If you are on short-term sick leave or unpaid medical leave and unable to work for four months or more due to illness or injury, you may qualify for long-term disability, which will provide you with a monthly income at a percentage of your regular salary.
Your long-term disability plan is called the Disability Benefit Plan (DBP). Sun Life is UBC’s insurer for the Disability Benefit Plan.
When you should apply
If you are in your second month of absence from work due to illness or injury and it does not seem that you will be able to make a full return to work, you should apply for long-term disability. Call the Benefits Claims & Finance Associate at 604-822-8696 or email email@example.com to learn how to apply for benefits and to obtain the application forms you’ll need.
If you are on an unpaid medical leave
If you have used up your paid short-term sick leave days and have not yet completed the elimination or waiting period for the DBP, you will be placed on an unpaid medical leave. During your unpaid leave, you have the option to continue receiving coverage for your DBP and your other benefits if you pay the full cost of these premiums.
UBC Payroll will send you an invoice where you can select what benefits you want to continue receiving coverage for and the cost of doing so. If you decide not to continue your DBP coverage, fail to pay your premiums or do not respond to your invoice, you are no longer eligible to receive DBP benefit payments after the elimination or waiting period. Your coverage will be reinstated when you return to active work.
If you are receiving DBP benefit payments, you are expected to make reasonable efforts to:
- recover from your disability, including participating in any reasonable treatment or rehabilitation program and accepting any offer of reasonable modified duties from UBC, and
- obtain benefits that may be available from other sources.
Your DBP benefit payments may be withheld or discontinued if you do not fulfill these responsibilities.
Am I eligible for coverage?
You are automatically enrolled in the DBP on your date of hire if you are a continuing full-time employee or a part-time employee:
- with an appointment of 12 months or more,
- working at least 17.5 hours per week and
- hired before your normal retirement date, which is the last day of the month in which you turn 65.
What are the premiums?
You pay for the DBP through a monthly deduction on your paycheque that is based on a percentage of your regular earnings. If you are receiving monthly DBP benefits, you do not need to pay your monthly DBP premiums for the period when you are receiving benefits. Review the cost of your monthly DBP premiums.
When does my coverage begin and end?
See Benefit Coverage Start and End Dates for details on when your DBP coverage begins and ends.
What are the eligibility requirements to receive benefit payments?
You must reside in Canada to receive DBP benefit payments.
You are eligible to receive benefit payments, if, during the four-month waiting period before your benefits begin (the elimination period) and the following 24 months, you are continuously unable to perform the essential duties of your own job due to illness. This is referred to as total disability.
An illness is a bodily injury, disease, mental infirmity or sickness. If you have had surgery to donate a body part to another person and your surgery causes your total disability, you are eligible for DBP benefit payments. See Reductions and limitations for more information on limitations.
You are still eligible for benefit payments if, after 24 months, you are continuously unable to perform any job that you are or may become reasonably qualified to do by education, training or experience, and for which your current basic monthly earnings would be 66.-2/3% or more of your pre-disability basic monthly earnings for your normal job.
If you hold a government permit or license to perform your duties you will not be considered totally disabled solely because such permit or license has been withdrawn or not renewed.
When you apply for benefits, you will be asked to provide proof that you became totally disabled while covered and that you have been following appropriate treatment for the disability since its onset.
What is the elimination period or waiting period?
The elimination period (or waiting period) is the period of time you must wait before your disability benefits become payable. The elimination period is four months after the date that your total disability prevented you from working.
However, if you are able to return to work for one more periods of less than 30 days before the elimination period has passed, you can accumulate your periods of disability to attain the four-month elimination period, provided they are accumulated in one 365-day period.
How and when do I apply for disability benefits?
If you are in the second month of your absence from work due to illness or injury and it does not seem that you will be able to make a full return to work, you should apply for the Disability Benefit Plan. Call the Benefits Claims & Finance Associate at 604-822-8696 or email firstname.lastname@example.org to learn how to apply for benefits and to obtain the application forms you’ll need.
