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Overview

If you experience a life event, you have 31 days to make changes to your health, travel and dental coverage. You may also change your optional life insurance, AD&D insurance and optional critical illness insurance at any time. Here are the changes you can make:

Important Deadline

You have 31 days following a life event to make changes to your health, travel and dental coverage; otherwise, you will need to provide proof of good health for health coverage and dental benefits will be limited. See the section What Happens if I Don’t Enrol in Time? for more information.

Health coverage You may change from single to family coverage, and vice versa, or add new dependents. Proof of good health may be required.

Dental coverage

You may change from single to family coverage, and vice versa, or add new dependents.

If you choose Plan A, you can change to Plan B any time. Once you choose Plan B, you cannot change back to Plan A afterward.

Travel coverage You may change from single to family coverage, and vice versa.
Optional life
insurance
You may change your level of coverage (for yourself and for your dependents) any time. You must provide proof of good health if you wish to increase your coverage.
Optional AD&D
insurance
You may change your level of coverage any time.
Optional critical illness
insurance
You may change your level of coverage (for yourself and for your spouse) any time. You must provide proof of good health if you wish to increase your coverage.

Change in Marital Status

If you get married or start a common-law relationship, you have 31 days to enrol your new spouse in the benefits plan, provided your spouse meets the definition of spouse. If you apply for coverage after the 31-day limit, your spouse will need to provide proof of good health.

You can only cover one spouse at a time, so if you have a former spouse, you will need to remove their coverage.

If you get divorced or separated, you can continue to cover your former spouse under your health, dental and travel benefits, if you wish, but you may cover only one spouse. If your spouse is still covered under another group insurance plan, you may still coordinate benefits for your children’s covered expenses between your plan and your former spouse’s plan.

What to Do

To add a new spouse:

  1. Complete the Enrolment form. You can get a paper copy by contacting Johnson Inc.
  2. Gather any supporting documents that may be required, such as a proof of good health medical questionnaire.
    • If you enrol your spouse within 31 days of the life event, you must submit proof of good health if you wish to purchase over $30,000 of optional life insurance for your spouse.
    • If you enrol your spouse within 31 days of the life event, you must submit proof of good health if you wish to purchase over $50,000 of optional critical illness for your spouse.
    • If you enrol your spouse in the PSGIP over 31 days after the life event, you must provide proof of good health for all coverage.
    • Depending on the responses in the proof of good health medical questionnaire, your spouse may be required to undergo a medical examination.
  3. Return the form and any supporting documents to Johnson Inc.
  4. Coverage will take effect once Canada Life approves the proof of good health, if any.

To remove a former spouse:

  1. Notify Johnson Inc., in writing, of the change in your marital status.
  2. Specify that you wish to terminate coverage for your former spouse.

Dependent Children

If you welcome a new child into your home, either by birth or adoption, you have 31 days to enrol your new child in the plan, provided they meet the definition of child. Coverage for new borns begins at birth or on the date coverage would otherwise begin, whichever is later.

If your child is an overage student, meaning that they are over age 21, but under age 26, you can continue their benefits coverage, provided they are enrolled in full-time studies at an accredited learning institution. You can also continue coverage for overage children if they are physically or mentally disabled.

What to Do

To enrol a new child in the plan:

  1. Complete the Enrolment form. You can get a paper copy by contacting Johnson Inc.
  2. Gather any supporting documents that may be required, such as a proof of good health medical questionnaire.
    • If you are applying to cover the child more than 31 days after having them, you must submit proof of good health. Depending on your responses, your child may be required to undergo a medical examination.
  3. Return the form and any supporting documents to Johnson Inc.
  4. Coverage will take effect as of birth, or once Canada Life approves the proof of good health, if any.

To declare an overage student:

  1. Notify Johnson Inc. when your child’s dependent status changes. Each fall you must provide proof of full-time attendance at an accredited learning institution to confirm your child’s continuing studies.

Leave of Absence or Layoff

If you take an approved leave of absence (with or without pay), such as maternity or parental leave, or are on a layoff, all PSGIP coverage, except LTD will continue.

With the exception of Optional Critical Illness and LTD, coverage can continue for up to 18 months (24 months for Civil Service employees on a leave of absence) following the month in which your leave or layoff began. You must pay the applicable premiums to maintain coverage.

LTD coverage may be continued for a maximum of:

  • 3 months, if you are on a layoff or an unpaid leave of absence,
  • 12 months until the end of the leave, if you are on maternity or parental leave, or
  • 18 months for Health PEI employees and 24 months for Civil Service employees if you are on paid leave of absence.

If you take an approved educational leave, benefits will be based on your actual salary. During a period of deferred salary leave, your benefits can be continued. Check with your supervisor or human resources manager for details.

What to Do

Johnson Inc. will contact you regarding your benefits arrangements and premium payments. If you have not been contacted by Johnson Inc. soon after your leave begins, call them directly at 902 628-3537 or 1 800 371-9516.

Disability

The continuation of your benefits while on LTD leave depends on the benefit and your employment group. Certain benefits could be continued without premium payments. Johnson Inc. will provide you with details at that time.

