Eligibility and enrollment
Who is eligible to join?
Is participation mandatory?
When must I join?
When can my eligible dependents join?
What are my choices of category of coverage?
How do I enroll?
When does coverage begin?
Can I change category of coverage?
Can I opt out?
If I opt out, can I rejoin the Plan later?
How do I communicate a change in personal data?

 

 


Who is eligible to join?

   
• Full-time teachers in the English Montreal School Board (EMBS)
   
•

Part-time teachers in the youth sector of the EMBS
   
• Eligible dependents: spouse and dependent children

 

Is participation mandatory?

If you … You ...
Do not have coverage elsewhere

Must participate in the Dental Plan

Although your participation is compulsory, your dependents' coverage is optional.
Already have coverage elsewhere May choose to opt out of the Plan, if you provide satisfactory proof of coverage elsewhere

When must I join?

You must join immediately if you are already working for the school board.

Otherwise, you must join on one of the following dates:

If your contract takes
effect …		 You must join the Dental Plan on …
Before or on the first working day of the work year The first working day of the work year
Any other day during the work year The day your contract is scheduled to begin

However, you may opt out of the Plan under certain circumstances.

When can my eligible dependents join?

You can enroll your spouse and dependent children in the Dental Plan:

   
• at the same time you join the Plan; or
   
•

when they become eligible, according to the Plan's definitions, if later.

Enrollment is entirely optional for your dependents.

What are my choices of category of coverage?

You have four categories of coverage to choose from:

  1. You only

  2. You and your spouse

  3. You, your spouse, and your children (this option also applies if you do not have a spouse but would like to cover yourself and your children)

  4. No coverage at all (allowed only under certain circumstances)

You will pay the premium for the category that you are insured for.

How do I enroll?

  1. Complete a Participation Request form.

  2. Give the completed form to your school board.

When does coverage begin?

•
 For you
   
 

Your coverage takes effect on the Plan's effective date or when you meet the eligibility conditions, whichever occurs later.

If you opt out of the Plan and later rejoin, different rules apply.
   
•
 For your eligible dependents
   
  Your dependents' coverage begins on the latest of the following dates:
     
  the date on which your coverage takes effect;
     
  the date on which your spouse and dependent children become eligible, according to the Plan's definitions; and
     
  the date Industrial Alliance receives the application, provided your spouse and dependent children are eligible, according to the Plan's definitions.

Can I change category of coverage?

Yes. You can change your category of coverage if a major life event occurs.

Major life events include:

   
• the loss of coverage elsewhere, such as your spouse's dental plan where he or she works;
   
•

the birth or adoption of your first child;
   
• your divorce or legal separation;
   
• the death of your spouse or of your last dependent child; or
   
• when your last dependent child is no longer eligible, according to the Plan's definition.

In any event, you must join the Plan as soon as you become eligible, unless you provide satisfactory proof of coverage elsewhere.

To change category of coverage:

  1. Complete the Participation Request form.

  2. Return the completed form to your school board.

Can I opt out?

Yes, but only if you provide proof that you have coverage for yourself elsewhere. No proof is required for your eligible dependents.

Here's what you need to do:

   
• Complete the Participation Request form.
   
•

Return it to your school board. Please be sure to attach satisfactory proof that you already have coverage under another dental plan elsewhere, such as through your spouse's employer.

 

If I opt out, can I rejoin the Plan later?

Yes, you and your eligible dependents may rejoin the Plan if you provide proof to Industrial Alliance's satisfaction that:

   
•
you had coverage under another dental plan elsewhere; and
   
•

your coverage under that plan has been terminated.

 

To rejoin the Plan:

   
•
   
•
Return it to your school board, along with satisfactory proof that you no longer have coverage under another dental plan elsewhere.


You should apply to join QPAT's Dental Plan within 60 days after your coverage under the other plan ended. If you apply after this 60-day period, coverage under the Dental Plan will not take effect until the first day of the month following the end of the 60-day period beginning on the date Industrial Alliance receives your application.

If you enroll more than 31 days following your eligibility date, reimbursement for dental expenses during the first year of coverage may not exceed $200 per person.

Special note: Industrial Alliance cannot be held responsible for the payment of benefits that may be payable by the previous insurer under an extended coverage or conversion provision.

How do I communicate a change in personal data?

Contact your school board for the appropriate form and return the completed form to the school board.

Changes in your personal data include:

   
•
   
•
a new address; and
   
• a new telephone number.