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Office of the Chief Human Resources Officer

Pensions and Benefits

Disability Insurance Plan

1. Introduction

The Disability Insurance (DI) Plan provides employees in the Public Service who are included in collective bargaining, and who are members of the plan, with benefits to replace a substantial portion of earnings lost as a result of extended periods of disability.

2. Authorities

2.1 Legislative and regulatory

Financial Administration Act;
Disability Insurance Directives made by TB 791772 of January 19, 1984, as amended from time to time.

2.2 Administration

2.2.1 General

The provisions of the DI Plan were developed and recommended to the government by the National Joint Council and were adopted by the Government following consultation with employee associations not represented on the National Joint Council. The same consultation process precedes various changes in the plan.

2.2.2 The insurer

The plan is underwritten and administered by SunLife Assurance Company of Canada, hereafter known as the insurer.

2.2.3 Advisory committee

Based on the recommendation of the National Joint Council, the Treasury Board Secretariat has established an Advisory Committee to the President of the Treasury Board on the Disability Insurance Plan. Under its terms of reference, the Committee has discretion to review individual cases with respect to applications and adjustment of claims.

2.2.4 Grievance procedure

In cases of alleged misinterpretation or misapplication of the Disability Insurance Directives by the employer, the grievance procedure, for all represented employees, within the meaning of the Public Service Staff Relations Act, will be in accordance with the National Joint Council By-Laws. For unrepresented employees the departmental grievance procedure applies.

The grievance procedure does not apply to decisions by the insurer with respect to claims adjudication or the evaluation of declarations of insurability submitted to the Insurer in connection with late applications for membership.

3. General provisions

3.1 Purpose of the plan

The DI Plan is intended to provide a benefit which will supplement other disability benefits available under such plans as the Public Service Superannuation Act, the Government Employees Compensation Act, the Canada Pension Plan and the Quebec Pension Plan, and will assure a reasonable level of income during periods of long-term disability.

In general, membership in the plan is compulsory. Membership is optional only for those employees who were eligible to join the plan on a voluntary basis immediately prior to the applicable effective date, but did not do so, and who have remained continuously employed since that date.

The cost of the plan is shared by the employee and by the government, as employer.

3.2 Membership

Membership in the plan is open to both full-time and part-time employees as defined below:

a full-time employee means a person who is assigned to work an average of at least thirty hours per week;
a part-time employee means a person who is assigned to work more than one-third of the normally-scheduled full-time hours for his or her occupational group, but less than thirty hours per week.

Appendix A to this chapter consolidates the few provisions of the DI Plan which apply exclusively to part-time members. Generally speaking, however, the coverage of part-time members is proportionate to the coverage of full-time members and the terms and conditions of participation are essentially the same for both groups.

3.3 Effective date

For the purposes of joining the plan, "effective date" means:

with respect to employees of any board, commission, corporation or other portion of the Public Service of Canada specified in Parts I and II of Schedule I of the Disability Insurance Directives, the date on which it is so specified;
with respect to seasonal employees, January 1, 1973;
with respect to part-time employees, September 1, 1982; and
with respect to all other employees, November 1, 1970.

4. Specific provisions

4.1 Eligibility

The plan applies to all eligible employees, including seasonal employees, in a department or other portion of the Public Service of Canada listed in Part I of Schedule I to the Public Service Staff Relations Act or Schedule I to the Disability Insurance Directives, except:

employees locally engaged outside Canada;
persons assigned to work one-third or less of the normally-scheduled full-time hours of work for their occupational groups;
persons to whom the Public Service Management Insurance Directives apply; and
employees who have attained the age of 64 years, 9 months.

For the purposes of the DI Plan, the definition of "seasonal employee" is the same as that for the Public Service Superannuation Act. Provisions of the plan as they apply to seasonal employees are contained in appendix B of this chapter.

4.2 Effective date of coverage and premiums

4.2.1 Compulsory coverage

For persons whose membership in the plan is compulsory, coverage is effective:

the day following the day on which the employee completes six months of continuous employment where the employee is appointed for a term of six months or less; or
the date of employment, where the employee is appointed for an indeterminate period or for a term of more than six months.

For such employees, premium deductions commence effective the first day of the month following the month in which coverage commenced.

In any case where an employee is on sick leave or on leave without pay for any reason on the date coverage would otherwise become effective, insurance is deferred until the employee returns to active duty, and premiums are deducted effective the first of the following month.

4.2.2 Optional coverage

Employees for whom coverage under the plan is optional and who did not apply to join the plan within two months of the applicable effective date may still become members, provided that they submit a declaration of personal insurability acceptable to the insurer.

For such employees, coverage will be effective on the first day of the month following the month in which their application, together with the declaration of personal insurability, is received by the appropriate personnel office. Although deductions will commence immediately, coverage in such cases will be subject to the approval of the insurer. If coverage is not approved, deductions so made will be refunded.

4.3 Cancellation of coverage

Membership in the plan cannot be cancelled by an employee who is still employed in an eligible category.

Coverage continues until age 65, but contributions cease at age 64 years, 9 months.

