Here are the administrative steps to be taken by employers when a member is unable to work for health reasons:
Step A: Notify HOOPP of Health Leave
It is up to you to place a member on a health leave. HOOPP does not need to be notified about the health leave until it has continued for at least 30 days.
If a member has been on a health leave for at least 30 days, submit the necessary information to HOOPP in order to let HOOPP know that you have placed the member on an employer-approved health leave. If a member returns to work permanently (or for longer than a 3 week period) before the 15 week qualifying period has been reached, submit the necessary information to HOOPP and end the leave on the date the member returned to work.
Important
Members on an employer-approved health leave who are totally and permanently disabled may apply for a HOOPP disability pension at any time; they do not have to wait until the end of the 15 week qualifying period. If a member indicates that they are interested in applying for a disability pension before the end of the 15-week qualifying period or requests any information about HOOPP’s disability benefits please ask them to contact HOOPP directly.
✔ Submit the information to HOOPP. Health leaves should be reported to HOOPP once a member has been on a health leave for 30 days. ✔ If the member returns to work or the health leave is interrupted report these changes to HOOPP in a timely manner. |
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Step B: Contributions
✔ Place member on an employer-approved health leave ✔ Deduct contributions for the first 15 weeks of the health leave ✔ Stop deducting contributions after the 15 week qualifying period if the member is approved for free accrual by HOOPP |
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During the 15 week qualifying period members must make contributions on any employment earnings they received from your organization. Employers must also make contributions at the prevailing employer contribution rates. Any contributions the member makes during the health leave will be reported at year end to HOOPP as part of HOOPP's annual member data collection process.
Below are possible contribution scenarios during the qualifying period.
Full Earnings
If you pay a member 100% of their pre-leave earnings during the qualifying period, contributions must be made by members and employers on those earnings.
Partial Earnings
If you pay a member less than 100% of their pre-leave earnings during the qualifying period, contributions must be made on the pay received and the member will accrue contributory service at that level. Members also have the option to “top up” their contributions to the pre-leave level without employer approval.
If a member elects to “top up” they can make additional contributions to a maximum of 100% of the contributions they would have made if not for the leave. They can either make contributions during the qualifying period or no later than twelve months (temporarily extended from six months) after the end of the qualifying period. Employers must also contribute if a member chooses to “top up” their contributions.
If a member contributes less than the full amount of what they would have contributed had they been working, their contributory service will be prorated to reflect this.
Example: Before her health leave Susan earned $2175 bi-weekly. Susan earns $1305 bi-weekly during the disability qualifying period (60% of what she was earning before the leave started). Susan must
contribute on the actual employment earnings she receives ($1305) but she has the option to make contributions on her pre-leave earnings of $2175 or to make contributions on earnings between $1305
and $2175.
No Earnings
If you do not pay a member any earnings during the qualifying period, the same rules applicable to "partial earnings" apply. The member can make no contributions or "top up" contributions to 100% of the pre-leave level.
Example: Before her health leave Susan earned $2175 bi-weekly. Susan receives no earnings during her health leave and is therefore not required to make any contributions. She has the option to make
contributions on her pre-leave earnings of $2175 or to make contributions on earnings between $0 and $2175.
Workplace Safety & Insurance Board (WSIB) Benefits
The Workplace Safety and Insurance Act protects a member’s right to continue to make pension contributions during the first 12 months following a workplace injury or disability. If a member chooses to contribute for this period, they can make such contributions either during the period or within the time period set by HOOPP to make contributions after the end of the qualifying period, as a lump sum. You must also make contributions to HOOPP in this situation. The member’s contributory service for this period will be based on the contributions received by HOOPP.
Contributions after the Qualifying Period Contributions are not required after the end of the 15 week qualifying period if the member qualifies for free accrual. However, you can permit members to continue making contributions if they remain on a health leave and are not receiving free accrual after the qualifying period has ended. This might occur if a member does not provide HOOPP with medical evidence to support their disability, or if a member is not approved for free accrual because the medical evidence does not support that the member is at least partially disabled. Contributions should be made at the time they are received. Members can make contributions during the leave, or within the time period set by HOOPP to make contributions after the end of the first year of the health leave, as a lump sum.
For a health leave that continues after the 15 week qualifying period, a member’s contributions should be based on their “pre-leave level” which is determined as follows:
Full-time member: |
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Part-time member: |
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Step C: Disability Guide
HOOPP will mail information to members who reach 15 weeks on an employer-approved health leave, including a copy of Disability Benefits. This booklet contains important information for members about the disability benefits offered by HOOPP and how they can apply for them. It also includes a copy of an Application for Disability Benefits and Attending Medical Practitioners Assessment forms that members need to complete and submit to HOOPP if they wish to apply for disability benefits.
After reading the booklet, if a member wants to apply for disability benefits they must send the two forms to HOOPP after the end of the qualifying period, along with any other medical evidence they may have relating to their medical condition.
After receiving the forms, HOOPP will send the member a letter informing them whether or not they are approved for disability benefits based on the medical evidence submitted, and the date by which new medical evidence will be required in order for the benefits to continue. You can monitor the status of your employees’ free accrual benefits through the Member Disability Reporting on HOOPP Insight. The report lists members that are currently on free accrual or on a health leave that qualifies for free accrual, or members that have started the disability application process.
A member who is not approved for free accrual may apply again if their condition worsens, as long as new medical evidence is provided to HOOPP.
If you do not report a health leave to HOOPP then a disability guide will not be mailed to the member. Health leaves should be reported to HOOPP once a member has been on a health leave for more than 30 days.
Step D: Member Returns to Work
If a member who is receiving free accrual returns to work (permanently, performing either their own job or a different job), submit the necessary information to HOOPP. Free accrual ends and the member must start contributing on the day they return to work.
If a member on free accrual has returned to work, and subsequently goes back off work within three weeks for the same cause or a cause related to their initial disability, they may be able to continue on the same health leave, as though they had not returned to work. Please contact HOOPP if this situation occurs.
Step E: Member Returns to Work on an Employer-Approved Rehabilitation or Modified Work Program
If a member who is receiving free accrual returns to work, HOOPP will consider the health leave to have ended and free accrual will stop. There is one exception to this rule. If the member is returning to work on an employer-approved rehabilitation or modified work program, the health leave may continue until their next medical review date. Free accrual will also continue if the member continues to be eligible and continues to satisfy the medical evidence requirement.
In general, HOOPP does not consider a member to be on a modified work or rehabilitation program if the member is back at work permanently, performing either their own job or a different job. A rehabilitation or modified work program does not need to be approved by HOOPP, but as a general guideline these types of programs should meet the following criteria:
Have the objective of enabling the member to return to work
Have specific, measurable goals which are time-dependent
Not continue beyond the fourth year of a health leave, if the member is partially disabled
Be weeks or months in duration, not years
If a member returns to work at his or her own job or a different job on a permanent basis you must inform HOOPP that the member’s health leave has ended so that free accrual can stop being credited and you must resume deducting regular contributions for the member.
Termination When a Member is Receiving Free Accrual
Refer to section 8.2 Reporting a Termination for guidance on ending a member’s employment while they are in receipt of free accrual.