Life Insurance
Life insurance helps protect the financial security of the member’s family in the event of unexpected death. Plans may include basic and optional coverage for the member and optional coverage for the member’s spouse and children.
Beneficiary
To the extent permitted by law, you have the right to name a personal representative or beneficiary for life and accidental death and dismemberment benefits (where applicable) or change this personal representative or beneficiary by written request in a form satisfactory to the benefits providers. If your designated personal representative or beneficiary does not survive you, any benefit amount due will be payable to your estate.
Payment of Benefit
If you die while insured, the benefits provider will pay the amount of your group life insurance to your beneficiary. When you designate more than one person as beneficiary, the benefits provider will assume the benefit amount is to be divided equally unless you specify otherwise. If your designated beneficiary is under age 18, you should appoint a trustee for this beneficiary and have a trust agreement drawn up and signed. This trustee will receive and give the discharge for any benefit amount which becomes payable while your beneficiary is a minor. If no beneficiary survives you, the benefit amount will be paid to your estate.
Living Benefit
Terminal condition means an injury or sickness from which there is no reasonable prospect of recovery, as determined by the benefits provider, and which is expected to result in your death within 12 months.
If you have a terminal condition, the benefits provider will pay you the living benefit amount shown in the summary of benefits. You or your legal representative must submit a written request for this benefit and include written consent from your beneficiary (release form) and written proof of your medical condition from your attending physician.
Waiver of Premium
Should you become totally disabled before your 65th birthday and remain so for the period of time equal to the Core LTD elimination period, or if you are not eligible for Core LTD coverage, six months, the premium for your group life insurance will be waived. Premiums will continue to be waived for as long as the total disability persists. For the purpose of this provision, premiums will cease to be waived on the earliest of the following dates:
- the date on which the member ceases to be totally disabled,
- the date the member fails to provide the benefits provider proof of continued disability,
- the date on which the member attains age 65 or retires, if earlier,
- the date on which the member attains 35 years of pensionable service under the Municipal Pension Plan (MPP) or any other registered pension plan arising out of employment with an employer and a minimum age of 55,
- if eligible for Core LTD coverage, the date payment of the LTD benefit ceases.
Conversion Option
When a member’s Basic Life Insurance terminates or reduces on or before their 65th birthday, the member may convert, without evidence of insurability, all or part of this Basic Life Insurance to an individual policy offered and underwritten by Pacific Blue Cross as per the conditions below. The amount of insurance converted will not be less than the minimum amount for which Pacific Blue Cross issues an individual policy. The maximum amount which may be converted will be limited to the lesser of:
- $200,000, or
- the sum of the group life insurance and optional life insurance you had with us, or
- the amount of terminated basic and optional life insurance under the policy less any amount for which the member becomes eligible under any other group policy within 31 days after their insurance terminates.
The individual policy will be issued subject to the following:
- the receipt of the first premium and a duly completed application from the member within 31 days of the date of termination of the Basic Life Insurance of the member and
- the type of individual policy applied for will be without disability or accidental death benefits and may be an individual policy of term insurance for a period of one year or an individual policy of term insurance to the age of 65
- should the individual policy selected be a standard or non-smoker type, the standard rates will apply.
If the member dies within the 31-day period during which the member could have converted, the benefits provider shall pay the maximum amount of insurance coverage the member could have converted to the member’s beneficiary.
Claims
In the event of your death, the benefits provider must receive notice of your death within 30 days and a completed claim form along with any proof required, as requested by us, within 90 days. However, no payment will be made on any claim submitted later than one year from the date of death.
Dependent Life
Payment
If you are insured for this benefit, when one of your eligible dependents dies, the benefits provider will pay you the benefit amount.
Waiver of Premium
Should you become totally disabled before your 65th birthday and remain so for a period of time equal to the Core LTD elimination period, or if you are not eligible for Core LTD coverage, six months, the premium for your group life insurance will be waived. Premiums will continue to be waived for as long as the total disability persists. For the purpose of this provision, premiums will cease to be waived on the earliest of the following dates:
- the date on which the member ceases to be totally disabled,
- the date the member fails to provide the benefits provider proof of continued disability,
- the date on which the member attains age 65 or retires, if earlier,
- the date on which the member attains 35 years of pensionable service under the Municipal Pension Plan (MPP) or any other registered pension plan arising out of employment with an Employer and a minimum age of 55,
- if eligible for Core LTD coverage, the date payment of the LTD benefit ceases.