Effective April 1, 1982, those members of the DI Plan who become excluded are compulsorily transferred to the long-term disability (LTD) portion of the Public Service Management Insurance Plan (PSMIP), regardless of whether or not they apply for any other insurance under PSMIP. As the coverage provided under the two plans (DI and LTD) is virtually identical, this procedure does not alter the income protection enjoyed by those affected. The adjustment in premiums from DI to LTD should be made effective the first day of the month following the month the employee becomes excluded. LTD coverage becomes effective on the date of appointment to the excluded position.

4.4 Level of insurance and cost of coverage

Contributions and benefits are based on the employee's current annual salary, if that salary is a multiple of $250, or, if the salary is not a multiple of $250, they are based on the next highest multiple of $250 (the employee's "adjusted" salary). For a part-time employee as defined in paragraph 3 of this chapter, the "adjusted salary" is determined by reducing the full-time salary for his or her occupational group and level in proportion to the relationship his or her assigned hours of work bear to the normally-scheduled full-time hours of work for that group. If this amount is not a multiple of $250, it is rounded to the next highest multiple of $250.

Effective March 1, 1993, "insured salary" includes retroactive increases in salary when they are authorized after the date on which disability benefits became payable, provided the effective date of the increase is prior to the date of entitlement to benefits.

The current premium rate is 27¢ per month for each $250 of "adjusted" salary. Employees pay 4.05¢ and the remainder is paid by the employer.

4.5 Leave without pay

Coverage under the DI Plan continues during all periods of authorized leave without pay and premiums are collected on return to duty. However, where an employee has been granted leave to serve as a full-time paid official of a public service employee organization, or as a full-time paid official of a credit union, premiums are payable throughout the period of leave. Depending on the reasons for the leave without pay, the employee may be required to pay the employer's share of the premium in addition to his own. Only the employee's share of the premium is required from a member when the leave without pay is due to:

educational leave in respect of which the member would pay a single rate of contribution under the Public Service Superannuation Act;
illness or pregnancy;
paternal responsibilities for the purpose of caring for the member's child;
parental responsibilities for the purpose of caring for a child for which the member accepts custody for adoption;
personal needs for a period not exceeding three months when the leave was approved by the appropriate authority as leave for personal needs;
service with the Canadian Armed Forces;
service on a federal Royal Commission or a Board or Agency that is an agent of Her Majesty in Right of Canada but is not participating in the plan.

Subsections 3, 4 and 5 above only apply to those members who are entitled to leave without pay for family responsibilities related to paternity, adoption and other personal needs, as authorized by certain collective agreements and Treasury Board directives.

In all other leave-without-pay situations (including suspension), the full premium (employee's and employer's share) must be paid by the employee. Premiums are waived, however, during any period that an employee is on leave without pay on account of illness and is, or becomes, eligible for benefits under the plan.

In any case where an employee is paid for part of a month, whether or not the employee is on leave without pay for the remainder of the month, the employee's share of the premium is payable for that month, regardless of the reasons for leave.

4.6 Administrative errors affecting premium deductions

Where it is discovered that, as a result of administrative error, premium deductions are not being made from an employee's salary, the proper deductions should be commenced immediately and the paying office should also be instructed to pick up retroactive deductions back to January 1 of the year in which the error is discovered, or the date on which deductions should have commenced, whichever date is more recent. The retroactive deductions should be made over a period equal to the period for which collection is being made, that is by "doubling up" for as long as necessary.

4.7 Level of benefit and offset of other disability benefits

Where benefits are payable as a result of an event occurring after December 31, 1973, and are therefore taxable, the level of benefit is 70% of adjusted annual salary with total offset of other disability benefits paid in respect of the same disability, such as those payable under the Canada Pension Plan (CPP) or the Quebec Pension Plan (QPP), the Public Service Superannuation Act (PSSA) or provincial Workers' Compensation schemes.

Note: Effective July 1, 1982, benefits payable under the CPP or QPP to, or on behalf of, a disabled employee's dependent children are not offset from DI benefits.

Until January 1, 1974, when disability insurance benefits became subject to income tax, the amount of the disability insurance benefit was determined as 60% of the member's adjusted annual salary, with an offset of 85% of other disability benefits paid in respect of the same disability. Where benefits are payable as a result of an event occurring before January 1, 1974, this policy continues in force.

The "event" giving rise to the payment of benefits is, as a general rule, said to occur on the day that an employee, by reasons of his or her incapacity due to illness, is prevented from performing each and every duty of his or her regular occupation or employment, and consequently is absent from his or her usual place of work.

The net benefit (that is, the amount payable after other disability income has been deducted) will be subject to annual increase except that the annual increase of the net benefit will be limited to a maximum of 3%.

4.8 Waiver of premium

A member who becomes totally disabled may be entitled to the continuation of his or her insurance under the DI Plan without further premium payments providing he or she is, or becomes, eligible for benefits. The waiver will continue throughout periods of rehabilitative employment in the Public Service or undertaken in the course of a rehabilitation program approved by the Insurer. The member may apply through his personnel office.

