Part 4: The Existing Member Information Changes and Events

Disability or Workers Compensation Leaves

Summary

The following provisions are intended to assist those Members who are, or who are expected to be, disabled for more than 18 weeks.

As required in the Leave of Absence or Layoff section of this Manual, the Employer would have already submitted the:

Group Insurance Plan & Disability Income Plan Leave of Absence/Layoff Form (Form #44) (to be submitted to the MEBP Administration Office immediately for ALL Group Insurance and/or Disability Income Plan participants on Leave of Absence or Layoff)

Pension Plan participants in receipt of disability or Workers Compensation benefits, may be eligible to continue to accrue disability pension service credits and have “assumed earnings” applied to their pension account. Pension Plan participants that are not also participants in the MEBP Disability Income Plan may be eligible to apply for a disability pension from the MEBP Pension Plan. For more details, refer to the Pension Plan Participant section below or to the Pension Plan Employee Benefit Booklet.

Disability Income Plan (DIP) participants may apply for disability benefits upon fulfilling the eligibility requirements of the DIP. For more details, refer to the Disability Income Plan Participant section below or to the Disability Income Plan Employee Benefit Booklet.

Group Insurance Plan participants may be eligible for a waiver of insurance premiums during periods of disability. For more details, refer to the Group Insurance Plan Participant section below or to the Group Insurance Plan Employee Benefit Booklet.

NOTE:  When a Member returns to work from a Leave of Absence, they are to complete a Pension Plan - Leave of Absence (Form #43) within 30 days of return to work date.

Pension Plan Participants on Disability or Workers Compensation Leave

A Pension Plan Participant who in receipt of a Workers Compensation Benefit, a Disability Benefit from the MEBP DIP Plan or other disability income plan may be eligible to receive pension plan disability service credits and “Assumed Earnings” while they are considered disabled.

Each year a request for assumed earnings information is sent by the MEBP Administration Office to the Employers of Members who are in receipt of a MEBP Disability Income Plan benefit or for whom the MEBP Administration Office has been informed of a Workers Compensation leave or other type of disability leave. The assumed earnings and disability service credits are used in the calculation of the retirement pension that is payable when the Member retires. For the purpose of calculating their pension assumed earnings, it is ‘assumed’ that each year that the Member is in receipt of a disability benefit, the earnings are the same as the earnings for the regular position that the Member occupied immediately prior to becoming disabled or an equivalent position.

Alternatively, a Pension Plan Participant who is not a participant of the MEBP Disability Income Plan, may apply for a disability pension under the Pension Plan. MEBP is responsible for the adjudication and administration of disability retirement pensions. To apply, a Member must be under age 65, have 5 or more years of eligible service and meet the requirements of the 18-week waiting period. Only applicants who are assessed as totally and permanently disabled are eligible for a disability pension. Please have the Member contact the MEBP Administration for additional information and/or to request the forms to apply for the Pension Plan disability pension.

Disability Income Plan Participants on Disability or Workers Compensation Leave

The Disability Income Plan benefit is to assist those Members who are or are expected to be disabled for more than 18 weeks and elected to retain coverage and make the required contributions for the 18 week waiting period.

The Disability Income Plan (the Plan) is adjudicated and managed by Manitoba Blue Cross. The Board of Trustees oversees all aspects of the Plan and is committed to providing equitable and consistent services to the stakeholders in a timely and compassionate manner. There is an 18-week waiting period required for this benefit.

To be eligible to apply for disability benefits, the Member must experience a 50% reduction in employment earnings and be under the regular care of a medical physician, medical specialist, or health care practitioner for an 18-week period.

For the purposes of eligibility, sick leave payments and vacation pay are not considered employment earnings. Pension and disability contributions must be deducted from sick pay and any vacation pay paid prior to the end of the 18-week waiting period.

If the Member is receiving benefits from Workers Compensation or Manitoba Public Insurance, they may also be eligible for disability benefits under the Plan if their Workers Compensation or Manitoba Public Insurance benefits end, but they are still unable to return to work due to a medical condition / injury. In this situation, please contact the MEBP Administration Office for additional information.

The eligibility period will not be affected if the Member tries working for periods which in total are less than 20 working days, provided they are totally or partially disabled during the 18 weeks and the nature of the disability does not change.

A Member under age 64 and 8 months, who has become disabled and would like to apply for disability benefits under the Plan should not be terminated. Terminated employees are not eligible to apply for benefits under the Plan. Keep the Member on a leave of absence and do not complete a MEBP Separation Notice (Form #10). Eligibility for participation and benefits under the Disability Income Plan end on the date an Employee ceases to be an active member of the Pension Plan. If you are aware of an active Member who is considering terminating employment due to health-related issues, please advise them to contact the MEBP Administration Office for additional information.

