Document name

Coverage – Personal

Document number

POL 03/2014

Personal coverage is optional coverage for individuals not automatically covered under The Workers’ Compensation Act, 2013 (the “Act”).

1. Section 20 provides the Workers’ Compensation Board (WCB) exclusive jurisdiction to determine whether any industry or worker is within the scope of the Act.
2. Section 12 of The Workers' Compensation General Regulations, 1985 (the “General Regulations”), provides the guidelines for employer coverage. Section 12 indicates coverage is subject to a period of three months and empowers the Board to grant an employer personal coverage "on any terms and conditions, and for any period, that the Board may prescribe.”
3. Section 14(1) of the General Regulations allows a proprietor or partner of a business or an executive officer of a corporation not on the company’s payroll to obtain personal coverage.
4. Section 14(2) of the General Regulations states:
   Every proprietor or partner of a business who employs no workers or who does not submit to the board the statement required by… the Act, and every executive officer of a corporation who is not on the corporation’s pay-roll is deemed to be a worker when under contract to a principal and the earnings in respect of their services, as the board may determine, are assessable on the principal’s account unless ordered otherwise by the board.
5. Section 15 of the General Regulations states “where the spouse of a sole proprietor or partner of a business wishes to obtain coverage for himself or herself, section 12 applies”.
6. Section 13 of the General Regulations states:
   Unless otherwise fixed by the board, personal coverage requested for an employer engaged in more than one industry under the Act is to be assessed at the rate applying to the industry with the largest payroll reported to the board for the preceding year.
7. Employers are classified on the basis of industrial undertaking following the premise that employers in like industries are subject to the same relative risks. As noted under Background Point 6, the General Regulations suggest that payroll be the basis on which assessments should be made. In keeping with the underlying principle of risks, the Board believes that it is more fair and equitable to apply assessments on the basis of time spent in the industry working. The Board believes this is a better reflection of the risks to which the employer and workers are subject. Therefore, the Board directs that time spent in the industry or province will be the basis on which premiums will be assessed.

1. Personal coverage may be purchased by:
   1. Proprietors and their spouses.
   2. Partners and their spouses.
   3. Directors of a corporation who are not carried on the payroll.
   4. Elected officials of a city, town or village, and
   5. Members of the governing body of a non-profit corporation or organization.
2. When personal coverage has been purchased, the applicant becomes a worker and is eligible for benefits under the Act. Wage loss benefits will be based on the amount of coverage purchased by the applicant.
3. Personal coverage protects the individual only while working in the industry or industries for which coverage was purchased and approved.
4. Where an employer in an industry covered by the Act chooses not to purchase personal coverage for themselves, they will be considered a worker, but one who has chosen not to purchase protection for their own work injuries. This will mean they are a worker for the purposes of a barred action application under Section 169 of the Act (POL 01/2013, Determination of a Worker’s Right to Bring Action). All other benefits under the Act will not apply.

Application for Coverage

5. An application for personal coverage can be made by telephone or in writing to the WCB. 
6. Coverage will be effective 12:01 a.m. the day following the date the application is received by the WCB or at a later date if requested by the applicant. An injury claim that occurs prior to the effective date of coverage will not be accepted.
7. Personal coverage may be purchased for any amount between the minimum personal coverage amount and the maximum assessable wage rate set for that year. POL 08/2020, Maximum Assessable Wage Rate, will apply. 
8. The minimum personal coverage amount is based on assessable earnings for a 40 hour work week at the provincial minimum wage. If the provincial minimum wage changes within the year, the minimum personal coverage amount will not be adjusted until January 1st of the subsequent year.
9. Personal coverage is subject to a minimum premium of three months.
10. Where coverage is purchased during the year, the premiums will be prorated to the end of the calendar year. 
11. Coverage will remain in effect with premiums payable until the applicant requests in writing that the coverage be cancelled or until the WCB cancels it for a reason, which includes:
    1. Non-payment of premiums.
    2. Failure to provide the required payroll information. 
    3. Providing false or misleading information to the WCB.
    4. Mail is returned and an alternate address cannot be found, or
    5. Any other instance where the WCB determines coverage should be terminated.

Proof of Earnings

12. Where the amount of coverage requested is higher than the minimum personal coverage amount, the applicant will be required to substantiate actual employment earnings in the event of an injury. The WCB will accept one of the following documents as proof of earnings:
    1. A T4 income tax slip as submitted to the Canada Revenue Agency (CRA).
    2. A Statement of Business or Professional Activities as submitted to the CRA, or
    3. A declaration from a Chartered accountant, a Certified Management Accountant (CMA), or a Certified General Accountant (CGA) verifying the actual employment earnings.
    In the absence of these documents, the WCB may accept an audited financial statement.
13. Only earnings reported in industries covered under the Act may be used for substantiation, unless voluntary coverage has been requested and approved by the WCB for an industry excluded under the Act.
14. Failure to provide proof of earnings at the time of injury will result in the coverage being reduced to the minimum personal coverage amount.
15. It is the applicant’s responsibility to ensure that the amount of coverage purchased is not more than their actual employment earnings. Where the applicant is unable to substantiate the amount of coverage purchased, they will not be reimbursed for the extra premium paid.
16. Where the applicant can substantiate earnings above the amount purchased, wage loss benefits will be based on the level of coverage purchased.
17. Coverage amounts may be increased or decreased at any time. Any changes will be effective the day the WCB is notified of the change by the applicant. Where coverage is being increased, proof of earnings will be required at the time the increase in coverage is requested.

Premium Assessment

18. Premiums are based on the amount of coverage purchased and the industry in which the applicant operates.
19. Based on the rationale provided under Background Point 7:
    1. Where an applicant operates a business within more than one industry, premiums for personal coverage will be prorated based on the amount of time the applicant spends in each industry.
    2. Where the applicant works in more than one province, the WCB will prorate the premiums charged based upon the amount of time spent in each province. Benefits continue to be based on the personal coverage amount selected regardless of how the coverage is split. The coverage amounts are subject to Saskatchewan’s minimum personal coverage amount and maximum assessable wage rate.