Sun Life requires up-to-date medical information closer to the end of your elimination period in order to assess your claim. Therefore, we recommend commencing your application during your second month of absence from work, and instructing your attending physician to include copies of any supporting medical documentation, such as specialist consultation reports, x-ray results, other test results, etc.
To avoid delays in receiving the DBP benefit payments, it’s important that the information in your application is complete.
You must file your claim no later than six months after the four-month elimination period or you will not be eligible for DBP benefits.
Need help understanding your sick leave and applying for long-term disability? Read our claims process guide:
- UBC Disability Benefit Plan Claims Process: Guide for Staff
When will I receive my benefit payment?
Your first payment will be made on the first of the month after the end of your elimination period.
If you become totally disabled during an approved leave and you have continued to pay your DBP premiums during your approved leave, your first payment will be made following the date of your recall or scheduled return to full-time work. You must have been totally disabled for an uninterrupted period of four months and still be totally disabled on the date you are recalled or scheduled to return to full-time work.
If you are on an approved leave and you did not continue to pay your DBP premiums, you are not eligible to receive benefit payments for any illness or injury that occurred while you were on your leave. Your coverage will be reinstated when you return to active work.
How much will I receive each month?
The monthly benefit is calculated as follows:
- 60% of your basic monthly salary (up to a maximum of $3,500)
For example, based on a monthly salary of $3,500, you would receive a total monthly benefit of $2,100.
The maximum monthly benefit is $3,500, and net monthly payments from the Disability Benefit Plan are not subject to Income Tax. (See Reductions and limitations for information on net payments.)
A cost-of-living adjustment will be applied to your monthly benefit each January 1. The adjustment will be based on the percentage increase to the Canadian Consumer Price Index to a maximum of 6%.
The amount of your coverage may change if your salary increases or decreases due to a change in your employment status, or if there are changes to the Plan. Any resulting changes take effect on the date of the change in your employment status or the Plan. If you are not actively working when the change occurs, the change does not take effect until you return to active work.
Please refer to Other Group Benefits for more information on benefit coverage while you are receiving DBP benefits.
What reductions and limitations do I need to know about?
You might be entitled to receive benefits from other sources as a result of your disability. If this is the case, the amount you are paid under the DBP may be reduced by additional sources of income such as the following:
- CPP or QPP disability benefits (excluding dependents’ benefits);
- disability payments from any other government plan (excluding Employment Insurance and Department of Veterans’ Affairs benefits);
- disability benefits from any other group, association or franchise plan (this does not include private plans paid for by individual members);
- wage-loss benefits through WorkSafeBC;
- income replacement benefits from any automobile insurance plan or policy;
- income from other group benefit, pension or retirement plans provided by any employer when benefits are based on UBC earnings and as a result of UBC employment, including any coverage resulting from your membership in an association of any kind;
- payments or earnings from any employer for any work for wage or profit as approved by Sun Life, except for vacation pay and payments from the Living Benefits Loan Program; and
- any past or future wage loss recovered through a legally enforceable cause of action against some other person or corporation in accordance with provisions under third-party liability.
If your monthly DBP benefit payment plus the above sources of income exceeds 85% of your pre-disability basic earnings, your monthly DBP benefit payment will be reduced by the excess amount. The maximum DBP benefit payable is 85% of your pre-disability basic earnings after income tax.
If you are eligible for any of the benefits from other sources listed above and you do not apply for these benefits, Sun Life will still consider them part of your income and will base your DBP payment on the amount you would be eligible for if you had applied for these other sources of income.
DBP benefits are not paid for disabilities that result from:
- Pre-existing conditions that existed on or before the date your coverage began. However, this limitation will not apply if:
- you have been actively working continuously (up to three days of absence does not count) and covered for any 13 consecutive week period within the first 12 months after coverage began and during this time you have not been treated by a doctor, or any medical personnel under the direction of a doctor, for the condition, or
- you became totally disabled more than 12 months after your coverage began.
- Intentionally self-inflicted injuries or attempted suicide, while sane or insane.
- The hostile action of any armed forces, insurrection or participation in a riot or civil commotion.
- Participation in a criminal offense.
- Illnesses that are sustained while you are working for wage or profit, outside of your duties and responsibilities at UBC.
