Information on Disability

If your staff member is away from work for seven consecutive days (including weekends and holidays) due to an illness or injury, they must apply for Short-Term Disability (STD). You can only pay the employee a maximum of five consecutive sick days.

Forms:

• Employer Statement
• Employee Statement
• Attending Physician Statement

The employer must complete the STD EMPLOYER STATEMENT and attach a copy of the employee’s JOB DESCRIPTION. Please note that once you have submitted the scanned copy of the STD form(s), there’s no need to mail the original form(s).

You, as the employer, must provide us with the employee’s actual gross salary from the first of the month until the last day paid by submitting a group change form (GCF).

NOTE: Please send it electronically via email. Do not send the original document unless requested.

Send the forms to Benefits Administration Office. Once the employee is back to work full-time, you must provide us with the exact date they came back to work and the gross salary they will earn from the first day of their return to work to the last day of the month. Please contact our office for specific questions or concerns regarding a disability claim.

Maternity & Parental Leave Information

• Check the EI website for new rules and benefits amounts.
• Employer Statement
• Employee Statement
• Attending Physician Statement
• MATERNITY MEDICAL REPORT – For school use only. Please DO NOT submit this form to the Benefits Office or Disability Office.

The employer must complete the STD EMPLOYER STATEMENT and attach a copy of the employee’s JOB DESCRIPTION. Please note that once you have submitted the scanned copy of the STD form(s), there’s no need to mail the original form(s).

You, as the employer, must provide us with the employee’s actual gross salary from the first of the month until the last day paid.

NOTE: Please send it electronically via email. Do not send the original form unless requested.

Upload the forms to Benefits Administration Office. Once the employee is back to work full-time, you must provide us with the exact date they returned to work and the gross salary they will earn from the first day of their return to work to the last day of the month. Please contact our office for any specific questions or concerns regarding a disability claim.

Things to remember:

• • 1. Decide if you want to take 12 months or 18 months’ leave (there are no choices in between)
    2. Decide if you want to keep or waive your *Group Benefits and Pension (as per Federal Law, employees can now waive their Group Benefits while on Maternity. Employees can also choose to continue contributing to the match pension while on Maternity Leave)
    3. Arrange the Maternity leave agreement with your employer/PEC
    4. Request for your Record of Employment (ROE)
    5. Apply for Employment Insurance (EI) Maternity and Parental Benefits**
    6. Apply for Maternity STD Benefit**
    7. If you are a CISVA employee, provide the Maternity Medical report to your employer for top-up calculation.
    8. Add your baby under your plan (the latest date that you can provide this information is 31 days after your child is born)
    9. Prepare post-dated cheques to cover your Group Benefits and Pension employee contribution (if you are keeping your benefits and pension)

*The Group Benefits are life insurance, AD&D, STD, LTD, Critical Illness, Extended Health, and Dental.

**You can start receiving maternity benefits as early as 12 weeks before your due date or birth date. You cannot accept these benefits more than 17 weeks after your due date or the date you gave birth, whichever is later.

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Information on our Registered Pension Plan

Pension Eligibility/YMPE Amount

Rate of Return
Fund Library

Financial Planner Information for RCAV Employees

Pension Forms:

Send the signed form to  Benefits Administration Office

• APPLICATION FOR MEMBERSHIP IN A REGISTERED PENSION PLAN 35169
• APPLICATION FOR INCREASE TO PENSION CONTRIBUTION
• DESIGNATION OF REVOCABLE BENEFICIARY-TRUSTEE APPOINTMENT
• MEMBER INVESTMENT INSTRUCTION
• CHANGE OF MEMBER INFORMATION

• LUMP-SUM CONTRIBUTION TO GROUP RETIREMENT PLAN
• APPLICATION FOR MEMBERSHIP IN A RETIREMENT SAVINGS PLAN (RRSP)
• RRSP Transfer Form 35169
• APPLICATION FOR MEMBERSHIP IN TAX-FREE SAVINGS ACCOUNT (TFSA)

Pension Claim Form:

• Notice of Death claim form

Information on our Dental Plan
Form:

• Dental Claim Form

• Information on our Extended Health Care

  • Global Medical Assistance Brochure
  • Employee Assistance Program

Forms:

• Extended Health Claim Form
  • Assure Claim Form – Rx Drug Claims
  • Global Medical Assistance Brochure
    • Statement of Claim
    • MSP Out of Country Claim
    • Assignment of Payment Schedule A
    • Authorization to provide medical Information Schedule B

• WELCOME PLAN (EQUIVALENT OF PROVINCIAL HEALTH PLAN – MSP)
• WELCOME PLAN (Eligibility Guideline)

NOTE: Send the completed and signed form to Benefits Administration Office
Employees with a one-year contract and working 20 hours/week must be enrolled in the Benefits.

It is not the employee’s choice whether they want to join or not.

• Group Benefits ONLY:

• APPLICATION FOR GROUP COVERAGE
• RPP WAIVER OF PARTICIPATION

• Group Benefits and Pension

• APPLICATION FOR GROUP COVERAGE AND
• APPLICATION FOR MEMBERSHIP IN A REGISTERED PENSION PLAN 35169

NOTES:

Canada Life requires the member to sign the form in ink for legal purposes. A digital signature is only accepted if the member has physically scribbled their signature – typing the signature with the cursive font is not accepted. 

1. The Benefits Administration Office assigns the certificate number – please leave it blank.
2. The Pension Division/subgroup is always 01 – DO NOT enter your local division number.
3. The employee and employer MUST sign the Application for Group Coverage form.
4. Send the completed form to the Benefits Office through your secure folder.