Notice of Medical Absence to be sent the MEBP Administration Office: If you have a Member who has been absent due to a medical condition for 60 days or if you are informed by an Member that they have a medical condition that will cause them to be absent for an extended period of time, the following forms should be completed by the Employer and/or Member and sent to the MEBP Administration Office:

  • NOTICE OF MEDICAL ABSENCE – STATEMENT OF EMPLOYER (Form #63)
  • Employer is to provide a current job description.
  • APPLICATION FOR DISABILITY BENEFITS - STATEMENT OF EMPLOYEE (Form #62)
  • PHYSICIAN'S REPORT* (Form #64).
  • Blue Cross Collection, Use & Disclosure of Personal Information
  • Direct Deposit form
  • TD1
  • TD1 MB

*The Employee is responsible for the cost, if any, of the PHYSICIAN'S REPORT.

When all the medical evidence and necessary information has been obtained by the MEBP Administration Office, MEBP will contact Blue Cross. The applicant may be required to undergo an examination by a physician(s) appointed by Blue Cross.

Rehabilitation and Recovery:

The goal of rehabilitation is to help the Employee return to work, ideally to the same job or a modified version. The Employee is provided with information on rehabilitation and assisted in finding methods of returning to the work force wherever possible. Blue Cross may assign a Vocational Rehabilitation Consultant to assist in the return-to-work process.

Members, who have been granted disability benefits, are permitted and encouraged to continue working if at all possible. Although the disability may prevent the Member from continuing in the position occupied prior to becoming disabled, perhaps an alternate position could be considered. Blue Cross will inform you of any significant changes in the Member’s condition. You will be asked to identify any work that the Member may be capable of doing wherever possible. Blue Cross may assist disabled Members who want to return to some form of employment with further education, training, technical upgrading, etc. For more information now, or at any time in the future, please contact Blue Cross.

Participating Employers are expected to do everything possible to ensure the resumption of active employment of each Member who is able to accept gainful employment in any position with that municipal Employer or an associated quasi-municipal Employer. Information regarding Duty to Accommodate legislation may be obtained from the Manitoba Human Rights Commission. Their toll-free number is 1-888-884-8681.

The Member is expected to make the effort to seek other employment or obtain qualifications for a different occupation in those cases where is not practical to return to work in the pre-disability position. Blue Cross may decrease or discontinue the Member's disability benefit if it is determined that the Employee is not making reasonable efforts.

IMPORTANT: Please call the MEBP Administration Office, or Blue Cross, immediately if a disabled Member returns to work.

When an Member who is receiving disability benefits reaches age 65, disability benefits cease. About three months prior to a Member attaining age 65, the MEBP Administration Office will provide the Member with a letter outlining retirement and insurance options, if applicable. A letter will be sent to the Employer requesting a SEPARATION NOTICE (Form #10).

When a Member who is receiving disability benefits dies, the disability benefit stops at the date of death. The Employer will be required to submit a SEPARATION NOTICE (Form #10).

Group Insurance Plan Participants – Waiver of Insurance Contributions

A Member who has maintained their coverage by making the required contributions during a leave and has become disabled prior to retirement, may apply for the Waiver of Insurance Contributions benefit.

Contributions for Basic Life insurance and Basic Accidental Death & Dismemberment insurance could be waived, providing the disability continues. The Member would be covered for Basic Life insurance and for Basic Accidental Death & Dismemberment while in receipt of the Waiver of Insurance Contributions benefit. The amount of insurance does not increase while the Member is receiving the Waiver of Insurance Contributions benefit.

Optional Life, Family Life and Voluntary Accidental Death & Dismemberment Insurance are not covered under the Waiver of Insurance Contributions benefit. Members may make arrangements directly with their employer to pay the contributions to maintain voluntary coverage. Group Insurance Plan & Disability Income Plan Leave of Absence/Layoff Form (Form #44) is required.

The effective date of the Waiver of Insurance Contributions benefit, for Members who are eligible to apply for benefits under the Disability Income Plan (DIP), will be the same as the effective date of disability benefits under the DIP. The Member is responsible for maintaining coverage under the insurance plan(s) by making the required contributions until approval of their disability benefits. Members that do not participate in the Disability Income Plan are also eligible to apply for the Waiver of Insurance Contributions benefit. Please contact the MEBP Administration Office for additional information.

Members that have been in receipt of benefits from Workers Compensation for 18 consecutive weeks may be eligible to apply for a Waiver or Insurance Contributions benefit. Please contact the MEBP Administration Office for additional information.

If the application is approved the Member will be granted the Waiver of Insurance Contributions benefit. The Group Insurance Fund will be responsible for paying the Employee and Employer contributions for Basic Life and Basic Accidental Death & Dismemberment Insurance. The Member and Employer will be informed of the decision.

On the earlier of the date disability benefits end, termination of employment, retirement or at age 65, the Waiver of Insurance Contributions benefit stops for Basic Life Insurance and any other group insurance coverage held by the Member. The Member will either be provided with Retirement Insurance options or, if terminated, will be given the opportunity to convert their Basic Life Insurance and any Family Life Insurance to an individual policy. This information is provided to the Member by the MEBP Administration Office along with the retirement or pension plan termination package sent the Member.