- A total disability that results directly or indirectly from an impairment that existed on or before the date your coverage began under this plan (pre-existing condition); however this limitation will not apply if:
- you have been covered by this plan for at least 13 weeks and during this period you have been actively working continuously (up to three days absence does not count) and you have not been treated by a doctor, or any medical personnel under the direction of a doctor for the condition, or;
- you became totally disabled more than 12 months after your coverage began under this plan.
- The health-related portion of a maternity or parental leave where benefits are payable under UBC’s Supplemental Employment Plan.
Can I access my other group benefits while receiving DBP benefit payments?
You can still receive your other group benefits from UBC while you are receiving DBP benefit payments. If you were enrolled in the following benefit programs before you started receiving DBP benefit payments, you can still access these benefits as long as you continue to be employed by UBC:
- Medical Services Plan (MSP)
- Extended Health
- Basic Group Life Insurance
- Employee and Family Assistance Program (EFAP)
Sun Life will waive your monthly premium costs for Optional Life Insurance and Optional Accidental Death and Dismemberment Insurance (for you and/or your spouse and if applicable, your dependent children) if you were enrolled in these programs before your DBP claim. UBC’s Benefits Claims & Finance Associate will apply on your behalf to waive these premiums when your DBP claim is submitted.
You are also eligible for the Tuition Waiver while you are receiving DBP benefits.
While receiving DBP benefit payments, please note the following:
- You may add or remove dependents from your MSP, Extended Health, Dental and EFAP coverage. To do so, submit the appropriate change form to Payroll for processing.
- You are unable to apply for Optional Life and Optional Accidental Death and Dismemberment Insurance (also includes increases to your existing coverage).
- Keep your life insurance beneficiary up-to-date. To make a change, submit a form to change your basic life insurance beneficiary and/or optional life insurance beneficiary to Payroll. Keep a copy of the form for your records.
Staff Pension Plan
If you are receiving DBP benefit payments, you will no longer accrue pensionable service unless you contribute both the employer and employee portion to the Staff Pension Plan. Since this may or may not be to your advantage, contact the UBC Staff Pension Office to discuss your options. However, if you were approved for DBP benefits before July 1, 2009, you will continue to accrue pensionable service without being required to contribute to the Staff Pension Plan.
Taxability of benefits
Employer-paid premiums for MSP and Basic Group Life Insurance are taxable benefits to you. The amount of these premiums will be included in Box 40 and 14 of your year-end T4 slip. You will be required to report the Box 14 amount as income on your tax return.
For more information, please refer to the Canada Revenue Agency General Income Tax and Benefit Guide.
When will my group benefits end?
Your group benefits will end when your disability claim ends.
- Your MSP, Extended Health, Dental and EFAP coverage will end at the end of the month your claim closes;
- Your Basic Group Life Insurance will end on the day your claim closes.
What are the rehabilitation and gradual return to work programs?
You may be required to participate in a rehabilitation program approved by Sun Life. You may be asked to:
- consult with a rehabilitation team (consisting of a rehabilitation specialist, your physician, your department and UBC’s Return to Work Program (Vancouver campus) and the Work Re-Integration and Accommodation Program (WRAP) (Okanagan campus),
- work part time,
- work in another occupation, or
- pursue vocational training to help you become capable of normal work week employment.
During your rehabilitation program, you will continue to receive DBP benefit payments. However, your DBP benefit payments will be reduced by 50% of any income you receive while working under the rehabilitation program. During any month, the total income you receive from all sources cannot be more than 100% of your pre-disability basic earnings (after income tax), indexed for inflation. If your total income exceeds this limit, your DBP benefit payment will be reduced by the excess. Benefits will be paid for a maximum period of 24 months.
Gradual return to work program
After a disabling accident or illness, many people return to work gradually. The Return to Work Program (Vancouver campus) or the Work Re-Integration and Accommodation Program (WRAP) (Okanagan campus) can help to coordinate this. While you are gradually increasing your work activity, and being paid for the time you work, your DBP benefit payment will be replaced with a rehabilitative subsidy. Your net income will increase as the amount you work also increases. The combination of your rehabilitative subsidy plus your net salary will not be greater than your pre-disability net earnings when your total disability began.
