If you have Peace of Mind (POM) benefits as part of your Blendable benefits plan, you may have coverage such as Life, Accidental Death & Dismemberment, Critical Illness, Short-Term Disability, or Long-Term Disability. These benefits are designed to help you and your family in the event of an unexpected injury, illness, or other tragedy.
This article explains:
- The limits on your Peace of Mind coverage
- How your coverage is calculated
- How to increase your coverage
Before you keep going, open your Benefits Booklet (in the Resources section of your Member Centre) so you can follow along.
Maximums on Peace of Mind coverage
There are two maximums you may see when you review your Benefits Booklet:
- Non-Evidence Benefit Maximum (proof of insurability required)
- Benefit Maximum, or Overall Maximum
Non-Evidence Maximum
The Non-Evidence Maximum (NEM, sometimes called Non-Evidence Limit (NEL), or “proof of insurability required”) is the maximum amount of coverage you can have without providing medical evidence (such as a health questionnaire or medical exam).
When you first become eligible for benefits, typically when you’re hired, after a waiting period, or when your plan begins, you’re enrolled in coverage up to the NEM with no questions asked. This simplifies the process and ensures you have quick access to protection.
You will not receive benefits greater than the NEM without applying and providing medical evidence.
Overall Maximum
The Overall Maximum is the maximum amount of coverage you can get through the group benefits plan, even with medical evidence.
How your coverage is calculated
The NEM and Overall Maximums are limits to coverage. They don’t mean that you automatically receive this amount of coverage. That depends on how your benefit is calculated.
For each benefit, your benefit booklet will include details about how the benefit is structured and calculated. This might be:
- A flat amount
- A multiple of salary
- A percentage of regular earnings
If your benefit is a multiple or percentage of your salary, do this calculation first.
- If the amount is less than the NEM, that’s your coverage.
- If the amount is more than the NEM, your coverage is capped at the NEM unless you apply for additional coverage.
Example 1
Salary: $60,000
Benefit: 1x Salary
NEM: $80,000
Coverage: $60,000
This person will receive a $60,000 benefit based on their salary, even though the NEM is $80,000.
Example 2
Salary: $100,000
Benefit: 1x Salary
NEM: $80,000
Coverage: $80,000
This person will receive an $80,000 benefit based on the NEM. If they want an amount equal to 1x their salary they will have to apply for additional coverage.
How to increase your coverage
If your benefits are limited by the NEM (like Example 2, above), you may be able to apply for more coverage. However:
- Your plan must have an overall maximum higher than the NEM
- You will typically need to complete a health questionnaire or provide other medical information.
- The insurer will assess your application and may:
- Approve the full requested amount
- Approve a lower amount
- Decline the additional coverage
To review your benefits and discuss increasing your coverage, just say hello@blendable.ca We’ll help you understand what’s available, and what the next steps are.