Hi Mr David.
My medical benefits has been inactivated by my insurance company since May 2022 onwards. This I noticed when my pharmacy could not cover my prescriptions. No prior information by insurance company. Upon contacting the insurance company, I got the information that my employer inactivated/ terminated my benefit plan. My employer is not responding me.
I am on LTD since 2017 and still getting LTD payments, in 2020 my employer issued me letter of frustrated contract and paid me minimum as per ESA 2005 act. I am still under totally disable as approved by insurance company beyond 2 year mark of LTD in 2020.
Kindly suggest and guide me, how my medical benefit can be reactivated, because I need medication and treatment for my medical condition.
Your medical benefits were probably part of the group health insurance paid by your employer.
When your employment ended due to frustration of contract benefits through employment probably ended.
I would get the free consult from a lawyer:
I’ve looked into this for myself and talked to a few lawyers about.
In a nut shell, an employer can cut off extended health benefits at any point after an employee goes on LTD. As long as the company has a policy and they treat all employees on LTD the same way they can pretty much cut off extended health benefit when ever they want too with no legal claim repercussions. From my HR experience most employers do this around the 24th month.
Under my group benefits my employer pays the extended health benefits (medical and dental) for the first 2 years while I am on LTD. At the 2 year mark they are supposed to get in touch with me to give me 2 options. Option 1. extended health benefits continue but I have to pay the premium or Option 2. I don’t pay the premiums and the extended health gets cut off and I will go with Option 2 has my spouse has better health benefits than me,
Hi, thank you for reaching out. I am sorry to hear about your situation.
Medical plans are linked to employment. They can generally only continue as long as a person is employed with a company. Once people get terminated for frustration of contract it also closes the medical plan.
The LTD benefits keep going because the claim started when the person is an employee. But no new LTD claims can be made.
I can’t speak to your specific situation, but generally you can’t reactivate medical benefits after you are terminated form employment. There might be rare exceptions with some union plans, but that is very rare and would have had to be done at the time of termiantion. In those cases you are really getting the benefits through the union rather than the employer.
The only options I know of in situations like you describe is to apply for medication coverage through your province.
David Brannen
Disability Lawyer with Resolute Legal
The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-917-7050 to speak with a member with our disability claim support team.