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Who is eligible to join?
Is participation mandatory?
| If you … |
You and your eligible
dependents … |
| Do not have coverage elsewhere |
Must participate in the Health Plan with drug coverage |
| Already have coverage elsewhere |
May choose to opt out of the Plan, if you provide satisfactory proof of drug coverage elsewhere |
Is it possible to participate in only part of the Plan?
Yes, it is possible to participate in part of the Plan in the following instances ONLY:
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If you are a part-time teacher |
| You may choose to cover your eligible dependents under the drug portion of the Plan only. Click here for details. |
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If you live in Quebec and are at least 65 years old |
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Drugs that appear on the list of the Régie de l'assurance maladie du Québec (RAMQ) will be covered under the provincial government's universal drug plan, unless you wish to have them covered under QPAT's Health Plan and you pay the additional required premiums. Click here for details. |
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 Health 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 must my eligible dependents join?
You must enroll your spouse and dependent children in the Health Plan:
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at the same time you join the Plan; or |
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when they become eligible, according to the Plan's definitions, if later. |
Your eligible dependents, however, may opt out of the Plan under certain circumstances.
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Special note for part-time teachers
When your eligible dependents are first eligible to join, you may choose to cover them under:
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the entire Health Plan; or |
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only for the drug portion of the Plan. |
You must complete and return the Participation Request form within 60 days following the date on which your dependents become eligible.
Otherwise, you must, at your own expense, provide satisfactory evidence of insurability for your dependents. In this case, your dependents will be eligible for:
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drug coverage under the Health Plan on the date of the application; and |
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all other coverage under the Health Plan, if applicable, on the date Industrial Alliance approves the evidence of insurability. |
If, at a later date, you wish to switch your dependents' coverage from drug coverage only to full coverage, evidence of insurability will be required.
Note: If you choose to cover your eligible dependents only for the drug portion of QPAT's Health Plan, you CANNOT cover them under the Medical Assistance Service outside Canada.
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What are my choices of category of coverage?
You have five categories of coverage to choose from:
- You only
- You and your spouse
- You and your children
- You, your spouse, and your children
- No coverage at all (allowed only under certain circumstances)
You will pay the premium for the category that you are insured for.
Also, if you are a part-time teacher, you may choose to cover your eligible dependents only for the drug portion of the Health Plan.
How do I enroll?
- Complete a Participation Request form.
- Give the completed form to your school board.
When does coverage begin?
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For you |
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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.
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For your eligible dependents |
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Your dependents' coverage begins on the latest of the following dates:
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the date on which your coverage takes effect; |
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the date on which your spouse and dependent children become eligible, according to the Plan's definitions; and |
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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:
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the loss of coverage elsewhere, such as your spouse's health plan where he or she works; |
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the birth or adoption of your first child; |
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your divorce or legal separation; |
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the death of your spouse or of your last dependent child; or |
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when your last dependent child is no longer eligible, according to the Plan's definition. |
In any event, if you live in Quebec, the law requires that you and your eligible dependents be covered under a group health insurance plan, such as QPAT's Health Plan.
To change category of coverage:
- Complete the Participation Request form.
- Give the completed form to your school board.
Can I opt out?
Yes, but only if you and your eligible dependents have coverage elsewhere.
Here's what you need to do:
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Complete the "exemption" section under Health insurance on the Participation Request form. |
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Return it to your school board. Please be sure to attach satisfactory proof that you already have coverage under another group health insurance plan elsewhere, such as through your spouse's employer. |
Note: Quebec law requires that you and your eligible dependents be covered under a group health insurance plan, if one is available to you.
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Special note for active members who live in Quebec and reach age 65
If you live in Quebec and are at least 65 years old, the law allows you to choose to have the drugs that appear on the list of the Régie de l'assurance maladie du Québec (RAMQ), covered under either:
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the provincial government's universal drug plan; or |
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under a group insurance plan such as QPAT's. In this instance, you must pay an additional premium for such coverage. |
In fact, at age 65, you automatically join RAMQ's universal drug plan. Unless you inform QPAT otherwise, we will assume that you will remain with that plan for RAMQ drug coverage since the cost for such coverage is lower under that plan than under QPAT's Plan. However, whichever plan you choose for drug coverage does not affect your coverage of other eligible expenses under QPAT's Health Plan.
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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:
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you had coverage under another group health insurance plan elsewhere; and |
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your coverage under that plan has been terminated. |
In fact, if you live in Quebec and your other coverage elsewhere ends, you and your eligible dependents must join the QPAT Health Plan.
To do to rejoin the Plan:
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Complete the Participation Request form. |
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Return it to your school board, along with satisfactory proof that you no longer have coverage under another group health insurance plan elsewhere. |
You should apply to join QPAT's Health Plan within 60 days after your coverage under the other plan ended. If you apply after this 60-day period, coverage under the Health 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.
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:
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