Health & Dental Benefits Research

 In Group Insurance & Benefits

Virtually all employers provide extended health benefits and dental plans for their employees and eligible dependent children. Although coverage on the employees continues as long as the employee remains employed with the organization, the coverage on dependent children terminates when the children no longer meet the eligibility definition.

At such time as the dependent children coverage terminates, the employee and/or the dependent children will likely be interested in replacement coverage. The provision of information and assistance to employees regarding the termination and possible replacement of coverage is an important employee relations issue. In order to assist employers, WCBC completed a research survey in March, 2017 regarding employer practices, and subsequently developed recommendations regarding employee notification and assistance.

Full results are available to participants only. The following are recommendations developed from the survey results:

Recommendations

Employees which have their children covered as dependents under the employee’s employer-provided health plans have a considerable interest in replacement coverage. In the interests of good employee relations, we therefore recommend that employers consider the following:

  • ensuring that procedures are in place to advise the employees at least three months in advance that dependent coverage will be terminating;
  • making available to employees a list of possible sources of replacement coverage; and
  • advising employees of possible criteria to consider when evaluating replacement coverage, including
    • pre-existing limitations
    • deductibles and coinsurance
    • inside dollar limits on covered services such as paramedical, vision care, major dental services
    • out-of-province/country coverage
    • amount of the premiums.

Participants in WCBC research projects receive a complete summary of the results at no cost. If you would like to be notified of  future research projects, ensure you subscribe.

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