Plan administrator resources

Complete the Online Access Agreement and email it to admin@groupinsurance.rbc.com or fax to 1-855-257-1599. You will receive a welcome email once your application has been processed.

Sign in to Online Administration and update your profile with your new email address.

Please contact RBC Insurance Customer Service at our toll-free number: 1-855-264-2174.

Select ‘Forgot Password’ on the Online Administration sign-in page and answer the personal verification questions. Your account will be locked after three failed attempts to enter your password. If you are locked out or cannot answer your personal verifications questions, please call us at 1-855-264-2174.

You may not have requested the correct access. Review and complete the Online Access Agreement. Email the completed form to us at admin@groupinsurance.rbc.com or call 1-855-264-2174.

The Group Enrolment Form allows you to capture required information to register your employee. Have your employee complete the Group Enrolment Form and then sign in to Online Administration to enrol your employee. Keep the original form on file. Refer to the ‘How To’ Section, ‘Add a Plan Member’ within the Plan Administrator Guide.

When enrolling a plan member, the Extended Health and Dental Coverage question cannot be left blank. Simply select ‘Single’ and proceed.

To waive the waiting period of a new hire, one of the following conditions must apply:

• It is a condition of their employment

• The employee has moved from part-time or contract to full-time status and has satisfied the waiting period during their period of employment

• The employee earns more than $50,000 annually

To waive the waiting period, enrol the employee using “Add A Plan Member” and in Step 2, confirm you wish to waive the waiting period. Acknowledge that the criteria is met and select “‘Next Step” to process.

• If you select “YES” to waive a waiting period, you will receive a drop down with the confirmation of allowances for waiving a waiting period.

• If the plan member does not meet the criteria, you can change the response to NO and the waiting period will apply.

• If you confirm to the terms for Waiving the Waiting period, Input “NEXT STEP” and the coverage will begin on the date of hire.

Statements are available each month in PDF or Excel format within Online Administration. When your billing is posted to the site, you will receive an email with this subject line: Your bill has been posted to the site.

You can view and print your booklets and contracts within Online Administration.

Your group policy number is included on your group billing statement.

To avoid a request for Evidence of Insurability, it is imperative that you enrol all eligible employees within 31 days following the completion of the Waiting Period, or the date he or she becomes eligible for coverage.

The best way to make changes to your plan is to call your Group Benefit Advisor. They can walk you through all the options that are available to your company.

Sign in to Online Administration. Detailed instructions for performing specific tasks are in the ‘How to’ section within the Plan Administrator Guide. Select a topic from the drop-down list. ‘How to’ topics include: Add a Plan member, Terminate a Plan Member and more. If you need assistance contact RBC Insurance Group Benefits Solution Team.

To change a beneficiary designation (where allowed by law), have the plan member complete the Beneficiary Designation Form and keep the original form for your records. You can make the necessary change by signing in to Online Administration and updating the plan member’s beneficiary.

Always pay billing statements as billed. Any employee changes previously reported and not included on the current monthly billing statement will be reflected on the next statement with any appropriate back charge or credit.

If you have an employee absent from work for an extended period of time and you anticipate that they will not be returning to work prior to the end of the long term disability (LTD) benefits elimination period, the claim process should begin.

To help ensure minimal or no interruption in pay to your employee, claim forms should be completed at least 8 weeks before the end of the elimination period (i.e. the waiting period before benefits are paid).

Please complete the Employer’s Statement of Disability to the fullest, and include any supplemental information required such as job description, last pay stub or statement, attendance records, etc.

Your employees will need to complete the Client’s Statement of Disability and the Attending Physician’s Statement of Disability – Choose the Form: Attending Physician’s Statement Short-term Disability. Please note: The Attending Physician’s statement is only required for Short Term Disability (STD) Claims.

It is your employee’s responsibility to submit their form, as well as the Attending Physician Statement, directly to RBC Insurance. The cost for completing the Attending Physician Statement is the responsibility of the employee. However, we will pay a nominal fee should your employee’s physician provide us with copies of their medical records, including office notes, test results, etc.

