Canadian about to marry a British Citizen

[Becki567]

Mind you, I do wish the wife can get on the spouse work benefits. But isn't that's the company's decision, not the insurance's decision?

If you call the insurance company directly asking them, isn't that like calling them to see if they will cover your spouse without company's involvement. In other words, sure they will cover the wife, as a private insurance outside the work benefits.

I still think the OP's work company still have authority on how the employee's spouses get access to work benefits. They are the one paying the insurance company to handle/manage the work benefits. Since a company can hire any insurance company they want to manage the work benefits, I'm sure they dictated to insurance how employee's spouses are qualified.

In short, when the OP and his wife do settle in BC working, OP is best to contact his work HR department on how his wife can access the work benefits.

I don't know who you work for or why you have such horrible experience. But you are wrong.

When an employer offers health benefits and you are adding a spouse you complete the paperwork from the INSURANCE company. It is the INSURANCE company guidelines that are used to determine eligibility. If the insurance company deems common law as after 12 months then EVERYONE covered by that insurance company would not be able to cover their common law spouse (as an example) until after 12 months. If the company wanted common law covered after 6 months, TOO BAD! If the employer wanted common law only covered after 2 years, TOO BAD. That is an insurance company policy.

An employer is not legally allowed to know any part of your insurance claims. They can't know prescriptions you have had filled, counsellor a you may have seen. If an employee files for short term disability the employer does not even have to be told why. All medical documents are sent to solely to the insurance claim processor. IF it fits within the insurance company guidelines it is covered.

The employer can pick the level of coverage. Will you coverage massage? What is the yearly limit on dental? Etc but for who is covered that is 100% dependent on the insurance company guidelines are what makes a spouse or common law partner.

I have real life experience from my own company and my last job in a smaller company one of my responsibilities was signing up new employees. I don't know where you are getting your information from the internet? Your head? An illegally run company? If a company agrees to offer employee family benefits, they do not determine what or who makes up the family. Truth.

 

[Becki567]

Dave if you require any further help please feel free to private message me. I am no longer going to follow this thread.

Again, call your insurance company. If you ask your HR department, they will surely refer you to the company as well.

 

[screech339]

Becki. Why are you rambling about what the company what the company should know or should not know about employee personal life. That is what what I am talking about in terms of qualification for company's benefits. That's confidential information that the company knows nothing about.

I am only telling you that employers can dictate how the spouse can get on employee's work benefits. Not how they are common law or married has nothing to do with it. If the couple is legally common law or married, so what. Doesn't mean swat to them. Just if the common law is not on provincial health care, they can say to the employee that the common law or spouse cannot get on work benefits until that person has gotten provincial health care to qualify. The company is not dictating who is married or common law. I don't know where you got that reasoning from.

MofC even demostrated her example to make my point.

 

[Becki567]

Becki. Why are you rambling about what the company what the company should know or should not know about employee personal life. That is what what I am talking about in terms of qualification for company's benefits. That's confidential information that the company knows nothing about.

I am only telling you that employers can dictate how the spouse can get on employee's work benefits. Not how they are common law or married has nothing to do with it. If the couple is legally common law or married, so what. Doesn't mean swat to them. Just if the common law is not on provincial health care, they can say to the employee that the common law or spouse cannot get on work benefits until that person has gotten provincial health care to qualify. The company is not dictating who is married or common law. I don't know where you got that reasoning from.

MofC even demostrated her example to make my point.

MofC specifically said that blue cross will add a spouse even if the spouse does not have provincial health care!
That is not what you have been saying. Your reply to that was blue cross would only add the spouse if you paid out of pocket. Again, NOT true. Also confirmed by Mofc

My "rambles" were to try and educate you on what a company could and could not decide. If a company offers their employees family insurance (spouse and kids).
It is NOT the company decision on who qualifies as a spouse or if they can be covered. It is the insurance company!

Provincial health care and workplace benefit plans cover COMPLETELY different things. If a spouse did not have provincial health care that would not increase the workplace benefit plan payout or affect them in anyway. MofC has said manulife cares, but blue cross doesn't. I am aware blue cross and sun life do not require provincial health care.

Could you please inform us all where you are getting your information? I have repeatedly told you how it works from FIRST HAND knowledge through my own company and then as a financial administrator in a different company.

I do not know how to break it down any simpler for you.

Best of luck Dave, this forum is great for guidance but at the end of the day it's just people that May or may not be educated on what they are preaching. Always confirm for yourself, especially with your application.

 

[MofC2014]

I should add that my understanding is that even if the private insurer insures a spouse who does not have provincial healthcare (via employer provided benefits), and if that spouse was to end up in a hospital i.e. surgery or had an accident and broke a leg for example, the private insurer would not cover them for the hospital/doctors/surgery/x-rays etc. even if they were on the benefits lets say with Blue Cross or Sunlife. What the private insurer would cover (via employer benefit plans) is everything over and above provincial healthcare (for hospitals, they top up for a semi or private room, they would cover medication and that's about it. The above information is in the benefit booklet.

I think what spouses without provincial healthcare should do is purchase their own private insurance to have coverage for doctors, hospitals etc.

 

[Becki567]

I should add that my understanding is that even if the private insurer insures a spouse who does not have provincial healthcare (via employer provided benefits), and if that spouse was to end up in a hospital i.e. surgery or had an accident and broke a leg for example, the private insurer would not cover them for the hospital/doctors/surgery/x-rays etc. even if they were on the benefits lets say with Blue Cross or Sunlife. What the private insurer would cover (via employer benefit plans) is everything over and above provincial healthcare (for hospitals, they top up for a semi or private room, they would cover medication and that's about it. The above information is in the benefit booklet.