If the application is approved, no further premiums will be required until age 65, when his or her insurance will terminate, as long as the member remains totally disabled in the opinion of the Insurer.

4.9 Definition of disability

Benefits are payable, for up to 24 months, in respect of any physical or mental disability which prevents an employee from performing the regular duties of his or her own occupation.

Benefits will continue to be paid, after the 24-month period referred to above, as long as the disabling condition prevents the employee from performing the duties of a commensurate occupation for which the employee is reasonably qualified by education, training or experience. For the purposes of the plan, a commensurate occupation is one providing earnings equal to at least two-thirds of the current rate of earnings for the employee's own regular occupation. In no case are benefits payable beyond age 65. It is important for personnel officers to remember, and to remind potential claimants, that in order to be eligible for any benefits under the DI Plan, a claimant must satisfy the insurer's medical consultants, on the basis of concrete medical evidence, that he or she is totally disabled within the exact meaning set out in the plan.

If, for example, an employee's retirement on grounds of disability has been approved by Health Canada, or if the employee has been ruled eligible for benefits under the Canada or Quebec Pension Plan, this may provide useful additional information to the insurer but does not alter the fact that the employee's condition must still be shown to be one of total disability as defined in the plan. Similarly, where an employee is involuntarily released for cause under Section 11(2)(f) of the Financial Administration Act (FAA) as amended by the Public Service Reform Act, the employee should be made to understand clearly that this does not mean he or she will automatically be eligible for disability insurance benefits. "Incapacity" under these circumstances can be quite different from "total disability" for the purposes of the DI Plan, and personnel officers and claimants should govern their expectations accordingly.

4.10 Pre-existing conditions

Under the provisions of the DI Plan, no benefits are payable in respect of a disability resulting from any illness or condition which existed at the commencement of an employee's insurance.

This limitation is waived once an employee has completed a period of 13 continuous weeks of active employment, while insured, with no absence due to illness, during which the employee did not receive any medically required services for the disabling condition. In applying this provision, the insurer will, at its discretion, disregard up to two days of absence due to illness, and assess the claim as though no absence had occurred.

This limitation is waived, in any event, after the employee has been a member of the plan for 12 months, provided that the disability does not commence during that time.

4.11 Commencement of benefits

Disability insurance benefits become payable when all accumulated sick leave credits are exhausted or injury-on-duty leave terminates. If sick leave or injury-on-duty leave granted does not extend to 13 weeks, benefits become payable at the end of 13 weeks from the onset of the disability.

If an employee retires voluntarily before exhausting all accumulated sick leave credits, the unused sick leave credits will still be counted in determining the date DI benefits begin.

4.12 Earnings from rehabilitation programs

While in receipt of benefits, an employee may engage in a Rehabilitation Program, which means a program of vocational training or a period of work for the purpose of rehabilitation, either of which is approved in writing by the Insurer. Depending on the circumstances, the employee may be able to engage is such a program for up to 24 months, from the end of the elimination period, without losing his/her qualification for benefits. Earnings from an approved rehabilitation program will not be offset from DI benefits, unless the person's total income would otherwise exceed 100 per cent of his pre-disability income. Other than under these circumstances, any earnings received by a DI recipient will be offset from DI benefits.

5. General information

5.1 Claims

The Insurer wishes to make prompt and proper payment of any benefits to which an employee is entitled. If an employee becomes disabled and there is reason to believe that the disability will last long enough to qualify for benefits, personnel officers should provide the employee with the appropriate Claim Forms. The personnel officer should forward the completed Claim Form DSS 2043 to Superannuation Branch for processing. Part A (Employee Statement) and Part B (Attending Physician's Statement) of Form DSS 2044 should be submitted according to the instructions on the form.

Employees should also be advised that the Insurer has the right to request additional medical information from the physicians, or to arrange for medical examinations, of any one claiming or receiving benefits, by independent specialists as often as may be reasonably required. In addition to the physician's reports, the Insurer frequently uses independent medical consultants to provide the necessary supplementary objective medical evidence. This is the only objective way the Insurer has to assess, or monitor the course of a disability, to ensure that benefits are not paid to persons who are not eligible or who have recovered to the point where they no longer qualify.

Departmental personnel should provide employees who intend to submit a claim with a copy of the latest Disability Insurance (DI) booklet, issued by the Treasury Board, which outlines the terms of the plan, along with a copy of "Your Disability Insurance Coverage", issued by Government Services Canada which provides specific details on the claims process.

Personnel officers may find the details on how to complete the claim form and the related process in Chapter 3, Binder 2 of Government Services Canada's publication, Insurance Administration Manual.

5.2 SunLife departmental review committee

In some instances, the medical evidence initially submitted with a claim is insufficient to clearly establish that the claimant is disabled within the terms of the insurance contract. When this happens, SunLife writes to the claimant declining payment of benefits and indicating that he or she may wish to request the attending physician(s) to provide additional detailed medical information to substantiate the claim. Upon receipt, this new evidence is reviewed and the claim is either approved or declined. If the decision is that benefits still cannot be approved, the whole claim file is referred to the SunLife Departmental Review Committee for reconsideration by Senior Claims Analysts and medical consultants. If payment of benefits is then approved, a cheque is issued as soon as possible. If the claim still cannot be approved, a letter declining payment of benefits is sent to the claimant without delay.

