition restrictions for your Long Term Disability Insurance and your Critical Illness Insurance (if you choose to re-apply for this coverage).


You are Approved for Long Term Disability Benefits

The following benefits will continue without payment of premiums for as long as you are receiving Long Term Disability benefits:

  • Basic Life Insurance;
  • Optional Life Insurance;
  • Optional Accidental Death & Dismemberment Insurance; 
  • Long Term Disability Insurance; and
  • Critical Illness.

If you wish to continue your Health coverage and/or your Dental coverage, you may do so as long as you continue to pay the premiums for these benefits.

In addition, if you are a member of Nova Scotia Health Employees' Pension Plan (NSHEPP), you will continue to accrue pensionable service and have your contributions waived while receiving LTD benefits.


You Leave your Employer

The following benefits end immediately when you leave your employer:

  • Critical Illness coverage;
  • Long Term Disability Insurance;
  • Optional Accidental Death & Dismemberment Insurance;
  • Basic Life Insurance for your dependent children; and
  • Optional Life Insurance for your dependent children.

The following benefits end immediately when you leave your employer, but you may convert your coverage to an individual policy within 31 days of your coverage ending:

  • Basic Life Insurance for you and your spouse; and
  • Optional Life Insurance for you and your spouse.

Ask your Benefits Administrator for a completed copy of the Sun Life Financial Conversion Form.

The following benefits continue until the end of the month in which you leave your job:

  • Dental coverage; and
  • Health coverage.

You may choose to convert your Dental Coverage and/or your Health coverage to an individual policy within 60 days of your coverage ending.


You Retire 

If you retire, have at least 10 years of service and receive a pension from the Nova Scotia Health Employees' Pension Plan (NSHEPP) or any other pension plan sponsored by a member organization, you may:

  • choose to continue your Basic Life Insurance. Your coverage will begin to reduce by 20% each year, starting on the first day of the month after your retirement. Your Basic Life Insurance coverage will end at age 70 or 4 years after your retirement, whichever occurs first.
  • choose to continue your Health coverage as long as you pay the full cost of this coverage. Prescription drug coverage ceases at age 65 if you retire prior to age 65, at which time you may apply to the Seniors Pharmacare Program.

Contact your Benefits Administrator for more information about continuing your coverage. Your Health coverage will end when you retire if you do not choose to continue and pay for this coverage. The following benefits end immediately when you retire, regardless of your length of service or membership in the Pension Plan:

  • Critical Illness coverage;
  • Long Term Disability Insurance;
  • Optional Accidental Death & Dismemberment Insurance;
  • Basic Life Insurance for your spouse and dependent children;
  • Optional Life Insurance for you, your spouse and dependent children
  • Dental coverage; and
  • Emergency Travel coverage.

When you retire, you may choose to convert the following coverage to an individual policy within 31 days of your coverage ending:

  • Basic Life Insurance for your spouse; and
  • Optional Life Insurance for you and your spouse.

When you retire, you may choose to convert the following coverage to an individual policy within 60 days of your coverage ending:

  • Dental coverage; and
  • Health coverage if you choose not to participate in the Health Association retiree plan.

Ask your Benefits Administrator for a completed copy of the Group Life Conversion Privilege Notification.

  

You Die Before Retirement

In the event of your death before retirement, your spouse and dependent children may continue their Dental coverage and Health coverage for up to two years after your death and their Optional Accidental Death & Dismemberment coverage for up to six months after your death. No premiums are required for this coverage.

All other benefits end upon your death.

If you have Basic Life Insurance, Optional Life Insurance, Critical Illness coverage, and/or Optional Accidental Death and Dismemberment Insurance, your beneficiary should contact your Benefits Administrator to make any applicable claims.

 

Your Spouse or Child Dies

If your spouse or child dies, you should notify your Benefits Administrator. Your Benefits Administrator will help you make any applicable Life Insurance and/or Optional Accidental Death & Dismemberment claims.