What happens when I am considered a late applicant?

Employees who do not complete and sign the PEBT Benefits Enrolment Form within four months of the initial Eligibility Date will be considered a late applicant.

For basic life and extended health: If you are considered a late applicant, you must provide satisfactory medical evidence of insurability to the benefit provider prior to becoming eligible for coverage. To become eligible for coverage, the following steps must be taken:

  • You must complete the Evidence of Insurability Form and submit it to the benefit provider.
  • The benefit provider will send the school district a letter stating whether you have been approved or denied coverage. Once the letter has been received, the administrator can enroll the member using the administration system with the effective date stated in the letter.
  • Your coverage commences when formal written approval is received from the benefit provider(s). Retroactive premiums to the effective date of coverage may be required.

For dental: If you are considered a late applicant, the effective date of your coverage will be based on whether your district requires you to submit a dental declaration for approval or if there is a dollar amount restriction for your first year of coverage (i.e. $100/$125/$250 maximum for the first year). Your School District Benefits Administrator will advise which dental late applicant rules apply to your plan. Based on these options, the following steps must be taken to become eligible for coverage:

  • For school districts that require a dental declaration to be submitted, the district administrator will send the declaration and a copy of your PEBT enrolment form to the benefit provider. The provider will send the school district a letter stating whether you have been approved or denied coverage.
  • If approved, the effective date of coverage will be the 1st of the month following approval by the provider.
  • For school districts with a dollar maximum late applicant restriction for the first year of coverage, the district administrator will enroll you onto the dental plan and PBC will apply the dollar maximum restriction for the first year. The effective coverage date will be indicated by the benefits administrator on the enrolment form.
  • The effective date of coverage will be the date indicated by the benefits administrator on the enrolment form