Benefits during a rehabilitation or gradual return to work program
Your group benefits will revert back to the normal cost-sharing arrangement after three months of employment at 50% FTE or more. This means that you will be responsible for paying the employee share of any benefit costs (contributions/premiums) that you paid before you began receiving DBP benefit payments.
However, you do not need to pay DBP premiums and any Optional Life/Accidental Death and Dismemberment and Spousal Optional Life/Accidental Death and Dismemberment Insurance premiums waived by Sun Life. Any Staff Pension Plan contributions will be pro-rated on your earnings in the rehabilitation program.
What is the partial disability program?
You may be required to participate in a partial disability program approved by Sun Life.
During your partial disability program, you return to your own job for a reduced number of hours per week and receive a salary for the hours worked. Your DBP benefit payments will be reduced by the percentage of your normal work week that you are now working. During your partial disability program your total income from all sources cannot exceed 100% of your pre-disability basic earnings, indexed for inflation (less provincial and federal income taxes). If this is the case, your DBP payments will be further reduced by the excess.
Your participation in a partial disability program will be limited to your own job and for a period of 24 months. However, you may continue to participate in an approved partial disability program beyond this period if, because of your disability, you are unable to earn more than 66-2/3% of your pre-disability basic earnings, indexed for inflation.
Benefits during a partial disability program
Your benefits will remain at the normal cost-sharing arrangement if you are working 50% FTE or more. If you are working less than 50% FTE, UBC will continue to pay for your employee share of any benefit costs (contributions/premiums) that you paid before you began receiving DBP benefit payments. However, you do not need to pay DBP premiums and any Optional Life/Accidental Death and Dismemberment and Spousal Optional Life/Accidental Death and Dismemberment Insurance premiums waived by Sun Life. Any Staff Pension Plan contributions will be pro-rated on your partial UBC earnings.
What are my responsibilities?
If you are receiving DBP benefit payments, you must make reasonable efforts to:
- recover from the disability, including participating in any reasonable treatment or rehabilitation program and accepting any offer of reasonable modified duties from UBC, and
- obtain benefits that may be available from other sources.
Your DBP benefit payments may be withheld or discontinued if you do not fulfill these responsibilities.
When do my DBP benefit payments end?
As long as you continue to meet the eligibility requirements, you will continue to receive DBP benefit payments up to the following date, whichever occurs first:
- The date you are no longer totally disabled. However, if:
- you must hold a government permit or licence to perform your own occupation, and
- you cease to be totally disabled but cannot return to your own occupation solely as a result of your government permit or licence having been withdrawn or not renewed solely due to your total disability,
benefit payments will continue until the earlier of:
- 6 months after the date you cease to be totally disabled, or
- the date your government permit or licence is reinstated or renewed.
- The last day of the month in which you reach age 65.
- The date you are incarcerated in a prison or mental institution by authority of a criminal court.
- The date you die. In such event, the last payment will include the date of death.
Benefit payments may stop before the dates mentioned above, if:
- You are not receiving appropriate treatment.
- Further proof of your disability is requested but is not received within 90 days of the request.
- You fail to take a medical examination requested by Sun Life.
- You do any work for wage or profit except as approved by Sun Life.
- You are not participating in an approved rehabilitation program, if required by Sun Life.
- You refuse to provide Sun Life with requested information if you have a claim against a third party for loss of income that could have been earned while disability benefits are paid or payable under this plan.
- You are serving a prison sentence or are confined in a similar institution.
- You are absent from Canada longer than four months for any reason, unless Sun Life agrees in writing in advance to pay benefits during this period.
For more information
The outline above is a descriptive summary of the plan and is not a contract. All terms and conditions are governed by Contract Number 100328 with Sun Life Assurance Company of Canada. In the event of a discrepancy, benefits will be paid according to the official document and applicable legislation. For complete details about your Disability Benefit Plan, refer to the Sun Life benefits booklet.
If you were disabled prior to December 1, 2010, please refer to the Sun Life benefits booklet for Contract Number 023218.