Canada Pension Plan (CPP):
Government plan that pays a monthly pension to eligible individuals. See Offsets.
The insurer who agrees to underwrite the group contract and provide certain types of coverage and service.
Person who is trained in the treatment of minor foot disorders and licensed by the appropriate provincial licensing authority.
Services provided by a member the Canadian Chiropractic Association or an affiliated provincial association (Chiropractor).
A demand by the insured person to the insurer for the payment of benefits either directly by the person or through a third party. See Notice and Proof of Claim.
A plan beneficiary exercising their right to receive benefits.
An individual assigned by the LTD carrier to be involved if the plan member is likely to become a LTD claimant. The Claims Specialist is responsible for ensuring that any required additional information is requested/received in a timely manner and that there is no delay in claim payment should a plan member’s absence evolve to a LTD claim.
This is a term used to indicate that the insured and the insurer share the cost of the claim within a specified ratio. For example, the insurer pays 80%, the insured pays 20% of the claim.
Two persons, of the opposite or same sex, who have been cohabiting and residing with each other for a continuous period of at least 1year, and whose spousal relationship has been publicly recognized.
Consumer Price Index:
A price index produced by Statistics Canada that measures the percentage variation, over time, of the cost of purchasing a specific list of goods.
A plan which requires the Employee to pay part of the cost for the benefit plan.
A facility that provides rehabilitative care and is eligible under the provincial hospital insurance legislation.
An insured individual has the right to convert their group insurance coverage to an individual plan without presenting evidence of insurability, if converted within 31 days of termination of the Employee’s group coverage.
Co-ordination of Benefits:
A policy which will determine how benefits will be calculated and paid if the claimant is insured under several group contracts insuring the same event.
The employee plus one dependent.
A classification of benefits provided under a group policy or the amount of insurance or benefits stated in the group policy for which an insured is eligible.
The usual charge for providing a service or supply which does not exceed the general level of charges made by similar providers in the area. The term “area” means a region large enough to obtain a representative cross section of similar providers.