Managing your Coverage

Basic Eligibility

In order to be eligible to receive ASEBP benefits coverage through your employer, you must:

  • Be an active employee and have completed at least one day of work for your employer
  • Work a minimum number of hours that is equivalent to at least a 0.2 of a full-time position (your employer’s eligibility criteria may include a higher number of minimum hours or a waiting period) 
  • Be covered under a provincial health care insurance plan
  • Be under the age of 65 (see Working Past Age 65 below for exceptions)
  • Be a resident of Canada

 

Getting Started

When you start working for your employer, they’ll send us the basic information required to enrol you in ASEBP coverage. There are a few things you may need to do as well. 

  • Depending on your employment arrangement, you may have to make some of the following choices about your benefit coverage:
    • If your coverage or participation is optional, you’ll need to decide whether to participate or not. (Note that if you waive coverage but want to apply at a later date, you may face late applicant restrictions. See Applying Late for details.) 
    • If you have benefit coverage through your spouse you can choose not to participate in benefits that you receive under their coverage. (Note that it’s important to indicate that you’re waiving the benefit because of spousal coverage so you don’t face late applicant restrictions if you lose that coverage at a later date. See Applying Late for details.)
    • You will need to let your employer know whether you want single or family coverage.
  • Depending on your situation, you may also need to enrol your dependants or designate beneficiaries for your benefits. 

All of the above must be completed and submitted to your employer within 31 days of becoming eligible. Applications submitted after 31 days are considered late and may include restrictions. See Applying Late for details. 

In most circumstances, when all of the above has been completed and submitted to your employer within the 31 days, the effective date of your coverage will be your first day of employment or the first day that you become eligible for benefits under your collective or employment agreement.

 

Details for Substitute Teacher and Casual Staff

If you're a substitute teacher or casual staff you (and your dependants if applicable) may be eligible for a voluntary benefit package administered through ASEBP that includes Life Insurance, Accidental Death & Dismemberment, Drugs, Other Medical Services & Supplies and Dental. Note that you're not eligible for Extended Disability Benefits as a substitute teacher or casual staff member.

Eligibility

In order to be eligible you must:

  • Currently be on a roster of substitute teachers or in a casual staff pool with an employer participating in ASEBP coverage
  • Be ineligible for group benefits through your employer
  • Be under age 65 at the time you apply 
  • Be a resident of Canada
  • Not be receiving Early Retirement benefits through ASEBP 

Getting Started

You will need to apply for coverage within 31 days of being placed on the substitute teacher roster or casual staff pool. Applications submitted after 31 days are considered late and may include restrictions. See Applying Late for details. 

  • Start by completing the application form and mailing it to us with the following attachments:
    • Personalized blank cheque marked VOID or banking details (for automated monthly premium payment withdrawals)
    • Copy of your birth certificate
  • If approved, your benefit coverage will be effective on the first day of the month following the approval date
    • Note that you don't have to be at work on your effective date but you must be able to perform the duties of a substitute teacher or casual staff on that date. If you are not, your effective date will be delayed until you are able to perform the duties for one complete day

Temporary Contracts

If you accept a temporary contract position and are eligible for group benefits either through ASEBP or another benefit plan, your Substitute Teacher and Casual Staff benefits will be suspended while you are receiving benefits under that contract. As soon as you accept the contract you must:

  • Complete a Change Application indicating the start and end date of the contract and eligible benefit period and submit it to us
  • Complete another Change Application 31 days prior to the end of the contract to have your Substitute Teacher and Casual Staff benefits reinstated (provided you are still eligible)
    • Note that if you fail to submit the application within 31 days, there will be a break in coverage and late application restrictions may apply. See Applying Late for details

 

Details for Part-Time Staff

If you're part-time staff you (and your dependants if applicable) may be eligible for a voluntary benefit package administered through ASEBP that includes Life Insurance, Accidental Death & Dismemberment, Drugs, Other Medical Services & Supplies and Dental. Note that you're not eligible for Extended Disability Benefits as a part-time staff member.