Exclusions
Dependents who do not reside in Canada or the USA or who are members of the armed forces in any country are not eligible for the dependent life insurance benefit.
Claims
In the event of death of a covered dependent, the benefits provider must receive notice of the death within 30 days and a completed claim form along with any proof required, as requested by us, within 90 days. However, no payment will be made on any claim submitted later than one year from the date of death.
Definitions
Insured person means you (the member) and/or your spouse (if applicable, please see summary of benefits), provided the benefits provider has approved the evidence of insurability.
Non-smoker means the insured person has abstained from smoking any tobacco or nicotine products within the past 12 months from application for coverage.
Smoker means the insured person has smoked tobacco products or nicotine products within the past 12 months from application for coverage.
Coverage Effective Date
If an insured person wishes to apply for optional term life insurance, access the application on the forms pages or ask your School District Benefits Administrator for the application. The application and medical evidence of insurability must be submitted to the benefits provider for our approval before this insurance becomes effective.
Changes in Amounts of Insurance
- An Insured person may elect to change the amount of this insurance. The change will be effective:
- for an increase on the date of approval, provided the benefits provider approves the evidence of insurability, and
- for a decrease, on the date of application.
- If you are not actively at work on the date an increase would otherwise become effective, you will not be insured for the additional amount until you return to active employment.
Payment of Benefit
If an insured person dies, the beneficiary will receive payment of the benefit amount. If no beneficiary survives, the benefit amount will be paid to the insured person’s estate.
Waiver of Premium
Premiums will be waived for your optional term life insurance during the period that premiums are waived for your group life insurance. If you and your spouse were approved for optional term life insurance at the same time, your spouse’s premiums will be waived during the time your premiums are being waived.
Conversion Option
When a member’s Optional Life Insurance terminates or reduces on or before their 65th birthday, the member may convert, without evidence of insurability, all or part of this Optional Life Insurance to an individual policy offered and underwritten by Pacific Blue Cross as per the conditions below. The amount of insurance converted will not be less than the minimum amount for which Pacific Blue Cross issues an individual policy. The maximum amount which may be converted will be limited to the lesser of:
- $200,000, or
- the sum of the group life insurance and optional life insurance you had with Pacific Blue Cross, or
- the amount of terminated basic and optional life insurance under the policy less any amount for which the member becomes eligible under any other group policy within 31 days after their insurance terminates.
The individual policy will be issued subject to the following:
- the receipt of the first premium and a duly completed application from the member within 31 days of the date of termination of the Optional Life Insurance of the member, and
- the type of individual policy applied for will be without disability or accidental death benefits and may be an individual policy of term insurance for a period of one year, or an individual policy of term insurance to the age of 65.
If the member dies within the 31-day period during which the member could have converted, the benefits provider shall pay the maximum amount of insurance coverage the member could have converted to the member’s beneficiary.
This conversion option is not available to your spouse or dependent child.
Suicide Exclusion
No benefit amount is payable if death occurs within the first two years of coverage as a result of suicide or self-inflicted injuries, whether the injuries are intentional or not intentional.
This exclusion applies to:
- The benefit amount that the covered person or spouse initially selects
- Any increase in the benefit amount selected at a later date
- Any increase in the benefit amount selected at a later date
Claims
In the event of death, the benefits provider must receive notice of death within 30 days and a completed claim form, along with any proof required as requested by the benefits provider, within 90 days. However, no payment will be made on any claim submitted later than one year from the date of death.
Disclaimer:
The information contained on this website is provided for general information purposes only. Every effort has been made to ensure that this information is accurate, but this site is not a substitute for the official Plan documents, nor is it an employment contract. In the event there is a discrepancy between this website and the official Plan documents, the official Plan documents will prevail. For more information, or if you have questions about the information provided on this website please contact your School District Benefits Administrator.
