Group Benefits – Areas of Risk and Employers Obligation

As an employer, you have committed to provide your employees with employee benefits that, for example, provide a certain amount of insurance and disability coverage. If the coverage is compromised or reduced by error or omission, your company could be liable for the shortfall or the entire benefit.

Administrators can reduce the risk by:

  • Employees should not be allowed to opt out of the life and disability plan.
  • Submitting new enrolments 30 days in advance of employee effective dates.
  • Ensuring changes and employee terminations are done in a timely manner.
  • Updating employee salaries as required.
  • Encouraging employees who are eligible for a Life or LTD benefit above the maximum available, without providing health evidence, to provide health evidence and make an application.
  • Maintaining availability of up-to-date booklets and plan details for employees.
  • Paying premiums on time.
  • Beginning LTD claims process early.
  • Informing the insurer when an employee is planning to go on leave.
  • Notifying an employee leaving the company that they can convert their coverage within 31 days of termination.

Disability Insurance and the Duty to Accommodate

  • The goal of accommodation is to allow equal benefit from and participation in the workplace.
  • Under the Human Rights Code, employees in the workplace are entitled to the same opportunities and benefits as people without disabilities.
  • An employee with a disability cannot be denied an opportunity for promotion or training, for example, simply due to the presence of a disability.
  • An employee with a disability is entitled to the same benefits as people without a disability.
  • In some circumstances, employees with disabilities may require special arrangements or “accommodations” to enable them to fulfill their job duties.
  • The duty to accommodate is the legal obligation that employers and a union (if there is one) have under legislation.
  • Shared responsibility – the employee has to cooperate in the process, exchange relevant information and explore accommodation solutions put forth by the employer.
  • A collective agreement may not, in many circumstances, be considered a barrier to a reasonable accommodation.
  • Many accommodations may be made easily and at minimal cost.
    • In some cases, a solution may not be possible without “undue hardship”. This is the standard which an employer must pursue to meet its obligation under the Ontario Human Rights Code.
  • For more information visit Ontario Human Rights Commission Duty to Accommodate

Undue hardship includes:

  • Source of funds
  • Costs
  • Health and Safety Factors

Employer Obligation

When confronted by a request for accommodation, the employer should look at the nature of the request – is it temporary or permanent?  Will it add substantial cost to the enterprise?  Will it affect the health and safety of others?

Undue hardship must be looked at in the specific circumstances an organization faces.  An employer should ask:

  • What is the accommodation required?
  • What is the financial cost of the accommodation?
  • Will the accommodation require a change to a collective agreement if there is one in place?
  • Will your funding agency contribute to the cost of accommodation?
  • Will the accommodation cause you to reduce staff to meet the costs?

Exceptions

Exceptions occur when it is clear that an accommodation is impossible. Arguably, a person confined to a wheelchair would be unable to perform the duties of a firefighter. That same person may however be able to perform the duties of a guide in a museum, social worker, accountant or program manager sometimes with and other times without the need for accommodation.