Dependents

Dependents

Dependents of an insured (employee or retiree) may benefit from insurance coverage when they are recognized by MÉDIC Construction. To have them recognized, insureds must declare their dependents and provide the required supporting documents. Insureds must also inform the Commission de la construction du Québec (CCQ) of any change in status of their dependents. They may modify their file for this purpose in MÉDIC online, at sel.ccq.org, or send the required form by mail with the documentation required.

The dependents of an employee or retiree are:

The spouse

  • Dependent children
  • Spouse’s children who are dependents of the employee
  • An insured who disagrees with a decision by the CCQ regarding recognition of a dependent may contest it. To do this, the insured must contact Customer Services, which will send him or her appropriate form.

Spouse

For the purposes of the insurance plans, a spouse is a person of the opposite or same sex who meets one of the following conditions:

  • Is married to or in a civil union with the insured

    OR
  • Has been living in a conjugal relationship with the insured for at least 12 months

    OR
  • Is living in a conjugal relationship with the insured and one of the following situations occurs:
    • At least one child is born of their union
    • They have jointly adopted at least one child while living together in a conjugal relationship 
    • One of them has adopted at least one child who is the child of the other while living together in a conjugal relationship
    • They have, in the past, lived together in a conjugal relationship for at least 12 consecutive months
Situation  Documents to provide 
Married or in a civil union Marriage or civil union certificate, or another equivalent document 
Living in a conjugal relationship for more than 12 months

2 proofs of residence in the spouse’s name:

  • 1 recent proof (dated within 3 months)
  • 1 proof dated 12 months before the recent proof provided

The dates of the 2 documents must cover a period of at least 12 months.

Living in a conjugal relationship for less than 12 months, but have a child in common

2 proofs of residence in the spouse’s name: 

  • 1 recent proof (dated within 3 months)
  • 1 proof dating from the month corresponding to the beginning of the conjugal relationship 

A copy of your child’s birth certificate or any other official proof of birth or adoption giving the names of 
both parents

Returning to a conjugal relationship after having previously lived together for more than 12 months

2 proofs of residence in the spouse’s name: 

  • 1 recent proof (dated within 3 months)
  • 1 proof dating from the month corresponding to the beginning of the conjugal relationship 

And, if the spouse has never been recognized as a dependent of the insured, 2 supplementary proofs of residence are required covering a period of at least 12 months and attesting that they have lived together in the past. 

Important: To complete the spouse’s file, the insured must fill out the form Declaration of Spouse’s Insurance Benefits and send it to the CCQ, or do it directly in MÉDIC online, at sel.ccq.org 

If the insured and the spouse are living together, with or without children, the acceptable documentation must fulfil the following three conditions:

  1. The document must contain the date of issuance, the last and first names of the spouse, and his or her civic address.
  2. The spouse’s address must correspond to the insured’s address in the CCQ’s register on the date of the document If the insured’s address in the CCQ’s register does not correspond to the spouse’s, the insured must also provide two proofs of residence, addressed to him or her, on the same dates as those provided by his or her spouse to prove that they are living together.
  3. The document must come from an official organization or a recognized company:

    Utilities bill (phone, cell phone, cable, natural gas, etc.), tax statement, statement from a governmental agency, bank statement, history of previous addresses available free of charge at a Société de l’assurance automobile du Québec (SAAQ) counter.

    Note: Leases, tax returns and invoices for purchases of medications are not accepted. 

A person is no longer the spouse of the insured when, following the failure of their union, the spouse has ceased living with and has not been living with the insured person for over 90 days or, if applicable, since the date on which another person became the spouse of the insured person. However, for the purposes of life insurance coverage, a person who ceases to live with the insured following the failure of their union is no longer the spouse of this insured.

In order to comply with the Québec Supplemental Pension Plans Act, the definition of a spouse set out in the retirement plan differs from the definition given above for insurance purposes.

Dependent child

A dependent child is defined as a spouseless child of the insured or of the insured’s spouse, most of whose support is provided by the insured, and who:

  • Is under 18 years of age

    OR
  • Is aged under 26 years of age and is a full-time student at an educational institution recognized by the ministère de l’Éducation et de l’Enseignement supérieur (MEES)

    OR
  • Became disabled while he or she fulfilled one of the two above conditions and has remained continually disabled since.

A child over whom the insured exercises parental authority is considered the insured’s child.

A child for whom the insured is designated the legal guardian may be eligible until age 18. However, the insured must provide the CCQ with a photocopy of official documents, such as a court decision, attesting that he or she is the child’s legal guardian.

It is no longer required to present a photocopy of a birth certificate to register a dependent child. However, the insured must keep this document, as MÉDIC Construction may request it during a random verification.

A child who reaches the age of 18 years between January 1 and August 31 remains a dependent child until August 31. A child who reaches the age of 18 between September 1 and December 31 remains a dependent child until January 31 of the following year.