5.3 Advisory committee

The Advisory Committee to the President of the Treasury Board on the Disability Insurance Plan was established to review and make recommendations on certain cases forwarded to it by the insurer, by departments and by employee associations.

It should be emphasized that the existence of the committee does not lessen the responsibility of the employee, the personnel sections of departments and agencies and employee associations to ensure that all possible remedies for individual problem cases are investigated. Problem cases should be submitted to the Committee only when other approaches have failed to provide solutions. In addition, all reasonable requirements of the insurer for information or medical evidence necessary for the adjudication of claims or applications for membership in the plan should be complied with prior to submission to the Advisory Committee.

Particulars of the case may be outlined in a letter accompanied with the claimant's Authorization for Release of Information and a recommendation by the submitting party, to:

The Secretary
Advisory Committee on Disability Insurance
Human Resources Policy Branch
Treasury Board Secretariat
Ottawa, Ontario
K1A 0R5

5.4 Booklet and audiocassettes

A comprehensive description of the general provisions of the plan is given in the Disability Insurance Plan booklet. A copy of this booklet should be provided to each employee immediately upon becoming eligible for membership in the plan. Booklets may be purchased from:

Government Services Canada
Capital Regional Supply Centre
1010 Somerset Street West
Ottawa, Ontario
K1A 0T4

(Stock Item Supply Catalogue: 7610-21-885-3408 / Catalogue number: BT43-93/1991)

The DI booklet is also available on audiocassettes for visually-impaired employees. These may be borrowed by making a request through the departmental library's interlibrary loan service. Upon receipt of a request, the departmental library should send an interlibrary loan request via ENVOY to: Library Services, Department of Finance and Treasury Board Secretariat of Canada, ILL.OFF, telephone 996-5493.

5.5 Administrative procedures

Specific information on administrative procedures under the plan, in relation to the submission of applications and claims, in particular, and the responsibilities of personnel offices, in general, is contained in Binder 2 of the Insurance Administration Manual issued by Government Services Canada.

Special and Change Bulletins are issued from time to time by Government Services Canada.

6. Enquiries

Enquiries or suggestions related to policy should be directed to:

Income Protection Policies Group
Pensions and Benefits Division
Human Resources Policy Branch
Treasury Board Secretariat

Appendix A - Disability Insurance for Part-Time Employees

1. Purpose

The purpose of this Appendix is to consolidate the basic terms of participation in the Disability Insurance (DI) Plan for eligible part-time employees.

2. Policy

2.1 Overview

Effective September 1, 1982, all part-time employees not excluded from the collective bargaining process who are assigned to work more than one-third of the normally-scheduled full-time hours of work for their occupational groups and who meet all the normal membership requirements of the DI Plan are eligible to participate in the plan. The coverage of part-time employees who join the plan is proportionate to the coverage of full-time members, and the terms and conditions of participation are, apart from the few exceptions noted below, essentially the same for both groups.

The terms of participation for part-time employees under the DI Plan are consistent with those applied to excluded part-time employees under the Public Service Management Insurance Plan (PSMIP).

2.2 Eligibility

A part-time employee's assigned hours of work, and not the actual hours worked, determine his or her eligibility and level of insurance under the plan. Therefore, it is essential that departments ensure that the hours of work formally assigned to a part-time employee are as close as possible to the current average of the hours he or she actually works. Whatever period is chosen to average the actual hours of work, it should be, in each case, as fair and reasonable once given the nature of the work and the normality of the conditions prevailing during that time. If a part-time employee belongs to an occupational group for which there are no normally-scheduled full-time hours of work, departments may use as the standard full-time hours of work most common within the department or to the occupational groups where employees are engaged in work of a similar nature.

A part-time employee assigned to work one-third or less of the normally-scheduled full-time hours of work for his or her occupational group is not eligible to join the plan.

A part-time employee assigned to work thirty or more hours a week, that is, a person eligible to contribute to the Public Service Superannuation Account, is eligible to participate in the plan on exactly the same basis as a full-time employee.

A part-time employee assigned to work more than one-third of the normally-scheduled full-time hours of work for his or her occupational group, but less than thirty, is eligible to participate in the plan under the special terms and conditions applicable to "eligible part-time employees". The inclusion of this group of employees makes the definition of an eligible employee for the purposes of the plan fully consistent with the definitions of "employee" in the Public Service Staff Relations Act and the Public Service Employment Act.

Of course, those part-time employees described in the above paragraph must also satisfy the normal conditions concerning duration of employment as set out in section 4 of this chapter, that is, those conditions applied to full-time employees, in order to be eligible to join. One example of the application of these conditions is that part-time employees appointed for terms of six months or less will only become eligible upon the completion of six months of continuous employment.

2.3 Optional membership

All part-time employees who satisfied the conditions of membership in the plan as part-time employees on August 31, 1982, must apply if they wish to join. Applications received by personnel offices on or after December 1, 1982, must be accompanied by a completed declaration of personnel insurability.

