Did You Know – Coordinating Group LTD and WCB

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Did you know…Coordinating your Group Long Term Disability (LTD) and Workers Compensation Board (WCB) Claims can save you time and money?

Lately we have seen many instances where plan administrators have not notified their Group Insurer of WCB claims, therefore not taking advantage of a benefit that may be included under their group contract. When a WCB claim extends into the elimination or waiting period for Group LTD coverage, careful consideration should be given to notifying the Group Insurance Carrier. The majority of Group Benefits contracts include coverage for waiver of premium. This benefit waives the monthly premiums for life and disability benefits while an insured is receiving disability income benefits including Workers Compensation. In order to apply for waiver of premium, your insurer must first be made aware that the member is on claim. The timeframe for waiver of premium to begin can vary depending on the contract and the insurer, and is generally after a pre-determined length of time. This timeframe is usually driven by the date last worked and the date the insured begins receiving disability payments. It generally results in premiums being waived after the member has been receiving disability income payments for 6 months.
Here is a scenario to help illustrate how this can work:
John works for ABC Company and is enrolled in their comprehensive group benefits program that provides him with life, long term disability, extended health and dental benefits. The plan includes a waiver of premium benefit. He is also covered by Workers Compensation. John suffered a work injury on June 15, 2011. He and his employer completed all of the paperwork required and filed a claim with WCB, but they did not notify the group insurer. John’s claim with WCB was accepted and benefit payments were approved effective June 16, 2011. This injury prevented John from returning to work for 16 months until October 2012. During his absence from work, premiums for his group benefits continued to be charged by the insurer. While John was in receipt of WCB disability benefits, coverage under the group life insurance and long term disability insurance plan may have been eligible for waiver of premium, had the insurer been notified.
Keeping thorough records through the application process of a WCB claim is a good practice as you will be required to provide documentation to an insurer in order to apply for waiver of premium. Having to secure paperwork from WCB and your workplace after the fact can be tedious and cause unnecessary delays. Applying for waiver of premium can be an expedited and an easy process if good records of the workplace illness or injury are easily accessible. Informing your insurer at the 4 month mark of a WCB claim is advisable.
Of course, all Group Benefit plans are designed differently and contracts vary. Have your WCB documentation ready and contact your benefit Plan Member Advocacy team or Plan Administrator to assist you with the application for waiver of premium.