The Schedule and General Definitions portions of your group insurance policy/contract provide a definition of employees in your plan that are eligible. The benefits manager for your company should have a copy of the policy.
If insurance coverage is "non-contributory", the employer pays the entire cost of the employees' coverage, and all eligible employees must be enrolled as soon as they become eligible. If insurance coverage is "contributory", the employer must offer each eligible person coverage within 31 days of the date they become eligible. "Contributory" means the employee pays part of the premium and therefore has the opportunity to refuse the coverage.
The first step is to apply/add the service requirement to the eligible employee's date of employment. The service requirement is found in the Schedule of your group insurance policy. The date of hire plus the service requirement is the date of eligibility. Once you have determined the date of eligibility (i.e. applied the service requirement), you must then determine the actual "entry date" for employees under your plan. The entry date is also found in your group policy Schedule.
When coverage is contributory, it is imperative that employees elect or refuse coverage within 31 days of the date they become eligible. If an employee does not elect coverage (signified by completing an application, with signature and date) within 31 days of the date he/she becomes eligible, that employee will be considered a late applicant. If an individual is a late applicant, he/she will be required to complete health questions, meaning an extended enrollment form must be completed (see What if Proof of Good Health is Required for more information.)
Note: When an employee switches from part-time to full-time, the part-time service will count toward fulfillment of the service requirement. Therefore, if the employee's part-time service is longer than the service requirement, he/she will become eligible immediately upon entering the full-time eligible class.
Select the applicant's state of residence from the list on the Administration Page to display the Employee Application for that state. Our Employee Application is available in Portable Document Format (PDF). To view the form, you may need to download the latest version of Adobe ® Acrobat ® Reader from the Adobe site. Print the Employee Application for the employee to complete. It may then be faxed to us toll-free at 888.208.2323.
Employee enrollments are also easily performed on our online system. To register for this service, click here.
It is important that every application be fully completed prior to submission.
The employer should complete the following areas:
- Policy or group number (your policy number is referenced on the cover page of your policy.)
- Account number (if applicable)
- Your company's name
- Your company's address and phone number
The applicant should complete the following areas in their entirety:
- Salary (if applicable) and frequency of payment (annual, monthly, weekly, etc.)
- Full name
- Date of hire
- Date of birth
- Social Security Number
- Beneficiary (Life insurance)
- Job title (if applicable)
The applicant must sign and date the Employee Application to complete the request.
You may fax the Employee Application to 888.208.2323 or mail it to:
Sun Life Financial
P.O. Box 2939
Clinton , IA 52733-2939
The applicant should complete an Extended Employee Application. He/she must answer all health questions and provide full details to any "yes" answers. Please check to be sure that:
- the applicant has provided his/her height and weight
- each question has been answered "yes" or "no"
- the applicant has included his/her physician's name and full address (for each condition)
- full details have been provided for any question answered "yes"
- the applicant has signed and dated the application
Failure to fully complete the health questions and sign and date the application will delay the review. Please note that additional medical requirements may apply depending upon the amount of insurance requested, the applicant's age and/or information provided on the extended card. We will notify you of any additional requirements upon review of the application.
When an applicant is "late" and/or evidence of insurability is required, we will enroll him/her for coverage upon approval of the medical evidence submitted. The effective date of coverage will be either the date of the last piece of medical evidence used for approval or the first of the month following that approval, depending upon your policy.
Once the enrollment is complete, you will receive a face page for each applicant reflecting the approved coverage(s) and amount(s). Please carefully review to ensure these are accurate.
You should also have a supply of certificates which describe your plan of insurance. The face page, along with a certificate booklet, should be provided to each insured for his/her records. If you did not receive certificates or you need additional booklets to replenish your supplies, please contact us immediately.
Maintenance of your policy records is important to assure our records are correct and agree with yours. Please verify that:
- our roster of insureds is correct, based on your employee population;
- your insured's benefit amounts are updated when salary increases are received (Life and Disability);
- name changes are reflected; and
- beneficiary changes are reviewed and recorded (Life coverage only).
You can save time and simplify the administration of your policy by signing up for our free online service. To register, click here.
You may use any of the following methods to make changes.
- Our online service. To register, click here.