If a part-time employee in this situation was previously eligible as a full-time employee to join the DI Plan or the LTD portion of the PSMIP on an optional basis, chose not to do so, has been continuously employed in the Public service ever since, and now chooses to apply for DI membership, his or her application will be considered a late one, and evidence of insurability satisfactory to the insurer will be required before the application is accepted.

2.4 Compulsory membership

For all part-time employees who become eligible to join the DI Plan on or after September 1, 1982, membership is compulsory with effect from the date they first become eligible.

For part-time employees on strength in the Public Service on August 31, 1982, who were not eligible to join the DI Plan on that date, because, for example, they were in the middle of a term of six months' duration or less, or were assigned to work one-third or less of the normally-scheduled full-time hours for their occupational group, membership is compulsory from the date they first become eligible. If they were previously eligible as full-time employees to join the DI Plan or the LTD portion of the PSMIP, chose not to do so, and were continuously employed in the Public Service until becoming eligible once again as part-time employees, they must apply if they now wish to join the DI Plan in accordance with the procedure described in the last paragraph of the preceding subsection.

2.5 Premiums

The current premium rate is 27¢ per month for each $250 of "adjusted" salary. Employees pay 4.05¢ and the remainder is paid by the employer.

2.6 Level of coverage

A part-time employee's contributions and benefits are based on his or her "adjusted salary". A part-time employee's adjusted salary is determined by reducing the full-time salary for the employee's group and level in proportion to the relationship his or her assigned hours of work bear to the normally-scheduled full-time hours of work for that group. If this amount is not a multiple of $250, it is rounded to the next highest multiple of $250.

2.7 Effective date of coverage and premium deductions

For a part-time employee compulsorily enroled in the plan, coverage is effective on the day the employee first becomes eligible to join the plan, and premiums are deducted effective the first day of the following month.

For a part-time employee with an option who applies to join the plan within three months of September 1, 1982, coverage is effective the date the employee's application is received by the personnel office and premiums are deducted effective the first of the following month.

For a part-time employee with an option who submits an application after November 30, 1982, premiums will be deducted effective the first of the month following its receipt by the personnel office, and coverage is effective that same day, subject, of course, to acceptance by the Insurer.

2.8 Movement from full-time to part-time employment

When a member of the DI Plan who was assigned to work thirty or more hours a week is subsequently assigned to work more than a third of regular full-time hours but less than thirty hours per week, the terms of the member's participation in the plan will be automatically adjusted to those applicable to eligible part-time employees, and vice versa when the movement is from part-time to full-time employment.

2.9 Other conditions

Part-time employees participate in the DI Plan on the same basis as full-time employees for the purposes of all provisions of the plan, apart from the few exceptions noted above. For example, a part-time employee who works each and every hour he or she is assigned to work will satisfy the "actively at work" requirements of the plan in respect of the thirteen-week qualifying period related to pre-existing conditions, and in respect of the intervening period between successive period of disability.

3. Special administrative procedures

The administrative procedures related to the enrolment of part-time employees in the DI Plan and the processing of their claim forms are outlined in Disability Insurance Administrative Circulars issued by the Compensation Services Branch, Government Services Canada.

Appendix B - Disability Insurance for Seasonal Employees

1. Introduction

Since January 1, 1973, the provisions of the Disability Insurance Plan apply to seasonal employees who have completed a qualifying period of six months of continuous paid employment during one working season. (See paragraph 2.3)

In general, participation is compulsory for all seasonal employees who have completed the qualifying period. With the exception noted in paragraph 2.2 below, the participation is optional only for persons who had the status of seasonal employee on December 31, 1972, and whose employment has not been terminated since that date.

The majority of the provisions of the plan apply to all members, regardless of their status as employees. The following outline describes only those provisions referring specifically to seasonal employees.

2. Seasonal defined

2.1 Definition

For the purposes of the DI Plan, a seasonal employee is one who:

is appointed in accordance with the Public Service Employment Act as a seasonal employee, or
is appointed to perform duties for a period of less than 12 months in successive years of employment, but does not include a person who is appointed as a teacher at a school established under
the Indian Act, or
an ordinance enacted by the Commissioner in Council of the Northwest Territories.

This definition is substantially the same as the definition of a seasonal employee for the purposes of the Public Service Superannuation Act.

2.2 Exception to compulsory coverage

Persons engaged after December 31, 1972, as seasonal employees who, prior to such engagement, were employed in the Public Service continuously since October 31, 1970, and who were eligible on November 1, 1970, to join the plan but did not do so, are not required to join the plan. They may, however, join the plan, and provided they apply within two months from the date they become seasonal employees, they may do so without a declaration of personal insurability.

2.3 Effective date of coverage and premiums deductions

In the case of those seasonal employees for whom membership is compulsory, coverage is effective on the day following the day on which the employee completes the qualifying period of six months' continuous employment. Deductions will commence effective the first day of the following month. Although this qualifying period may include employment other than as a seasonal employee, periods on off-season status are not included in the qualifying period. It should be noted that the provisions of the DI Plan in this regard are not the same as the corresponding provisions of the Public Service Superannuation Act.

