D.A. TOWNLEY  -  Plan Administrators  
 

health benefits

 
 
 

ELIGIBILITY AND GENERAL INFORMATION

For the following Benefits:
— Life Insurance Benefit
— Accidental Death & Dismemberment Benefit
— Weekly Income Benefit
— Long Term Disability Benefit
— Extended Health Benefit
— Dental Care Plan

 

 

Commencement of Coverage

All eligible employees will be covered upon completion of 90 days employment with any one participating employer.
Employees absent due to disability, temporary lay-off or leave of absence on the date they would normally become eligible shall be covered from their date of return to active full-time employment. Dependents shall be covered on the same date as the employee or upon the date they become an eligible dependent. In regard to the medical coverage, an employee MAY enrol as soon as permitted by the rules of the Medical Services Plan of B.C. However, the employer contribution to such coverage will not be required until the waiting period (as outlined in the first paragraph above) has expired. Prior to that time the employee will pay the entire cost by payroll deductions. Should an employee die or suffer an accidental loss during his/her qualification period, the Plan will consider him/her to have qualified for coverage of $10,000 of Life Insurance and $10,000 of Accidental Death & Dismemberment coverage. Such claim(s), if approved, will be paid to his/her estate unless a beneficiary has been indicated on a completed enrolment card for such employee. The necessary criteria for an accidental loss listed under the Schedule of Losses in this booklet under the Accidental Death & Dismemberment section, must be met in order to qualify for payment of any Accidental Death & Dismemberment benefits.

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No Medical Examination
No medical examination or other evidence of insurability will be required in order to join the Plan. Evidence of insurability MAY be required for Long Term Disability coverage for NEW units with less than 10 employees NOT under the jurisdiction of a labour agreement with the I.L.W.U. or S.I.U.

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How to Join
All Eligible Employees Shall Participate. Complete the enrolment cards which are supplied and return them to your employer’s office.

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Definition of Dependent
1. The employee’s legal spouse, by virtue of a religious or civil ceremony except that if an employee is residing with a person of the opposite sex who he has publicly represented as his spouse and with whom he has resided for a period of at least 12 consecutive months, such common-law spouse shall be deemed to be the employee’s spouse; and
2. Each unmarried child of the employee who is:
(a) under the age of 21 years, except in the case of a dependent child when by virtue of his own employment is entitled or eligible for coverage; or
(b) at least 21 years of age but under 25 years of age and a registered student in regular full-time attendance at school; or
(c) at least 21 years of age and dependent upon the employee by reason of mental or physical infirmity.

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Change in Dependent Status
You must advise your employer of any change in your dependent status (for Medical, Extended Health and Dental) or you may be deprived of benefit payments.

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Termination of Coverage
Coverage will be terminated on the last day of the calendar month in which employment terminates. However, “lay-days” shall constitute continuation of employment. For example, if employment is terminated and the employee has “lay-days” to his credit, his coverage will terminate on the last day of the calendar month in which such credit is exhausted. Dependents’ coverage will terminate on the same day as that of the employee or upon ceasing to be a dependent as defined. Eligibility for Long Term Disability coverage will terminate on the last day of the calendar month in which the employee attains age 65, even if the employee remains employed thereafter.

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Reinstatement
Coverage will be reinstated immediately for any eligible employee who returns to active full-time employment with any participating employer within 6 months of the date his coverage terminated. If an employee does not return to active full-time employment within the 6 month period, he will be considered a new employee and will be covered upon completion of 90 days continuous employment with any one participating employer.

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Temporary Lay-off and Leave of Absence
At the employee’s option, arrangements may be made for coverage to be continued for up to 2 months from the end of the month in which lay-off or leave of absence commences except that in the case of an employee who is absent from work during any period of formal maternity leave taken by the employee pursuant to provincial or federal law or pursuant to mutual agreement between the employee and the employer, such time limit shall be extended to the end of such maternity leave, subject to payment of premiums. The employee must notify the Administrator within 5 calendar days of the end of the calendar month during which coverage terminates, that an extension of coverage is desired, at which time payment for the required premium must be received by the Administrator in full. During periods of extended lay-off, 3-6 months, and provided you are available for work and not actively working outside the Industry, you may make arrangements for Life,Accidental Death & Dismemberment andWeekly Income coverage. You will be covered by the Weekly Income Benefit on the basis of 1st day of disability due to an accident, 30th day due to sickness, or, if hospitalized, the 1st day of hospitalization, for a maximum period of 15 weeks. Extended Health, Dental and Long Term Disability benefits will not be available during this period. Where an employee undertakes a course of study to upgrade or attain a recognized seagoing certificate, coverage may be continued for up to one year subject to payment of premiums.

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Beneficiary
Upon enrolment in the Plan, an employee must designate the beneficiary to whom the death benefits will be payable. Subject to any legal restrictions he may change his beneficiary by completing the necessary change of beneficiary forms.

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Employee Benefit Identification Card
An Identification Card will be issued to each employee. It will indicate the benefit entitlements pursuant to the terms of employment.

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Form Links
A

Related Links
Government of BC site for PharamCare

 
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