No Pre-Ex for mat leave returns

Manulife confirms Pre-ex won’t apply when returning from maternity leave

November 1, 2021

For business owners, plan administrators, and sponsors

We understand a maternity leave can cause financial constraints. Sometimes paying for coverage can be difficult. But we also know an illness or injury can happen at any time. So, we strongly encourage plan members to continue paying premiums throughout their leave. 

If there’s a premium gap because of a maternity, paternity, or parental leave, Manulife will re-activate the coverage when the member starts paying again. We’ll reinstate long term disability (LTD) coverage and the pre-existing condition exclusion won’t apply.

The details

All benefit plans have exclusion periods. It’s usually for the first year a new member is in a plan. It ensures the plan is not paying disability claims for a condition that existed before coverage started. This helps manage costs and premiums for everyone in the plan.

If members stop paying premiums while they’re on maternity leave, LTD coverage starts again as soon as they restart their premiums. The pre-existing condition exclusion won’t apply.

How it works

Here’s a look at three maternity leave scenarios. It shows how LTD benefits work if a member continues to pay premiums or if they stop.

  1. Premiums continue. Coverage continues.
  2. If this member becomes disabled while on maternity leave, they can make a claim. If approved, we start paying disability benefits on the planned return-to-work date.

  3. Premiums stop. Coverage stops. Leave ends.
  4. When this member returns to work after their maternity leave, they start paying premiums again. Their LTD coverage starts again immediately. They can make a disability claim if they need to.

    In the third example, you’ll see why we encourage members to keep paying premiums while they’re on leave. This person becomes disabled while on leave. But they’re not covered because they stopped paying premiums.

  5. Premiums stop. Coverage stops. But disability strikes.
  6. If this member becomes disabled while on maternity leave, they can’t make a claim. They’re not covered for LTD. And they need to return to work in good health and start paying premiums before they can be covered again. That’s why it’s key to stay covered while on leave.

It’s important

We understand maternity leave can mean less money is coming in. And it means taking time to set up premium payments when a pay cheque stops. All while getting ready for a new baby.

But an illness or injury can happen at any time. That’s why we always encourage plan members to continue paying premiums throughout their leave. We know that a gap in premium payments means a gap in important protection.