Pregnant woman sitting on sofa with pet dog.
If you are going on a leave, and covered under the ETFO ELHT benefits plan, your school board will inform OTIP of your leave status up to two weeks after you begin your leave. You will then receive an email and letter via Canada Post from OTIP instructing you to review and update your benefits. It is important that you action this time-sensitive communication to avoid any disruptions in your coverage.
Here are a few things you need to know and do to update your benefits:
Types of leave:
1. Statutory leaves (e.g. pregnancy/parental leave, critical illness – adult/child, etc.)
Your benefits coverage will be funded in the same way it was when you were working, in the time immediately before you started your statutory leave.
2. Paid Sick Leave
Your benefits coverage will be funded in the same way it was when you were working, in the time immediately before you started your paid sick leave.
3. Long term disability (LTD) and WSIB
If you are in the first 24 months of an approved LTD or WSIB claim, your current benefits coverage and funding available to you during your leave will be the same as when you were working, in the time immediately before you started your leave. If you continue on an approved LTD or WSIB leave for longer than 24 months, you will then be responsible for 100% of your benefits costs until you return to work.
You may be eligible for a waiver of life insurance premium.
4. Other leaves (e.g. unpaid medical leave, unpaid full/part-time personal leave, deferred or x/y leave, etc.)
While you are on an LTD/WSIB leave longer than 24 months or a non-statutory leave, you are responsible for paying your health, dental, and basic life and AD&D benefit premiums if you wish to maintain your benefits.
You will receive a communication from OTIP to complete your benefit selections, and those selections must be made within 31 days of the date that the communication is initially sent. If benefits selections are not made within 31 days coverage will be suspended and the plan member will not be eligible for the reinstatement of the coverage until their return to active duties.
Your benefit costs while on an LTD/WSIB leave longer than 24 months (3) or a non-statutory leave (4).
If you elect to continue benefits while you are on a full-time leave
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If you elect to continue benefits while you are on a part-time leave
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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.
For example:
Your salary = $100,000
Coverage = 1X salary
Therefore, premiums are based on $300,000.
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You pay for the pro-rated benefits related to your leave/non-working FTE.
Health and dental – Examples:
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If your regular FTE is 1.0 and you are on a 0.2 leave, you pay 20%
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If your regular FTE is 0.8 and you are on a 0.5 leave, you pay 70%
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)
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Once OTIP is notified of the change in your employment status by your school board, AND you are required to pay for a portion or all your benefit costs, the following will occur:
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On the first day of your leave, benefits that you are paying for all or some of the costs, will be suspended. Depending on when your board reports your leave to OTIP, you may be suspended retroactively. It can sometimes take the board up to 2-3 weeks to report your leave.
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If you are not intending to maintain benefits during your non-statutory leave, you should avoid incurring new claims once your leave begins. NOTE: If you do not elect to maintain benefits during your leave, but incur claims, you will be required to repay the full cost of any claims reimbursed to you or your dependents during your leave.
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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 actively return to work.
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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.
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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.
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Premium deductions from your bank 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. For example, if your leave began in September, but you did not complete your benefits selection until after September 10th deduction date, your September and October deductions will be included in the October 10th deduction from your bank account.)
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Important notes:
- Depending on when your leave information is submitted to OTIP, 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 active work status information was received and processed. If you are returning to work following a part-time leave, you will have the option to reinstate, if applicable, optional life coverage if you had previously opted to suspend this coverage during your leave.)
- Contact OTIP Benefits Services at 1-866-783-6847 for more information.
Staying connected while on a leave.
- Update your preferred email address: Your school board email address may be your default email address for OTIP notifications. Consider updating your preferred email address to your personal email. This way you won’t miss any benefits information during your leave.
- Update your home address: To update your home address after you move, please advise your board and the board then will provide this update to OTIP.
Questions? If you have questions about what happens to your benefits coverage on a leave, contact OTIP Benefits Services.