- Faxable Change Document – This is included with every premium statement you receive. Your list bill is a convenient way to review benefits for all your insured employees as a group, and the Faxable Change Document is an easy way to update and notify us of any changes to outdated or incorrect information. You can fax the Faxable Change Document to us at 888.208.2323.
- Our toll-free telephone number 800.733.7879
- Our email address CustomerAdvocacy@sunlife.com
You should submit the change in writing or via our online system. Please provide the effective date of the life event (i.e. date of marriage/divorce, date of birth/adoption, etc.) If a dependent spouse is losing coverage under another plan and the employee therefore wishes to enroll that spouse under our plan, we will need the date that the other coverage terminated.
Please do not submit an Employee Application as this may result in a duplicate enrollment.
- Significant change of employment status (loss of job or hours)
- Loss of dependent status (child attains limiting age)
- Birth or adoption of a child
- Legal separation
- Significant change in insurance coverage (loss of coverage for the employee or dependent)
To determine when to submit a salary adjustment, you must apply the change date found in the Schedule of Insurance in your group insurance policy/contract. The benefits manager should have a copy of the policy. The following are definitions of change dates:
Immediate: The Insured's benefit amounts are to be updated when a salary adjustment is received.
Policy Anniversary: The Insured's benefit amounts are to be updated on the anniversary of the group policy.
Other: The Insured's benefit amounts are to be updated according to the change date stated in the contract.
If Sun Life is maintaining your beneficiary designations, the insured may complete, sign and date a Request for Change of Beneficiary form. You also have the option of maintaining these in your office. In the event of a claim, we will contact you for required documentation.
When an insured terminates employment or ceases to be a member of an eligible class, you should terminate his/her coverage. Terminations can be handled in a variety of ways, as with the other changes already reviewed. The quickest way to process a termination is through by calling us at 800.733.7879. You may also notify us via our online system, the Faxable Change Document, our e-mail address CustomerAdvocacy@sunlife.com, or by written correspondence.
Note: Failure to terminate an employee who becomes ineligible or paying premiums on behalf of an ineligible employee does not constitute continuation of coverage. A conversion privilege may be available to a person who is terminating employment or losing coverage. For Dental coverage, employees and their dependent(s) may also be eligible for continued coverage under the Consolidated Omnibus Reconciliation Act (COBRA). Please see your policy for additional details or contact us at 800.733.7879.
Have the insured call Client Services at 866.909.6065.
Your premium statement will be produced approximately two weeks prior to the date your premium is due. For example, your premium statement for the premium due on May 1st would be produced on or about April 19th. This allows you time to review and remit your premium prior to the May 1st due date.
If you have registered for our online service, you can view your bills online and we will send you an e-mail reminder advising you when they are available for viewing.
Your premium statement is probably a list bill, meaning that each current insured employee is listed on the bill along with his/her certificate number, benefit amount and premium due. Every active person at the time the bill is produced will appear in the "current premium" portion of the bill. Any changes processed since the last premium statement will appear in the "adjustment" portion of the statement, assuming those changes were received and processed prior to the bill production date. Changes may include credits or back charges or may result in no premium adjustment at all. Please carefully review the adjustment portion of your statement to ensure that we have processed changes, terminations or enrollments as requested. If you have reported changes that are not reflected on your statement, please call us at Client Services at 800.733.7879.
Finally, your statement will contain a summary of the current total volume of insurance, the number of lives, and a breakdown, by coverage, of your premium charges. You should carefully review the premium summary to see that it correctly reflects payments that you have previously made. If a previous payment is not reflected, please call us as soon as possible so that we may investigate.
Once your review is complete, use the detachable remittance stub and remit your premium utilizing the window envelope provided. You should remit the entire amount for which you have been billed and not adjust your payment for recent changes that have not yet appeared on your statement.
Please remember to write your policy or group number on your check.
Call our Client Services line at 800.733.7879, where you will speak with a knowledgeable person about your plan. This line is available Monday through Friday, between the hours of 8:00 a.m. and 7:00 p.m. ET.
In order to help us assist you, please have the following information available:
- policy or group number
- participation number (when applicable)
- account number or bill group name (when applicable)
- certificate number (when applicable)
This information can be found in the top right corner of your premium statement. Your policy or group number is also referenced on the first page of your policy. The account number, if any, and each individual certificate number can be found on your premium statement or on the employee's face page.