Eligibility

In order to be eligible you must:

  • Currently working a minimum of 0.2 of a full-time position with an employer participating in ASEBP coverage
  • Be ineligible for group benefits through your employer
  • Be under age 65 at the time you apply (note that if you are over 65 but under 70 years old and still actively working, you may be eligible for some benefits. See Working Past age 65 for details)
  • Be a resident of Canada
  • Not be receiving Early Retirement benefits through ASEBP 

Getting Started

You will need to apply for coverage within 31 days of the start date of your part-time contract. Applications submitted after 31 days are considered late and may include restrictions. See Applying Late (below) for details. 

  • Start by completing the application form (the employer section must be completed by your employer) and mailing it to us with the following attachment:
    • Personalized blank cheque marked VOID or banking details (for automated monthly premium payment withdrawals)
  • If approved, your benefit coverage will be effective on the first day of the month following the approval date

 

Applying Late

There are a few different reasons you or your dependants may be considered a late applicant and some situations have restrictions or coverage limitations. You are a late applicant if:

  • You do not make your benefit choices within the 31-day window
  • You do not advise us that you have dependants within the 31-day window
  • You choose to waive a benefit but decide to apply for it at a later date (after the 31-day window)
  • You cancelled your benefit coverage while on a leave of absence (or it was cancelled because of a missed payment) but want to reinstate it after you return to work

Please let your employer know if you are interested in applying for benefits as a late applicant.

The restrictions and requirements for late applicants are different depending on the benefit. 

For Life Insurance, Accidental Death & Dismemberment, Extended Disability Benefits and Extended Health Care (Drugs, Other Medical Services & Supplies and Travel Emergencies):

  • To qualify for these benefits as a late applicant, you (and your dependants if you have any) must provide medical evidence that you’re in good health. Please connect with your employer for the form and other details.
  • If approved, your coverage will come into effect on the first day of the month following the decision date (e.g. you were approved October 15, your coverage would come into effect on November 1).

For Dental Care and Vision Care:

  • Late applicant coverage for Dental and Vision Care benefits come into effect on the date you sign the forms with your employer. 
  • For late applicants, claims for Dental and Vision Care benefits have the following deductibles applied to them for 12 months from the time of your approval:

 

Dental Care Deductibles

Plan 1 Plan 2 Plan 3
$250 for basic services per person $500 for basic and major services combined per person $500 for basic and major services combined per person; orthodontic services are not covered during the first 12 months

 

Vision Care Deductibles

Plan 1 Plan 2 Plan 3
$75 per person $125 per person $175 per person

 

Working Past age 65

If you’re planning to work past the age of 65, you can continue some of your existing benefit coverage as long as you’re actively working at the time that you turn 65. Note that if you are eligible to continue your benefit coverage, the following rules and limitations apply:

For Extended Health Care (Drugs, Other Medical Services & Supplies and Travel Emergencies), Dental Care and Vision Care:

  • Your benefits can be extended up to age 70 as long as you remain actively working

  • Your coverage remains at the same levels/plans you had prior to turning 65 but shift to be the plan that pays second when you have coverage available through government-sponsored seniors’ health programs like Alberta’s Coverage for Seniors plan.

For Life Insurance and Accidental Death & Dismemberment:

  • The amount of coverage for these benefits is reduced by 50 per cent on your 65th birthday

  • Your benefits (though reduced) can be extended up to age 70 as long as you remain actively working

  • When you turn 65, you have the option of converting a percentage of your group life insurance policy to an individual policy (see Life Insurance for details)

 

Changes to your Employment Status

Employment changes can have important implications for your benefit coverage.

If you're on a Leave of Absence

See While on Leave for the full details around how your benefit coverage might change while on a leave of absence.

If you're Laid Off

You may be eligible for ASEBP benefit coverage for up to 90 days after you've been laid off. The first place to start is by connecting with your employer.

