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Understanding the components of a group benefits plan

Mar 26, 2018 1:34:00 PM

 

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Insurance can be complicated to understand. There is so much jargon and information being thrown at you when you search for answers. Thankfully, we’re here to help. Here are five common group benefits terms and what they mean.

1. Extended health coverage

Extended Health Coverage, or EHC, helps pay for medical expenses not covered by provincial health plans. Exactly what is covered, how much coverage you have, and what the deductible amounts will be different depending on your plan.

It can include things like:

  • Hospital care
  • Prescription drugs
  • Medical services and equipment
  • Paramedical services
  • Out-of-province/country emergency medical care
  • Vision care

2. Paramedical services

Paramedical services are services provided by professionals not in the public health system, i.e. not a doctor. These services include chiropractic services, physiotherapy, massage therapy, naturopathy, acupuncture, and more. They require a certified professional to perform the service, and different types of services will have different criteria for submitting a claim, such as requiring a doctor’s note or that the provider be certified by a national or provincial association.

3. Coinsurance

Coinsurance is the percentage of costs of a covered health care service plan members pay.

4. Premium

An insurance premium is the amount of money that an individual or business pays for an insurance policy.

5. Plan Administrator

A plan administrator is the person at your company who manages its group benefits plan. The administrator works with the plan provider to ensure that the plan meets your needs and can also handle administrative tasks like adding and removing members to the plan.

Find out which style of benefits plan is right for you with our 2-step decision tool

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