While you are receiving LTD benefits, an additional percentage of your earnings will be paid on your behalf to cover your contributions to the pension plan – the Civil Service Superannuation Fund.

What to Do

Notify Johnson Inc. of your disability no later than eight weeks before your qualifying period ends, even if you are applying for workers’ compensation benefits. A Johnson Inc. representative will then send you the information and forms you need to apply for LTD benefits and premium waiver. Johnson Inc. will help guide you through the disability process and can help you gather other information needed by Canada Life, the insurance company that handles disability claims.

For more information on applying for LTD benefits, see the Disability section and the guide How to apply for long-term disability benefits.

Loss of Spousal Coverage

If you did not choose PSGIP’s health, dental or travel coverage because you were covered under your spouse’s plan, you may join the PSGIP if your spouse’s coverage ends. You have 31 days following the end of your spouse’s coverage to enrol without having to provide proof of good health.

What to Do

  1. Complete the Enrolment form. You can get a paper copy by contacting Johnson Inc.
  2. Gather any supporting documents that may be required.
    • If you choose family coverage and have an overage student dependent (age 21 to 26), you must provide confirmation of your child’s continuing attendance at an accredited college or university each year for continued coverage.
    • If your child is disabled and over age 21, you must provide satisfactory proof that they are incapable of self-support because of the disability.
    • If you enrol in the PSGIP over 31 days after your eligibility date, you must provide proof of good health for health coverage.
    • Depending on responses in the proof of good health medical questionnaire, you or your spouse may be required to undergo a medical examination.
  3. Return the form and any supporting documents to Johnson Inc.
  4. Coverage will take effect once Canada Life approves application and proof of good health, if any.

Leaving Your Employment

If you leave your employment, your PSGIP coverage will end on your termination date. However, if you are a Health PEI employee, all coverage (except for LTD) will end on the first day of the month following your termination of employment.

If your employment ends for reasons other than retirement and you are age 50 or over, you may be eligible for certain retiree benefits (years of service may apply). For details, contact Johnson Inc. at (902) 628-3537 or 1 800 371-9516.

Converting Your Coverage

If you are under age 65, you have 31 days to convert your basic and optional life and AD&D coverage to individual policies, without providing proof of good health, when you leave your employment. After 31 days, you will no longer be eligible to convert your coverage. For details, contact Johnson Inc. at (902) 628-3537 or 1 800 371-9516.

In Cases of LTD Payments

LTD benefits will extend beyond your termination date provided you became disabled while you were still insured. LTD benefits will continue to be paid according to the contract provisions regardless of the subsequent termination of the group policy.

Canada Life reserves the right to request that you provide proof of the continuance of your total disability, and submit to an examination by Canada Life’s medical advisors when requested.

What to Do

  1. If you have any outstanding claims for eligible health and dental expenses, Canada Life must receive your health or dental claim within 90 days after your termination date for your claim to be processed.
  2. If you wish to convert your life insurance and AD&D insurance to individual policies, call Johnson Inc. at (902) 628-3537 or 1 800 371-9516. Johnson Inc. will send your request to the insurer on your behalf. The insurer will then send you an information package, including premium rates for individual insurance policies. Remember, you have 31 days to submit your application for conversion.
  3. Also call Johnson Inc. for coverage details should your employment end for reasons other than retirement and you are age 50 or over.

Working Past Age 65

If you continue to work past age 65, your benefits continue, however, some of your coverage changes or ends. Your coverage will end earlier than the dates specified below if you cease to be an eligible employee. For more information on when your benefits coverage ends, go to the section When Coverage Ends.

Health

You become eligible for the Seniors’ Drug Cost Assistance Program (DCAP) at age 65.

As an active employee, the PSGIP will continue to be the first payer on drug claims, but you can submit any amounts not covered under the PSGIP to the DCAP for possible reimbursement.

Travel

At age 70, your travel coverage moves under the PSGIP retiree plan, where there are some limitations, such as:

  • coverage is limited to the first 180 days of your trip, and
  • pre-existing medical conditions must be stable prior to travelling.

Basic life for your Dependents

(for Health PEI only)

Coverage ends at age 65.

Basic AD&D insurance

(for Health PEI only)

Coverage ends at age 80.

Optional life and optional AD&D

Coverage ends at age 65.

When you reach age 65, you have 31 days to convert your Optional AD&D coverage to an individual policy, to a maximum of $200,000 when combined with any Basic AD&D coverage, without providing proof of good health.

What to Do

Contact Johnson Inc. to inform them that you have reached age 65 and to inquire about converting your coverage.

Retirement

When you retire, you have the option to join the Retiree Public Sector Group Insurance Plan (PSGIP). Membership in the plan is voluntary and is 100% retiree-paid.

As you prepare for retirement, there are a few important things you need to know about the retiree plan, like the coverage it offers, how it differs from your current coverage, the rules for joining and associated costs. The best place to start is to view the Retirement Planning video. You can find more information and details in the Retiree Benefits Guide.