• Guaranteed Approval Voluntary Critical Illness (must be completed within 60 days upon benefits eligibility date)
• Optional Life Insurance
• Voluntary RRSP
• Tax-Free Savings Account

NOTE: Send the completed and signed form to Benefits Administration Office
Reminder: ALL updates must be reported within 31 days from the date of the change. NO EXCEPTION!

Employees who are away from work due to illness or injury for seven consecutive days (including weekends and holidays) MUST apply for disability benefits. The employee must fill out the EMPLOYEE STATEMENT and have their doctor complete the PHYSICIAN STATEMENT.

• EMPLOYEE STATEMENT
• ATTENDING PHYSICIAN STATEMENT

For STD-related to COVID-19, the employee must complete the following forms: 

• EMPLOYEE STATEMENT
• ATTENDING PHYSICIAN STATEMENT
• Short-Term Disability COVID-19 CLAIM

The employee can submit their completed form directly to CANADA LIFE (Langley.DMSO@canadalife.com) or the Benefits Administration Office.

• The employer must complete the STD EMPLOYER STATEMENT and attach a copy of the employee’s JOB DESCRIPTION. Send the completed form to Benefits Administration Office.
• You, as the employer, must provide us with the employee’s actual gross salary from the first of the month until the last day they have been paid by submitting a group change form (GCF).

NOTE: Once the employee is back to work full-time, you must provide us with a group change form (GCF), the exact date they came back to work, and the gross salary they will earn from the first day of their return to work to the last day of the month. The Benefits Administration Office will not ask for the information, and YOU ARE RESPONSIBLE FOR GIVING IT TO OUR OFFICE. Please contact our office for specific questions or concerns regarding a disability claim.

All women in our system are entitled to the STD Maternity Benefit once they gave birth. You must give the employee the following forms: 

• The member can submit the EMPLOYEE and the ATTENDING PHYSICIAN STATEMENT directly to CANADA LIFE or our office.
• MATERNITY MEDICAL REPORT – the medical report is for the school’s use only; do not send this form to GWL or our office.

You must complete the STD EMPLOYER STATEMENT and attach a copy of the employee’s JOB DESCRIPTION – MUST be emailed to Benefits Administration Office. Please note that once you had submitted the scanned copy of the STD form(s), there’s no need to mail the original form(s).

TOP-UP CALCULATOR:

• REGULAR Maternity Leave Calculator
• Teacher-Principal on Disability BEFORE Maternity Leave

All maternity leaves are different. If you have specific questions or concerns regarding maternity leave or top-up benefits, please contact our office. YOU MUST ALSO PROVIDE A COPY OF THE MATERNITY LEAVE REQUEST FORM TO THE BENEFITS ADMINISTRATION OFFICE.

NOTE: Send the completed and signed form to Benefits Administration Office

• To remove a member under your account (transfer of employment, retirement, or termination of employment), complete the:

• GROUP COVERAGE CHANGE FORM 

• To convert group life insurance to a private policy, complete the:
• Life Insurance Conversion when Leaving employment

An employee who had previously waived their extended health or dental coverage and would like dual coverage (not losing the spousal coverage) will be considered a late applicant. And will have to be subjected to the approval of CANADA LIFE ASSURANCE CO.

NOTE:

Dental coverage for an approved late applicant will be limited.

• Once approved, the employee and dependents have limited coverage of $250 for the first 12 months after the approval date.

Extended health for an approved late applicant is effective immediately after approval.

• Approval for extended health coverage is not guaranteed.
• Canada Life will approve the application based on the employee and the dependents’ medical insurability.

Please refer to our booklet for coverage information. DO NOT SEND THE FORMS TO CANADA LIFE DIRECTLY. NOTE: Send the completed and signed form to Benefits Administration Office.

Late applicants must complete the following forms:

• GROUP COVERAGE CHANGE FORM and 
• LATE APPLICANT FORM

NOTE: Send the completed and signed form to Benefits Administration Office

• GROUP COVERAGE CHANGE FORM must be submitted to our office to change their benefit class and to indicate if the employee will keep extended health and dental while they are on leave.
• GROUP COVERAGE CHANGE FORM when they return to work and to re-instate their benefit class and benefits.

If the return to work is not the first day of the month, make sure that the gross salary from the first day they return to work until the last day of that month is indicated on the form (this is for employees who have a pension).

Retirement/Leaving Employment – Retiree Form

How to become eligible for the retiree plan:

“When an employee ceases work, to be eligible to join Benefits Class 5, the Retirees Division, the employee must (a) formally declare their intent to retire (not just change employers) and (b) be over the age of 55 years at the time of retirement.”

• Benefit Class 5 – Retiree Members
• Retirement Benefit Overview
• Retirement Enrollment Form
• Pre-authorized Debit Form
• Life Insurance Conversion when Leaving employment
• Retirement Income Brochure
• Medical Services Plan Information

REMINDER: If your staff members have enrolled in the Voluntary Critical Illness, please inform them to contact Industrial Alliance to cancel the coverage and premium deduction.

For employee new to Canada – does not have MSP coverage.

The Welcome Plan is a temporary supplementary group plan of insurance that provides essential basic healthcare coverage for newcomers, returning Canadian residents and their families, or employees who had an expired Provincial Health Plan. Welcome Plan benefits are available as long as the employee meets all eligibility requirements. To be eligible under the Welcome Plan, the employee must be covered under the Extended Health plan; they must legally reside in a Canadian province or territory. They must not be eligible for coverage under a federal or provincial government health plan (i.e., MSP) because they do not satisfy the residency requirement in their province or territory of residence. 

• WELCOME PLAN APPLICATION