Your benefit plan may be set up with a Non-Evidence Maximum (NEM) for the Basic Life, AD&D, ASI and Disability benefits. The NEM is the maximum amount of insurance a member qualifies for under the plan without providing any medical information to the Insurer. A member may become eligible for a higher benefit level based on changes to their reported earnings.
If employee is eligible for an amount of insurance that exceeds the NEM, the portion of the increase in excess of the NEM will be subject to the submission and approval of the Evidence of Insurability Form. This form must be approved by the current carrier or GroupSource. GroupSource will automatically generate a “Non-Evidence Maximum Notification” with your Billing Statement for any member whose earnings make them eligible for benefits exceeding the NEM. This report shows the member’s current coverage and premium, as well as the additional coverage that the member is eligible for and the corresponding premium.
- You must offer the member any additional benefit amount for which they are eligible.
- If the member wishes to apply for the additional coverage, have them complete and sign the appropriate Evidence of Insurability form and send it by mail, fax, or email to GroupSource for underwriting. For more information or to apply please contact our Medical Underwriting department by email at medicalunderwriting@groupsource.ca.
- The Insurer will review the information and provide an answer in writing directly to the member.
- As the Plan Administrator, you will receive a letter from GroupSource advising whether the additional coverage is approved or declined. If approved, the higher benefit volume and increased premiums amount will appear on your next Billing Statement.
If a member has been approved for excess insurance amounts, and later receives a subsequent salary increase, the additional amounts are automatically approved up to 10%. If a member’s earnings place them over the NEM and the reported salary increase is 10% or more over current reported earnings, completion of the Evidence of Insurability forms will be required again.