Rationale
In accordance with subsection 11.4, the Board of Trustees may use all reasonable means to collect and receive all Contributions due to the Fund, and shall, promptly after receipt, deposit such Contributions in a Trust Fund account, established in a reputable bank, trust company, or other financial institution
It is the member’s obligation to pay member share premiums in the amounts prescribed, and in accordance with the collection method set out by the Trust. Payments are expected to remain current and delinquencies will be subject to the following delinquency policy.
Failure of members to pay member share premiums in a timely manner will result in suspension of member paid benefits. To reinstate eligibility will require repayment of all premiums owing.
- Payroll Deduction Delinquency (By Member)
- If an employer does not deduct premiums as expected, the employer will notify OTIP of non-collection of premiums on the premium remittance advice or payroll response file.
- Reasons that employers may not deduct premiums as expected include (but not limited to) unprocessed data changes related to member status or coverage, or timing of updates that occurred outside the normal payroll cycle of an employer.
- In addition, if a payroll deduction exceeds the high deduction threshold as prescribed by the Trust (currently more than 1 month retroactive and more than $200), the amount will not be processed as a payroll deduction and will instead be invoiced and collected directly from the member. See Section B.
Invoicing Active members who are paying current premiums on payroll:
- OTIP will send the invoice directly to member requesting payment, with warning that failure to pay will result in suspension of current coverage.
- In the event of non-payment, OTIP will send a Reminder letter after 30 days of 1st invoice, with reminder of upcoming suspension.
- In the event of non-payment, suspension of coverage will occur after 30 days of Reminder letter.
- Reinstatement will be possible back to date of suspension with no gap in coverage and no evidence of insurability required. However, payment of delinquent amount and any additional premium amounts incurred will be required in full prior to reinstatement.
- If no payment received, member’s coverage will be remain suspended
Direct Billing Delinquency (By Member)
One Delinquent Payment: Insufficient funds
It is recognized that there are many reasons one payment might be delinquent, and that a member’s benefits coverage should not be affected by one delinquent payment.
Result of one delinquent member payment (insufficient funds):
- Member is notified of the delinquent payment and date and amount of next attempt to withdraw funds;
- Warning that a subsequent failure to pay the total outstanding amount owing will result in suspension of benefits coverage.
- Withdrawal of delinquent amount plus a $25 OTIP administration fee, and next month’s premium on next direct-bill date; and
- Benefits coverage remains in place.
One Delinquent Payment: Incorrect PAD or closed bank account
Members may enter incorrect bank information by mistake, or to circumvent the enrolment process when direct billing is required. An incorrect or closed account number means that the Administrative Agent is unable to process a current or future deduction. It is critical for PAD information to be entered correctly and kept up to date.
Result of one delinquent member payment (incorrect PAD or closed bank account):
- Member is notified of the delinquent payment and date and amount of next attempt;
- Request for member to update correct PAD information prior to the next direct-bill date (within 10 days of next direct-bill date is recommended);
- Warning that failure to correct PAD information and a subsequent failure to pay the total outstanding amount owing will result in suspension of benefits coverage.
- Withdrawal of delinquent amount plus a $25 OTIP administration fee and next month’s premium on next direct bill date; and
- Benefits coverage remains in place.
Two Consecutive Delinquent Payments
If the Administrative Agent is unsuccessful in attempting to withdraw a second consecutive direct billing payment from a member’s bank account, then the member’s coverage will be suspended.
Result of two consecutive delinquent member payments:
- Benefits coverage is suspended.
- Reinstatement will be possible back to date of suspension with no gap in coverage and no evidence of insurability required. However, payment of delinquent amount plus a $25 OTIP administration fee for each delinquent payment and any additional premium amounts incurred will be required in full prior to reinstatement.
- If no payment received, member’s coverage will remain suspended.
- Direct Billing of Retroactive Amount if Initial Payroll Deduction Exceeds High Deduction Threshold
- If a payroll deduction exceeds the high deduction threshold as prescribed by the Trust (currently more than 1 month retroactive and more than $200), the amount will not be processed as a payroll deduction and will instead be invoiced and collected directly from the member.
- OTIP will send invoice directly to member requesting payment, with warning that failure to pay will result in suspension of current coverage.
- In the event of non-payment, OTIP will send a Reminder letter after 30 days of 1st invoice, with reminder of upcoming suspension.
- In the event of non-payment, suspension of coverage will occur after 30 days of Reminder letter.
- When coverage is suspended, the Administrative Agent will update the systems so that payroll deductions cease from the suspension date go forward
- Reinstatement will be possible back to date of suspension with no gap in coverage and no evidence of insurability required. However, payment of delinquent amount and any additional premium amounts incurred will be required in full prior to reinstatement.
- If the delinquent amount is paid and benefits are reinstated the Administrative Agent will update the systems so that payroll deductions are recommenced
- If no payment received, member will be suspended