When it comes to employment benefits, a pressing concern for many employees on long-term disability is whether their health and dental coverage will be terminated or not. The fear of losing health and dental benefits during a period when they’re needed most adds an extra layer of stress to an already challenging situation.
In this blog, we’ll be answering the question “Can my employer cancel my health insurance while on disability?” as well as outline cases in which benefits termination would be deemed unlawful and how a disability lawyer can help secure the benefits you are entitled to.
Health Insurance and Disability: How They Typically Work Together
Health insurance benefits generally encompass a wide range of medical, dental, and sometimes vision care expenses. These benefits are designed to alleviate the financial burden of healthcare costs, covering everything from routine checkups and prescriptions to more significant medical procedures and treatments.
When an employee faces the challenging circumstance of a long-term disability–a period where they’re unable to work due to a serious health condition–these health insurance benefits become even more necessary.
Does Canada Have Rules That Negate Health Insurance When on Disability?
Contrary to what many might think, Canada does not have overarching rules that automatically negate health insurance coverage for employees on disability. Instead, the continuation of these benefits often hinges on the individual employer’s policies and the specific terms of the benefits program.
What is the Continuation of Benefits Policy?
A continuation of benefits policy is a provision within an employer’s insurance coverage that outlines the terms under which health insurance benefits are maintained for employees during periods of long-term disability.
This policy dictates whether or not disabled employees will continue to receive extended health insurance benefits. If health benefits continue during disability, the policy will detail how long this will be the case, any contributions required from the employee, and specific conditions that must be met to maintain these benefits.
For example, a policy may allow for health coverage to continue as long as the employee remains officially employed, possibly requiring them to contribute towards their premium costs. Continuation of benefits policies are designed to align with provincial employment standards to ensure a level of uniformity and fairness. In most cases provisions must be made clear to employees and they must be implemented in a non-discriminatory manner.
What if My Employer Does Not Have a Continuation of Benefits Policy?
In the absence of a specific continuation of benefits policy, the fate of an employee’s health benefits during long-term disability can become uncertain, potentially leading to significant legal and financial ramifications for both employer and employee.
Without clear guidelines, employees might unexpectedly lose their health and dental coverage, a situation that not only poses a direct impact on their well-being but also leaves them vulnerable to the financial burdens of medical costs. This lack of clarity often results in legal grey areas where the boundaries of employer obligations and employee rights become blurred, increasing the risk of disputes about terminating benefits.
Unfair Termination of Health Insurance: When and How?
Terminating benefits during long-term disability may be deemed unfair or even illegal under certain circumstances:
- Violation of Employment Standards Legislation: Each province and territory in Canada has employment standards legislation that outlines the minimum conditions of employment, including provisions for health benefits during leave periods. Canceling health benefits for an employee on long-term disability in violation of these laws, such as failing to maintain benefits for the minimum duration mandated by provincial or territorial employment standards, would be considered both unfair and illegal.
- Breach of Employment Contracts or Collective Bargaining Agreements: If the terms of an employment contract, continuation of benefits policy or a collective bargaining agreement stipulate that employees on long-term disability are entitled to continued health benefits, terminating an employees benefits provision may expose the employer to legal disputes and potential liability.
- Unfair Termination of Employment as a Means of Cancelling Benefits: An employer may attempt to terminate an employee’s employment under the guise of performance issues, restructuring, or other reasons, but with the underlying motive of cancelling their health benefits while they are on long-term disability. This tactic not only deprives the employee of their entitled health benefits but also their job, solely because of their disability status. Such an act would be deemed unfair and illegal, as it constitutes discrimination based on disability.
DWA Law – Legal Protection When You Need It Most
Wading through insurance and disability policies while trying to recover from a debilitating injury is hard enough on its own, but add termination of essential benefits and your situation can start to seem hopeless — unless you have an experienced lawyer by your side.
An experienced long term disability lawyer from the DWA Law team can be instrumental in assessing your health insurance policy, your continuation of benefits policy, and judge whether or not the way your case has been handled falls within legal bounds.
At Dickson Wynperle Associates we are dedicated to helping those with disabilities secure the benefits they are entitled to. Whether your health benefits have been cancelled unjustly or you need support submitting an insurance claim, we have your back. Get in touch with us today to set up a consultation with one of our professionals. Tell us your story, and let us help you move forward.