Inside the Retiree Benefits Guide, you'll find:

  • A benefits at-a-glance overview of the options available for health, travel and dental coverage, as well as life and accident insurance options during your retirement,
  • Benefit rules during retirement outlining the restrictions and limitations for enrolling in the retiree health, dental and travel plans, opting out and the rules for rejoining at a later date,
  • A comparison of the differences between active and retiree coverage,
  • A list of things to consider when choosing your health care option,
  • A cost estimate example to help you understand your health care needs and determine which health option will work best for you,
  • Information on life and accident insurance options at retirement, including conversion to an individual policy,
  • A Retiree Checklist to review and assist as you prepare for retirement, and
  • Contact information for Johnson Inc. if you have questions or need more information.

To better understand the costs of the various plan options under the retiree plan, view the current Retiree Benefits Rate Sheet. Rates are reviewed on an annual basis and are subject to change.

Summary of Coverage Changes at Retirement

Here is a snapshot of what will happen to your benefits when you retire.

Health benefits

Your current coverage will end. However, if you had coverage as an active employee, you may choose one of four coverage options available to retirees and their dependents. You will receive details upon retirement.

Note: If you were in the health plan for active employees upon your retirement, you will have 31 days following your retirement date to elect an option without having to provide proof of good health.

You will have an opportunity to change your health plan option on April 1 of each year during your retirement.

Dental benefits

If you had coverage as an active employee, you may continue your dental coverage for you and your dependents upon retirement.

If you have Plan B as an active employee, you may reduce your coverage to Plan A upon retirement.

You will have an opportunity to change your dental plan option on April 1 of each year during your retirement.

Disability benefits

Coverage will end at retirement or age 62, less the waiting period, whichever is earlier.

Travel benefits

If you had coverage as an active employee, you may continue your travel coverage for you and your dependents upon retirement.

Death benefits

Your coverage

Your current basic coverage will end. If you retire at or after age 55 with 10 years of service as a Civil Service employee or with two years of service as a Health PEI employee, you are automatically covered for $5,000 of retiree life insurance. (Note: If you hold two positions at any time, one with Civil Service and one with Health PEI, your retiree life insurance is limited to $5,000.) If you are a Civil Service employee, you will be covered throughout retirement for basic AD&D insurance of $5,000, at no cost to you.

You may also maintain any optional life and AD&D coverage until age 65.

You can convert your current coverage to individual policies if you retire prior to age 65.

Your family’s coverage

Your family’s current basic life and AD&D coverage will continue at no cost. If you retire from the Health PEI, this coverage will end on the first day of the month following your 65th birthday.

You may also maintain your family’s optional life and AD&D coverage until you reach age 65.

You can convert your family’s current coverage to individual policies if you retire prior to age 65.

If you choose to end your health, dental or travel coverage at retirement because you are covered under your spouse’s plan, you may re-join the PSGIP if coverage under your spouse’s plan ends, provided you apply for coverage within 31 days of your spouse losing coverage.

What to Do

  1. When you know your retirement date, call Johnson Inc. at (902) 628-3537 or 1 800 371-9516. Johnson Inc. will provide you with all the details you need about the coverage available to you and to your family during retirement.
  2. If you have any outstanding claims for eligible health and dental expenses, you have 90 days after your termination date to submit a health or dental claim to Canada Life.
  3. When you retire, visit the PSGIP Retiree benefits website for ongoing information about your plan. Go to mybenefitplan.ca.

Death

If You Pass Away

If you pass away your beneficiary will receive the following death benefits:

  • Basic life insurance + optional life insurance (if you purchased optional coverage)

Plus, if the death was as a result of an accident

  • Basic AD&D insurance + optional AD&D insurance (if you purchased optional coverage)

Basic life insurance and AD&D insurance are not available if you are a Civil Service - Class 2 employee working less than 40% of the normal weekly working hours or a Civil Service - Class 4 temporary employee working less than 40% of the normal weekly working hours.

Benefits Coverage for Your Family

Your dependents’ health, dental and travel coverage will continue, provided they pay the cost of coverage. Your surviving spouse has 31 days after your death to choose to continue coverage.

Coverage for your eligible dependents will continue until the earliest of the following dates:

  • the date your surviving spouse passes away,
  • the date your dependents no longer meet the definition of eligible dependents, and
  • the date this plan terminates or this coverage has ended.

For life and AD&D coverage, your eligible dependents can convert their coverage (if applicable) into individual policies. If an application for conversion is made within 31 days of your death, no proof of insurability will be required. Your dependents can apply for conversion by calling Johnson Inc. at (902) 628-3537 or 1 800 371-9516.

What to Do

If you pass away, someone will need to inform Johnson Inc. of your death. A representative will then provide the necessary information and documentation.

If Your Spouse or Child Passes Away

If your spouse or child passes away you will receive the following death benefits:

  • Basic life insurance + optional life insurance (if you purchased optional coverage)

Plus, if the death was as a result of an accident

  • Optional AD&D insurance (if you purchased optional coverage)

What to Do

If your spouse or child passes away, you need to inform Johnson Inc. of your dependent’s death. A representative will then provide the necessary information and documentation.