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Home > Why OTIP > News > Going on a leave?
If you are going on a leave, and covered under a group benefits plan, your employer/school board will inform OTIP of your leave status.
You will then receive a communication from OTIP asking you to review and update your benefits. It is important that you action this time-sensitive communication to avoid any disruptions in your coverage, if applicable.
Here are a few things you need to know and do to update your benefits:
Types of leave:
Statutory leaves (e.g. pregnancy/parental leave, critical illness – adult/child, etc.)
Long term disability (LTD)
Other leaves (e.g. unpaid medical leave, unpaid full/part-time personal leave, deferred leave, etc.)
If you are on a full-time leave
If you are on a part-time leave
You pay 100% of your benefit costs during your leave.
Benefit costs include your health, dental, basic life*, accidental death and dismemberment (AD&D)* and optional life coverage (if applicable).
*Benefit premiums will be based on your pre-leave salary/coverage but are subject to change if the board reports a change in salary.
Your salary = $100,000
Coverage = 3X salary
Therefore, premiums are based on $300,000.
You pay for:
Health and dental
If your FTE = 0.667, you pay 33%
If your FTE = 0.333, you pay 67%
Basic Life and AD&D
Benefit costs will continue to be funded as they were prior to your leave of absence and will be based on the salary reported by the board. (i.e. If your earnings are reduced, your coverage will also reflect this change.)
Optional life (Member, Spousal, Child)
Once OTIP is notified of the change in your employment status by your employer/school board, AND you are paying for a portion or all your benefit costs, the following will occur:
On the first day of your leave, benefits that you are paying for all or some of the costs, will be suspended.
You will receive a communication to update your benefits during your leave by completing a Leave Selection – FTE Reduction event. You will have 31 days to complete your selections, or your coverage will remain suspended until you return to work.
As you make your benefit selections through your Leave Selection – FTE Reduction event, your monthly costs (before taxes) will be displayed beside each benefit. There is also a window that displays the combined total monthly costs (including sales tax) that will update as you change your coverage selections.
If you are going on a full- or part-time leave, you may need to provide your banking information to pay premiums for your coverage. Once you have added this information, your benefits coverage will be reinstated retroactively to the date immediately before you started your leave. If eligible claims were declined while your coverage was suspended, contact OTIP Benefits Services to arrange for the claims to be resubmitted for assessment.
Premium deductions from your banking account will occur on the 10th of each month. (NOTE: Your first deduction may include retroactive premiums, depending on the timing of when the leave information was received, and banking information was processed.)
Depending on when your leave information is submitted to OTIP by your employer, it may take up to three weeks to process the changes.
You have the option to continue all or some of your benefits. (i.e. You can continue basic life and AD&D only, or just health or dental benefits.) (Exception: If basic life and AD&D are mandatory benefits and funded by your group benefits plan, then these benefits cannot be suspended during your leave.)
If you choose to stop your benefits coverage during your leave, you will be able to reinstate it when you return to work.
When you return to work, you will get an email from OTIP to complete your Leave Return – FTE Increase-Coverage Update Option event. You will have 31 days to confirm your coverage without medical evidence. (NOTE: Your first deduction may include retroactive premiums, depending on when your work status information was received and processed.)
If you are a plan member of the CUPE Education Workers’ Benefits Trust, EWAO, OCEW or Unifor benefit plans, eligibility and/or requirements may vary for leaves. Contact OTIP Benefits Services at 1-866-783-6847 for more information.
Questions? If you have questions about what happens to your benefits coverage on a leave, contact OTIP Benefits Services.
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