2.4 Period of insurance

Insurance under the plan commences on the effective date of coverage and is mandatory during all subsequent period of active employment. It should be emphasized that seasonal employees do not contribute to and are not insured under the DI Plan while not actively employed, that is, during their off-season. Coverage under the plan, for seasonal employees, is in effect only while the employee is on active duty, including any periods of leave of absence during the on-season. Coverage ceases on the last day on which the employee is on active duty and will begin again on the first day of the employee's return to duty in subsequent seasons.

2.5 Level of insurance and cost of coverage

For the purposes of the DI Plan, the insured ("adjusted") salary of a seasonal employee will be an amount equal to 12 times the employee's monthly salary, if that amount is a multiple of $250, or the next highest multiple of $250, if it is not.

The premium payable by a seasonal employee, during periods of insurance, will be based on the "adjusted" salary and on the premium rate applicable to other members of the plan.

A full contribution is required in respect of employment for a part only of the final month of a season, but no contribution is required in respect of employment for a part only of the first month of the subsequent season.

2.6 Benefits

Seasonal employees who become disabled during their period of insurance will receive benefits to the extent and for the plan, subject to the conditions of the plan. In all cases, benefits are payable on a full year's basis and are payable during the full period of disability until the earlier of age 65 or the termination of the disability.

2.7 Pre-existing conditions

The provisions of the DI Plan include a limitation on the payment of benefits in respect of a disability resulting from any illness or condition which existed at the commencement of the employee's insurance.

This limitation is waived once an employee has completed a period of 13 continuous weeks of active employment, while insured, with no absences due to illness, during which the employee did not receive any medically required services for the disabling condition. In applying this provision, the Insurer may, at its discretion disregard up to two days of absence due to illness, and assess the claim as though no absence had occurred. This limitation is waived, in any event, after the employee has been a member of the plan for 12 consecutive months of employment, provided that the disability does not commence during that time.

For seasonal employees, these 13 continuous weeks must be served during one period of on-season employment, and cannot be met while on off-season status. The 12 months of membership in the plan refers, for seasonal employees, to 12 months of actual coverage, although separate but consecutive periods of active on-season employment may be counted as being one period of 12 consecutive months.

2.8 Elimination period

Benefits become payable either after 13 weeks of disability, or after the expiration of the member's paid sick leave and/or injury-on-duty leave, whichever is later. This elimination period may extend into the period where the member is considered as being on off-season status, and benefits will still be payable after the expiry of the elimination period.

Appendix C - Directives Respecting the Disability Insurance Plan Established for Certain Persons Employed in the Public Service

Short title

1. These Directives may be cited as the Disability Insurance Directives.

Interpretation

2.1 In these Directives,

company

(compagnie) - means the Sun Life Assurance Company of Canada;

department

(ministère) - has the same meaning as in the Public Service Superannuation Regulations;

deputy head

(administrateur général) - means the deputy head of a department and includes the chairperson, president or other chief officer of a department and the Commissioner of the Royal Canadian Mounted Police;

designated officer

(agent désigné) - means the person designated by a deputy head pursuant to section 4;

effective date

(date d'entrée en vigueur) - for joining the plan means

with respect to employees of any board, commission, corporation or other portion of the Public Service of Canada specified in Parts I and II of Schedule I to these Directives, the date on which it is so specified;
with respect to seasonal employees, January 1, 1973;
with respect to part-time employees, September 1, 1982; and
with respect to any other employees, November 1, 1970. T.B. 783788, July 8, 1982;

employee

(employé) - means a person who holds an office or position in or under any department or other portion of the Public Service of Canada specified from time to time in Part I of Schedule I to the Public Service Staff Relations Act and includes a person who holds an office or position in or under a board, commission, corporation or other portion of the Public Service of Canada specified in Parts I and II of Schedule I to these Directives;

Minister

(ministre )- means the President of the Treasury Board;

part-time employee

(employé à temps partiel) - means a person who is not required pursuant to paragraph 4(1)(c) of the Public Service Superannuation Act to contribute to the account established by that Act and known as the Superannuation Account;

pay agency

(organisme de paye) - means Government Services Canada or the agency, office or person that is charged with the duty, or that performs the function, of paying salary to an employee;

plan

(régime) - means the plan established by the policy;

policy

(police) - means the Group Disability Insurance Policy issued to Her Majesty in right of Canada by the Company for the benefit of employees;

salary

(traitement)- has the same meaning as in Part II of the Public Service Superannuation Act; except that for a part-time employee it means the full-time salary for the employee's occupational group and level reduced in proportion to the relationship the employee's assigned hours of work bear to the normally scheduled full-time hours of work for that group. T.B. 783788, July 8, 1982.

seasonal employee

(employé saisonnier) - means a person who

is appointed in accordance with the Public Service Employment Act as a seasonal employee, or
is appointed to perform duties for a period of less than twelve months in successive years of employment, but does not include a person who is appointed as a teacher at a school established under
the Indian Act, or
an ordinance of the Northwest Territories.

