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Loss of Spousal Coverage

Loss of Spousal Coverage

If an employee initially waives health and dental benefits because he/she had comparable coverage under a spousal plan and his/her spouse subsequently loses coverage, the employee must apply for benefits within 31 days of losing his/her spousal coverage. If an employee does not apply for coverage within 31 days of losing spousal coverage, he/she will be considered a “late applicant” and will have to submit satisfactory evidence of medical health before The Co-operators accepts the employee and dependents onto the plan.


Within 31 days:

  1. Plan Administrator completes Section 1 and 2 of the Group Benefits Plan Member Change form. Employee completes Sections 3 and 4 of the Group Benefits Plan Member Change form. Send a copy of the original form via email to:
  2. Group_Client_services@cooperators.ca

    OR

    Via Fax: (306) 761-7373

    OR

    Via Mail: Co-operators Life Insurance Company
    1920 College Avenue
    Regina, SK
    S4P 1C4

  3. Plan Administrator retains the original in the employee a file

After 31 days:

  1. Plan Administrator completes Section 1 and 2 of the Group Benefits Plan Member Change form within 31 days from the eligibility date will be considered a late applicant.
  2. Employee completes Sections 3 and 4 of the Group Benefits Plan Member Change form
  3. Employee completes a Group Health Evidence form
  4. Send the original Group Benefits Plan Member Change form and the original Group Health Evidence form via mail to:Co-operators Life Insurance Company

    1920 College Avenue

    Regina, SK

    S4P 1C4

  5. Plan Administrator retains a file copy of the Group Benefits Plan Member Change form
  6. Plan Administrator will receive a letter advising of The Co-operators’ decision (approval or declination) or of any additional requirements

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