Whether you’ve just gotten married or you’ve lived together for years, it can be easy to neglect important spousal or common-law partner paperwork.
Case in point? Adding your spouse or partner to your workplace or personal benefits.
Don’t skip this because it’s boring or tedious. In fact, it’s an important task that could help make things easier for you and your loved ones in the future if you take care of it now.
Why is it important to do add your spouse or partner to your benefits?
If you don’t add your spouse or common-law partner to your benefits, they could be missing out on coverage they may be eligible for.
If they have their own benefits plan, it can help with any out-of-pocket expenses that aren’t covered by this other coverage. And if they don’t have benefits at all, this is a great way to make sure they’re covered for many of those common expenses not covered by government health insurance, like physiotherapy, routine dental care and prescription drugs.
Do you have to put your spouse or common-law partner on your benefits plan?
No, but it may be to your benefit as a couple to do so. This decision may come down to cost, especially if they also have benefits they might be paying into.
Can you combine benefits with a spouse?
Yes, you can. The way that works is: Your spouse might have a medical expense that isn’t fully covered by their own workplace benefits. If they’re added to your benefits, they may be able to claim some of that outstanding amount through your plan.
Your plan might also cover services or products that theirs doesn’t.
How would the plans work if both people have a benefits plan?
Your spouse or common-law partner would first make the claim through their own workplace coverage. If that doesn’t cover the whole expense, they can then claim the difference through your benefits, which may cover that in full or in part, depending on the plan.
What does it mean to “coordinate” benefits?
If you’re covered by more than 1 benefits plan, those plans work together to cover a claim.
This is known as “coordination of benefits.” There is a set order in which you should make your claims: Generally, your spouse would make a claim on their own benefits first, and then your plan would be the “second payor.”
Because of this, having two plans available to you – where the second may cover some or all of the unpaid cost not reimbursed by the first plan – usually means that you’ll have more coverage as a couple, and you’ll pay less out-of-pocket, up to reasonable and customary amounts or the full cost of the service or item, whichever is less.
Can I add my girlfriend or boyfriend to my benefits plan?
This will depend on whether you’re considered to be “common-law” or not, something which differs depending on your specific circumstances, including the province or territory you live in and your particular benefits plan.
For example purposes, however, let’s assume that you live in a province where a common-law partner is defined as someone who you have been living with in a conjugal relationship for at least 12 months.
In this situation, this means that if you’ve been dating for 3 years and live separately, you won’t be able to add your girlfriend or boyfriend to your benefits – but if you’ve lived together as romantic partners for three years, you can.
Can I add or remove a spouse or partner from a benefits plan at any time?
Every plan has its own rules. While some may allow you to add a spouse at any time, others may have defined periods for this, possibly limiting adding or removing to major life events like getting married, divorced or your partner losing their job.
In some cases, you may need to add your spouse or common-law partner within 31 days of you joining the plan, otherwise they’ll be a “Late Applicant.” This can mean that they’ll need to answer medical questions that would have been waived if they’d signed up within those first 31 days.