2.2 In calculating the contributions of an employee and the amounts payable by the Minister under these Directives,

the salary of an employee, if it is not a multiple of $250, shall be deemed to be the amount above the employee's salary that is the nearest multiple of $250; and
where a calculation results in a fraction of a cent, that fraction shall be rounded to the nearest cent, with fractions of one-half cent being taken as one cent.

2.3 These Directives do not apply to:

an employee locally engaged outside Canada;
a person assigned to work one-third, or less than one-third, of the normally scheduled hours of work for a full-time employee in the same occupational group; or
a person to whom the Public Service Management Insurance Directives apply. T.B. 783788, July 8, 1982.

Eligibility of employees

3.1 Subject to subsections (3) to (8), every person who is an employee on the day immediately preceding the effective date is eligible to join the plan if the employee

has been employed in the Public Service of Canada continuously from May 1, 1970; or
became employed in the Public Service of Canada after May 1, 1970,

after having been continuously employed in the Public Service of Canada for a period of at least six months, or
during pleasure, or for a term of more than six months' duration, and has been an employee continuously thereafter.

3.2 Subject to subsections (3) to (8), a person who becomes an employee after the effective date is required to join the plan

on the day following the day on which the employee will have been continuously employed in the Public Service of Canada, for a period of at least six months, or
on the day on which the person becomes employed in the Public Service of Canada during pleasure or for a term of more than six months' duration,

whichever day is the earlier.

3.3 A person described in paragraph 2(3)(b) who subsequently becomes eligible to join the plan is required to do so on the day he or she becomes eligible. T.B. 783788, July 8, 1982.

3.4 For the purpose of subsections (5) to (8), "qualifying period" in respect of a seasonal employee is a continuous six-month period of employment of the employee that

took place
1. during one of the employee's working seasons,
2. during employment in the Public Service of Canada otherwise than as a seasonal employee and otherwise than as an employee described in subsection 2(3), or
3. partly during the individual's working season and partly during the employment described in paragraph (ii); and
commenced after June 30, 1971 and since the person last commenced employment in the Public Service of Canada otherwise than as an employee described in subsection 2(3).

3.5 A seasonal employee who is an employee on the day immediately preceding the effective date and who

at any time after the day on which the employee last commenced employment in the Public Service of Canada otherwise than as an employee described in subsection 2(3), was eligible to join the plan pursuant to subsection (1), or
has completed the qualifying period before the effective date,

is eligible to join the plan
on the effective date if that date occurs during the employee's working season; or
on the first day of the employee's working season next following the effective date, if the effective date does not occur during the employee's working season.

3.6 A seasonal employee who is an employee on the day immediately preceding the effective date and who

has not been eligible to join the plan pursuant to subsection (1) since the day on which he or she last commenced employment in the Public Service of Canada otherwise than as an employee described in subsection 2(3), and
has not completed the qualifying period before the effective date,

is eligible to join the plan on the day on which the qualifying period is completed.

3.7 A seasonal employee who is not an employee on the day immediately preceding the effective date is required to join the plan

on the day following the day on which the qualifying period is completed; or
on the first day of the employee's working season that commences after the qualifying period is completed, if the day following the day on which the qualifying period is completed does not occur during the employee's working season.

3.8 Every person who is employed with an employer specified in Part III of Schedule I to these Directives, who had joined the plan immediately prior to such employment and who is a contributor under the Public Service Superannuation Act is eligible to continue to be a member of the plan, and on so continuing, is deemed to be an employee for purposes of these Directives.

Designated officer

4. Each deputy head shall designate an officer of the department to perform the functions described in section 5.

Duties of the designated officer

5.1 The designated officer of a department is responsible for determining whether an employee is required to join the plan or whether an employee who applies to join the plan is eligible to do so.

5.2 Where, in the opinion of the designated officer, an employee who applies to join the plan is eligible to do so, the designated officer shall so certify on the application.

5.3 The designated officer of a department is responsible for notifying pay agencies when contributions are to be reserved from the salary of an employee pursuant to section 8 or section 9.

Effective date of joining the plan

6. Where a designated officer has, pursuant to section 5, certified on an application that the applicant is eligible to join the plan, that applicant shall be deemed to have joined the plan

where the designated officer received the application before the effective date, on the effective date; or
where the designated officer received the application after the effective date, on the first day of the month following the month in which the designated officer received the application and, where required by section 7, a statement of the applicant's health acceptable to the company.

Statement of health

7. Every employee who is eligible to join the plan,

other than a person required to join pursuant to section 3, and
who applies to join the plan on a date that is more than two months from the date on which the employee became eligible to join it,

shall, when required by the company pursuant to the policy, submit a statement of health acceptable to the company.

Contributions

8.1 Subject to section 9, every employee who joins the plan pursuant to section 3 shall contribute by reservation from his or her salary a monthly contribution determined in the manner set out in Column I of schedule II commencing:

with respect to an employee who is required to join the plan pursuant to subsection 3(2), 3(3), or 3(7), on the first day of the month following the month in which the employee is required to join the plan, or
in the case of any other employee, the date on which the employee is deemed to have joined the plan.