If you're on an Exchange or Secondment Outside Canada

If you’re considering participating in an approved teacher exchange program or accepting a secondment position, know that you are eligible for ASEBP benefit coverage as long as:

  • You have an Outside Canada Teacher Exchange/Secondment Agreement that outlines the coverage provided and any special conditions and it is signed by you, your employer and ASEBP before you start your placement  

If these conditions are met, your coverage will be subject to the following limitations:

  • If you qualify for Extended Disability Benefits (EDB) and decide to remain outside Canada, the maximum period you can receive benefits is 24 months. If you return home within the 90-day elimination period, the regular provisions of EDB will apply
  • ASEBP Extended Health Care (Drugs, Other Medical Services & Supplies and Travel Emergencies), Dental Care and Vision Care benefits (if enrolled) pay second to any other health care coverage the sponsoring agency or government involved requires you to have
  • If you need to be medically evacuated, your Travel Emergencies benefit (if enrolled) will use your current place of residence so you will not be returned to Canada unless you ask to be

If you do not have a signed contract to extend your benefit coverage while you’re on your exchange or secondment, your coverage will be further subject to the following limitations:

  • You will have only emergency services for the following benefits (if enrolled):
    • Drugs, Other Medical Services & Supplies, Dental Care and Vision Care 
    • If you need to be medically evacuated, your Travel Emergencies benefit will return you to Canada
  • If you require Extended Disability Benefits and refuse to return home, your eligibility to make a claim may be impacted

Before you leave on your exchange or secondment, be sure to:

  • Contact your provincial health care insurance plan (in Alberta this is AHCIP)
  • Include a copy of your signed agreement and cover letter with your VISA application if you're going to Australia
  • Update your email address and banking information on My ASEBP 
  • Complete the Greater Than 100 Day Supply of Prescription Drugs Request to obtain a supply of your current prescriptions for your entire stay
  • Remember to use the Emergency Out-of-Country Claim form for all claims you incur during your stay

If you're no Longer Employed

Your benefits are cancelled when you are no longer working for your employer (terminated) for any reason, though you will still have an additional 60 days to submit any expenses that were incurred up to the date you were terminated for your Spending Account benefits (if applicable) and will still be eligible to convert your ASEBP group life insurance plan into an individual policy.

Changes to Your Personal Information

Banking Information

It’s important to ensure your banking information is current. Benefit reimbursements and withdrawals of your benefit premiums (if applicable) are all done electronically. To change your banking information, visit My ASEBP, under the Profile tab. You can add a deposit account, and a withdrawal account depending on your needs.

Address and Contact Information

You can change your contact email address on My ASEBP under the Profile tab. We recommend using a personal email address so we can reach you regardless of any changes in your working status.

To change your address, you will need to contact your employer. If you’re a substitute teacher, casual employee, early retiree or part-time employee, please contact ASEBP.

Name and Marital / Dependant Status

For name changes, and changes to your marital status and dependants, you will need to fill out a change application form. Active employees should submit the form to their employers. If you’re a substitute teacher, casual employee, early retiree or part-time employee, please submit the form to ASEBP.
 

Reasons for Cancelled Benefits

Your ASEBP benefit coverage will be cancelled if:

  • You are no longer employed with the participating employer (e.g. termination, resignation, retirement (except Early Retirement), death) 
  • You are no longer eligible for coverage according to the terms and conditions of ASEBP benefit plans (see Basic Eligibility above for details)
  • You transfer to an employee group that doesn’t have ASEBP coverage
  • Your employer’s participation in the ASEBP plan ends
  • The premiums for your coverage are outstanding 

 

Making an Appeal

General Benefits Appeal

ASEBP’s appeal process is designed to ensure that:

  • no one entitled to benefits is denied them because procedure was not followed correctly
  • you have an opportunity to appeal if you are unsatisfied with the decision regarding your claim because of ASEBP policy

For more information, contact us.

Extended Disability Benefits Appeal

You can appeal a claim decision in either of the following two cases:

  • when you submit the claim, if your EDB claim is declined
  • after a period of disability where benefit payments were received, if Extended Disability Benefits are terminated

The Extended Disability Benefits appeal process is designed to ensure that no one with an entitlement to EDB is denied them because: 

  • procedure was not followed correctly
  • medical information on file was misinterpreted

For more information about the appeals process, contact your claims facilitator.
 

Benefit Inquiries

English/Français

Phone 780-431-4786
Fax 780-438-5304
Toll Free 1-877-431-4786