There are three ways to submit forms:

By email: intake@rbc.com

By fax: 1-800-714-8861

By mail: RBC Life Insurance Company, Life & Health Claims Department
P.O. Box 4435, Station A
Toronto, Ontario
M5W 5Y8

Once all three forms (Client’s Statement of Disability, Employer’s Statement of Disability, and Attending Physician Statement) have been submitted to RBC Insurance, a disability claims specialist will be assigned to your employee’s claim and the assessment will begin. We will contact you and your employee for a detailed telephone interview and may request additional medical information from the attending physician.

Our normal processing time to make a claim decision, from the time all forms are received to the completion of our initial review, is 10 business days.

If your employee’s claim is pended, this means we may require more information from their attending physician or your employee. We will advise you and your employee verbally and in writing of what we need to complete our assessment of their claim.

The time it takes to make a decision on a claim depends on the complexity of your employee’s condition and other factors preventing them from working. Therefore, a decision might take longer as we try to thoroughly assess and understand your employee’s medical and functional circumstances and how they impact their ability to work.

The best way to help speed up the decision process is to make sure that forms are fully completed and submitted to us right away. Claim forms should be sent to us at least 8 weeks before the end of the elimination period. You can also encourage your employee to do their part and send their claim for—and their physician’s form—to RBC Insurance as quickly as possible.

If your employee’s claim is payable, we will call you and your employee to communicate our decision. We will explain the benefit details and coverage information, as well as the next steps and expectations for the ongoing management of their claim. An approval letter confirming the decision and outlining the details will be sent to you and your employee.

A disability claim will be payable as long as the employee is deemed “disabled” according to the definition of disability in your group policy. The length of payment depends on a few major factors: severity and complexity of the medical condition, required recovery time and treatment of the condition, and any rehabilitation that might be needed to help your employee return to work. Because every claim is unique and the medical circumstances of an employee are different, the duration of a claim will vary.

If the claim is not payable, we will provide a clear and detailed explanation of our decision to your employee in writing and over the phone. We will also notify you of our decision in writing; however, keep in mind that medical information is confidential and will not be provided to you in order to protect your employee’s privacy. Our standard practice is to notify the employer of our decision first, then the employee in order to give you advance notice.

Examples of reasons why your employee’s claim may not be approved:

• They do not meet the definition of disability

• Their claim is due to a pre-existing condition, that is, they became disabled within a determined period of time of your policy’s coverage start date

• They are not under the appropriate care of a physician

• They do not meet the minimum hours requirement to qualify for coverage

Please ensure your employee reviews the group policy for full details of all terms of coverage. Should they have more questions, they can speak with their assigned disability claims specialist.

Our claim process is designed to ensure that your employee’s claim receives a thorough, fair and objective evaluation. Your employee has the right to appeal the decision within 90 days of the date of the decision letter. The appeal process will be clearly outlined in the denial letter. You may be contacted by our Appeals consultant should more information be required from you. Any questions about the appeal should be directed to them.

Your role is an important one. You can help by keeping in touch with your employee while they are off work. Please be ready to offer accommodations to allow for a gradual or modified return to work and let your employee know you will support and facilitate a transition to the workplace. This connection to the workplace will make their return that much easier.

We will monitor your employee’s progress and determine when they are medically able to return to work in a safe and timely manner. We will partner with you, your employee and their attending physician to coordinate the transition. Return-to-work potential is part of the claim evaluation from the start and, if required, we may assign one of our vocational rehabilitation specialists to assist in the process.

RBC Insurance HR Support provides valuable information to help your company stay up-to-date with employment standards legislation. To access these resources, sign in to Online Administration and click on the ‘HR Support Centre’ link on the main page

Yes! RBC Insurance HR Support gives you access to free HR policies and templates plus information on employment standards legislation. To access these resources, sign in to Online Administration and click on the ‘HR Support Centre’ link on the main page.

Our Work-Life Employee Assistance Program gives your employees 24/7 access to a valuable and confidential support resource.