When a dependent child reaches age 18, a certificate of school attendance may be required. 

Note: Even if a child is recognized as a dependent, some treatments may not be covered. For example, dental care is reimbursable only for dependent children under 21 years of age.

  • Declaration of Dependents
  • Certification of School Attendance
  • Declaration of Spouse’s Insurance Coverage

The dependents of an insured (employee or retiree) must be registered with the Commission de la construction du Québec (CCQ) so that expenditures made in their name can be reimbursed.

The first time that employees are insured by MÉDIC Construction, they automatically receive the forms required to declare their dependents. Subsequently, insureds must inform the CCQ’s Customer Services if they have a new spouse or new child. They must also notify of any change in status of their dependents. For example, if a dependent child gets married, that child is no longer covered by MÉDIC Construction. Similarly, following a  separation the ex-spouse of the insured is no longer covered by MÉDIC Construction. If claims were paid for expenditures made after the coverage ended, the insured will have to reimburse them.

Employees must use the form Declaration or Updating of Dependents to apply to the CCQ for recognition of their dependents. The documentation that must be provided is listed on the form. Insureds may also fill out or modify their file in MÉDIC online at sel.ccq.org.

Insureds must also declare if their spouse is covered by insurance other than MÉDIC Construction.

When the spouse of an insured is recognized, that person’s name is recorded on the insured’s MÉDIC Construction card. A card is also produced for the spouse. These cards are automatically sent by mail to the insured. No MÉDIC Construction card is produced for dependent children.

If there is a random verification of the file, services may be interrupted while the verification is taking place.

The form Certificate of School Attendance may be required for each semester in order to have recognized as a dependent child a child aged at least 18 and under 26 years who is studying full time and attends an educational institution recognized by the ministère de l’Éducation et de l’Enseignement supérieur (MEES).

If the child is aged:  Documents to provide: 
18 to 21 years old  The certificate of school attendance is optional.
However, we may ask for it during a random verification of the file.
22 to 26 years old

The certificate of school attendance must be provided twice a year. This document may also be transmitted in the CCQ’s online services, in the MÉDIC online section.

In general, depending on the beginning of the semester concerned: 

  • The certificate provided for the winter semester allows the child to be recognized from January to August
  • The certificate provided for the fall semester allows the child to be recognized from September to January.
If a dependent child is 18 years old when first registered in the insured’s file, a copy of the birth certificate will be required as well as the certificate of school attendance.

This form must be filled out by the dependent child, the employee, and an authorized representative of the educational institution after classes begin during the semester concerned. However, part C, to be filled out by the educational institution, may be replaced by a confirmation of registration letter written by the institution and bearing an original authenticity seal, or an electronic seal if the confirmation letter is sent by email or found on the Omnivox portal.

It is important to note that the child is recognized as a dependent starting in the month during which the semester starts. For example, if a form is provided for the period from September to December but the semester does not start until October, the child will be recognized as a dependent of the insured from October to December.

End of a child’s eligibility

  • Dental coverage ends on the day the child turns 21 years of age, even if the child is attending an educational institution.
  • When a child turns 26 years of age, he or she is no longer eligible for any coverage. His or her eligibility ends at the end of the semester during which he or she turned 26.

MÉDIC Construction must be notified when one of the following situations occurs:

  • The child gets married or has been living with a spouse for at least 12 months
  • A child aged between 18 and 26 years of age stops studying or becomes a part-time student according to the criteria of the educational institution

It is possible to notify MÉDIC Construction by using the online services, at sel.ccq.org, section “MÉDIC en ligne”. 

No MÉDIC Construction card is produced for dependent children.

Insurance coordination is mandatory under the MÉDIC Construction plan for all the healthcare and dental expenses covered by the insured’s spouse plan (medications, hospitalization fees, glasses, dental care, paramedical services, etc.). MÉDIC Construction therefore requires that all insureds (employees or retirees) declare whether or not their spouse is covered under another insurance plan.

The form Declaration of Spouse's Insurance Benefits must be used to provide the required information to the Commission de la construction du Québec (CCQ). The file may also be filled out or modified in the online services, at sel.ccq.org, section “MÉDIC online”. When an insured declares his or her spouse using the form Declaration or Updating of Dependents, the form required is already attached to it.

The first time an employee is insured by MÉDIC Construction, he or she automatically receives the forms Declaration or Updating of Dependents and Declaration of Spouse's Insurance Benefits by mail.

As long as the form Declaration of Spouse’s Insurance Benefits has not been sent to MÉDIC Construction, the spouse will be considered a secondary insured for all of the benefits provided in the insured’s plan. It is therefore very important to transmit this declaration, especially if the spouse doesn’t have insurance, because if MÉDIC does not receive a payment statement by a first insurer, the costs submitted will not be reimbursed.

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