I think what spouses without provincial healthcare should do is purchase their own private insurance to have coverage for doctors, hospitals etc.

That is correct. Because workplace benefits cover different items than provincial healthcare. So even if your spouse did have provincial health care the workplace benefits still wouldn't cover any of those things because that is not the type of insurance they are due to universal health care.

No workplace benefits cover doctor visits or X-rays or MRIs or CT scans etc etc. But they generally do cover prescriptions, eye glasses, dental, massages, sometimes physio etc.

So the spouse could still get workplace benefits provided that spouse meets the definition or requirement of spouse through the insurance company.

 

[MofC2014]

That is correct. Because workplace benefits cover different items than provincial healthcare. So even if your spouse did have provincial health care the workplace benefits still wouldn't cover any of those things because that is not the type of insurance they are due to universal health care.

No workplace benefits cover doctor visits or X-rays or MRIs or CT scans etc etc. But they generally do cover prescriptions, eye glasses, dental, massages, sometimes physio etc.

So the spouse could still get workplace benefits provided that spouse meets the definition or requirement of spouse through the insurance company.

Yes exactly. You see why I contacted Manulife is because they give 30 days to change benefits (add a spouse or add a baby) due to a "life event" such as marriage, birth of a child. So I was worried that when my husband gets here they wont let me add him to my benefits because our "life event" which is marriage happened more than 30 days prior. Manulife explained that my husband will be added to my benefits when he becomes resident of Canada (so the life event in this case is not the marriage but the time he comes to Canada and is a PR covered under alberta health care). I asked that they put this in writing LOL and they did send me an e-mail from the Manulife Benefit Manager in Waterloo, Ontario.

 

[Becki567]

Yes exactly. You see why I contacted Manulife is because they give 30 days to change benefits (add a spouse or add a baby) due to a "life event" such as marriage, birth of a child. So I was worried that when my husband gets here they wont let me add him to my benefits because our "life event" which is marriage happened more than 30 days prior. Manulife explained that my husband will be added to my benefits when he becomes resident of Canada (so the life event in this case is not the marriage but the time he comes to Canada and is a PR covered under alberta health care). I asked that they put this in writing LOL and they did send me an e-mail from the Manulife Benefit Manager in Waterloo, Ontario.

It is always a good thing to get stuff in writing. I hope your husband joins you soon here in Alberta

 

[MofC2014]

It is always a good thing to get stuff in writing. I hope your husband joins you soon here in Alberta

Thx. All in good time I try not to stress over this process, Im busy with school, work, friends and family.

My apologies to the OP btw for getting off topic. Wishing you all the best and speedy visa.

 

[screech339]

Becki. I would begin by apologizing to you. I would apologize for my limited knowledge on the workings between employers and insurance company.

You say that sunlife does not require provincial health care. My company is a major manufacturing company that provide products around the world. They use sunlife insurance for their work health benefits. Would you explain to me why my employer tells me that I cannot get my wife get work benefits like dental, prescription, through me until she gets on OHIP. If you say that sunlife doesn't require provincial health care, my wife should automatically get access to my work's benefits. But no. She needs to get on OHIP first. Does this means this is the company's decision or sunlife's decision?

This is where I get my initial thoughts of who makes the decisions on how the spouse or common law of the employee gets the work benefits.

I would like your thought on this please.

 

[MofC2014]

hi Screech, just like Manulife in my case, Sunlife will not let you add your spouse until she has provincial health care. See Below. This is not your company's rules, it is their group benefit providers rules, in your case Sunlife.

http://www.sunlife.ca/Canada/sun+aff/Insurance+products/Extended+Health+Care+insurance/Plan+details/Extended+Health+Care+Insurance-+Plan+details?vgnLocale=en_CA#eligibility

 

[MofC2014]

Additionaly if i can put in my 2 cents. Ontario and any other province that has this waiting period is just plain ridiculous!!!!!! I understand they make you wait if you move between provinces (as you can use AB health card in Ontario when you move lets say to Ontario and Ontario just bills Alberta during the first 3 months) but a new PR coming from another country should not be subject to this 3 months waiting period.

 

[screech339]

hi Screech, just like Manulife in my case, Sunlife will not let you add your spouse until she has provincial health care. See Below. This is not your company's rules, it is their group benefit providers rules, in your case Sunlife.

http://www.sunlife.ca/Canada/sun+aff/Insurance+products/Extended+Health+Care+insurance/Plan+details/Extended+Health+Care+Insurance-+Plan+details?vgnLocale=en_CA#eligibility

Thanks MofC for the link. Got another question. Take this example. Suppose my wife was not on OHIP but I got private medical insurance that covers everything that OHIP covers. This would be expensive option I imagined. Anyway, does this means my wife can now get access to my work benefits since her medical insurance is the same as OHIP.

 

[MofC2014]

Thanks MofC for the link. Got another question. Take this example. Suppose my wife was not on OHIP but I got private medical insurance that covers everything that OHIP covers. This would be expensive option I imagined. Anyway, does this means my wife can now get access to my work benefits since her medical insurance is the same as OHIP.

To be honest I don't really know if Sunlife would accept this or not. I think in each situation it is best to call the insurer to find out if that's possible.

 

[screech339]

To be honest I don't really know if Sunlife would accept this or not. I think in each situation it is best to call the insurer to find out if that's possible.

I may have not been very clear in earlier discussion about this. This is what I meant. I was under the impression from Becki that if the spouse has private insurance, the spouse should get access to employee's work benefits.

In my opinion, again due to limited knowledge of the working relationship between employers and insurance companies, I think she would still not get access to the spouse's work benefits just because he/she has own private insurance.