8.2 Notwithstanding subsection (1), where a designated officer discovers that, due to an administrative error or oversight, an employee who has joined the plan has not made the contributions required pursuant to subsection (1), the employee shall be required to make such contributions from:

the first day of the year in which the oversight or error was discovered by the designated officer, or
the date on which the employee joined the plan, whichever is later.

8.3 The contributions payable by an employee pursuant to subsection (2) shall be paid by reservation of equal amounts from salary for a period equal to the period for which such contributions are required.

Leave without pay

9.1 Subject to subsection (2) to (5), an employee who has joined the plan and who is absent on leave without pay shall contribute a monthly contribution equal to the total of the contributions determined in the manner set out in Columns I and II of schedule II.

9.2 Where

an employee receives salary for a portion of any month while absent on leave, or
a deputy head certifies to the pay agency that an employee is absent on leave without pay
1. for the purpose of undergoing training or instruction to the advantage of Her Majesty,
2. because of illness, disability or maternity reasons,
3. for the purpose of serving on a commission established under the Inquiries Act or a federal board or agency that is an agent of Her Majesty in right of Canada,
4. for the purpose of serving with the Canadian Forces,
5. because of paternal responsibilities for the purpose of caring for the member's child,
6. because of parental responsibilities for the purpose of caring for a child for which the member accepts custody for adoption, or
7. because of personal needs for a period not exceeding three months and the leave was approved by the appropriate authority as leave for personal needs,

the amount of the contributions required to be paid by the employee shall be the amount determined in the manner set out in Column I of Schedule II.

9.3 The contributions required to be paid by an employee described in subsection (1) shall be paid by reservation of equal amounts from salary for a period equal to the period during which the employee was absent on leave without pay, commencing upon the expiration of the leave of absence.

9.4 Notwithstanding subsection (3), where an employee is absent on leave without pay and

is serving as a full-time paid official of a public service employee organization, or
is serving as a full-time paid official of a credit union,

the employee shall pay the contributions required to be paid at such time and in such manner during the course of leave of absence as the Minister may prescribe.

9.5 An employee who becomes entitled to the disability benefits prescribed under the policy while absent on leave without pay is not required to make the contributions referred to in subsection (1) or (2) in respect of any period of leave without pay during which the employee is in receipt of such benefits or during the qualifying period for such benefits.

Payments to the company

10. Subject to section 11, the Minister shall pay monthly to the company in respect of each month during which the plan is in effect,

an amount equal to the amount determined by the Minister in the manner set out in Column II of Schedule II, to be the share of the Government of Canada of the premiums to be paid under the plan for that month in respect of its employees; and
an amount equal to the amount contributed pursuant to sections 8 and 9 by those employees.

11.1 The deputy head of a board, commission, corporation or other portion of the Public Service of Canada specified in Part II of Schedule I, or an employer specified in Part III of Schedule I, shall pay monthly to the company in respect of every month during which the plan is in effect,

an amount equal to the amount determined in the manner set out in Column II of Schedule II, to be the share of the said board, commission, corporation or other portion of the Public Service of Canada, as the case may be, of the premiums to be paid under the plan for that month in respect of its employees; and
an amount equal to the amount contributed pursuant to sections 8 and 9 by those employees.

Insurance

12. Every employee who pays the contributions required by these Directives is, subject to the terms and conditions of the policy, entitled to the disability benefits provided by the policy.

Schedule I

Part I

Atomic Energy Control Board
Communications Security Establishment
House of Commons
Indian Oil and Gas Canada
Library of Parliament
Medical Research Council
National Film Board
Natural Sciences and Engineering Research Council
National Research Council
Senate of Canada
Social Sciences and Humanities Research Council of Canada

Part II

Atlantic Pilotage Authority
Canada Deposit Insurance Corporation
Canada Post Corporation
Canadian Advisory Council on the Status of Women
Canadian Centre for Occupational Health and Safety
Canadian Commercial Corporation
Canadian Film Development Corporation
Canadian Museum of Civilization
Canadian Museum of Nature
Canadian Security Intelligence Service
Cape Breton Development Corporation (employees at Point Edward Industrial and Marine Park)
Farm Credit Corporation
Government of the Northwest Territories
Government of the Yukon Territory
Halifax Port Corporation
Heritage Canada, Staff of
International Center for Ocean Development
International Development Research Centre
Laurentian Pilotage Authority
Montreal Port Corporation
National Battlefields Commisssion
National Gallery of Canada
National Museums of Science and Technology
Northern Pipeline Agency
Office of the Correctional Investigator
Pacific Pilotage Authority
Parliamentary Centre for Foreign Affairs and Foreign Trade
Prince Rupert Port Corporation
Quebec Port Corporation
Royal Canadian Mint
Standards Council of Canada
Vancouver Port Corporation

Part III

Victoria Hospital
Camp Hill Hospital
University of Alberta Hospital
Deer Lodge Hospital

Schedule II

Monthly Rates

Employee Status	Column I Employee	Column II Government or additional
Every member	$0.0405 for each $250 of salary	$0.2295 for each $250 of salary of each member.