Under the Ontario Workplace Safety and Insurance Act (WSIA), employers are generally legally required to continue paying their portion of your health, dental, and pension benefits for up to one year after your workplace injury, provided you continue paying your share. Terminating these benefits prematurely is a strict violation of provincial law.
Suffering a severe workplace injury is overwhelming enough without the added fear of losing your family’s medication coverage or dental plan. For many workers across Ontario, from Toronto to Sudbury, relying on employer-provided health insurance is critical for ongoing non-injury-related medical needs. It is very common to wonder if your boss can simply cut off your benefits the moment you transition onto Workplace Safety and Insurance Board (WSIB) benefits.
The short answer is no, they cannot do it immediately. The Workplace Safety and Insurance Act (WSIA) provides strong protections for injured workers. To ensure you are not left vulnerable, the law mandates a continuation period. However, this protection is not indefinite. Understanding exactly what your employer must pay, and for how long, is essential to protecting your financial health during recovery.
Understanding Employer Benefit Obligations in Ontario
Ontario law explicitly outlines which benefits must be maintained and the conditions under which they operate. This generally applies to multi-employer benefit plans and standard corporate group insurance policies.
| Type of Benefit | Employer Legal Obligation | Employee Responsibility |
|---|---|---|
| Extended Health & Dental | Must maintain the company’s premium contributions for up to 1 year. | Must continue paying any standard employee-side deductions. |
| Pension Contributions | Must continue matching or paying into the pension plan as usual for 1 year. | Must remit their usual pension contributions directly to the employer. |
| Life Insurance | Must keep the group life insurance policy active for the 1-year period. | Must provide post-dated cheques to cover the employee portion if not receiving a company paycheque. |
Step-by-Step Process for Maintaining Benefits on WSIB
Whether you work in a bustling Mississauga warehouse or an Ottawa office building, navigating the benefit continuation process requires active communication with your Human Resources department.
Step 1: Notifying Your Employer of Your Intent
As soon as your WSIB claim is approved, you must inform your employer that you intend to maintain your group benefits. 📝 Even though the law requires them to offer it, you must actively agree to continue paying your portion. Sending a formal email to HR ensures you have a written record of your request.
Step 2: Arranging Employee Contributions
Because you are receiving tax-free Loss of Earnings (LOE) payments directly from the WSIB, your employer is no longer issuing you a standard paycheque to deduct premiums from. You will generally need to provide post-dated cheques or arrange a monthly bank transfer to cover your portion of the benefit costs.
Step 3: Monitoring the One-Year Milestone
The WSIA legally binds the employer to maintain these benefits for exactly one year from the date of your injury. As the 12-month mark approaches, you should begin exploring private health insurance options or speaking with your union representative, as the employer is legally permitted to cease contributions on day 366.
Step 4: Reporting Non-Compliance to WSIB
If your employer abruptly cancels your benefits before the one-year mark, you must report this immediately to your WSIB case manager. The WSIB has the authority to investigate the employer, levy penalties, and order them to reinstate your coverage and reimburse you for any out-of-pocket medical costs incurred during the cancellation.
How Much Does it Cost in Ontario?
Enforcing your right to benefit continuation should not put you out of pocket.
- WSIB Enforcement: $0 CAD. Your WSIB case manager handles employer compliance at no cost to you.
- Employee Premiums: You must continue paying your usual share. If you usually paid $50 CAD per pay period for health coverage, you must keep remitting that exact amount.
- Lawyer Fees: If an employer terminates you maliciously while on WSIB to avoid paying benefits, you may need an employment lawyer. Most work on a contingency fee basis, taking 25% to 30% of a wrongful dismissal settlement.
How Long Does the Process Take?
Benefit continuation is immediate. There should be no lapse in your health or dental coverage when you transition to WSIB LOE benefits. If an employer unlawfully cancels your benefits, a WSIB investigation into the matter typically takes 3 to 6 weeks to resolve, during which time you should keep all receipts for prescription medications to seek reimbursement.
Frequently Asked Questions (FAQ)
What happens if I cannot afford my portion of the premiums?
If you fail to remit your share of the benefit premiums to your employer within a reasonable timeframe, the employer is legally allowed to cancel your coverage, even before the one-year mark.
Does my union collective agreement override the 1-year rule?
Yes, often in a positive way. Many unionized workplaces in Ontario have collective agreements that require the employer to maintain benefits for two years, or even indefinitely, while a worker is on WSIB.
Can the employer fire me at the one-year mark to cut benefits?
An employer cannot fire you simply because you are on WSIB. However, after the WSIA re-employment obligation period expires (usually one to two years depending on the company size), they may claim contract frustration. You should always consult a lawyer if terminated.
Will WSIB pay my medication costs if the employer plan stops?
WSIB will only pay for medications that are directly related to your workplace injury. They will not cover your regular household prescriptions, such as asthma inhalers or blood pressure medication, once your employer benefits expire.
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