The Administrator - Co-ordinates enrolment into the Plans, claims payment, pension processing and answers all Member questions regarding the Group Insurance or Pension Plans.
Beneficiary - The person(s)/Estate that you designate to receive Life Insurance, Accident Insurance and/or pension benefits upon your death.
Co-Insurance - The percentage reimbursed by our benefits carrier for each eligible benefits expense.
Coordination of Benefits - The ability to make a claim for Extended Health Care and/or Dental eligible expenses under your Benefits Plan and your spouse's benefits plan. This allows you to receive up to 100% reimbursement for an eligible Extended Health Care or Dental expense.
Deductible - The amount of out-of-pocket expense that a Member must incur prior to being eligible for reimbursement on subsequent claims.
Dispensing Fee - The pharmacist's charge for filling a prescription (also see Professional Fee).
Drug - Medications that have been approved for use by the Federal Government of Canada and have a Drug Identification Number.
Licensed, Certified, Registered - The status of a person who legally engages in practice by virtue of a license or certificate issued by the appropriate authority, in the place where the service is provided.
Lowest Cost Alternative Drug - The lowest cost equivalent product that can be legally used to fill the prescription as listed in the Provincial Drug Formulary listing.
Paramedical Services - provided by a licensed practitioner including: naturopath, physiotherapist, podiatrist, chiropractor, clinical psychologist or osteopath.
Pay-Direct Drug Card - A card issued to Plan Members that allows the Pharmacy to bill the insurer directly for the covered amount of prescription drug costs. The Member is only required to pay their share at the pharmacy and therefore does not have to submit any claim forms. Not all Plans distribute pay-direct drug cards to their Members.
Provincial Plan - Any plan which provides hospital, medical, or dental benefits established by the government in the province where the insured person lives.
Reasonable and Customary - Within the usual range of charges being made by others of similar standing in the area in which the charge is incurred when providing the same or comparable services or supplies.
Waiting Period - A period of continuous active employment with the Employer, as shown in the Benefit Schedule, following which the Employee becomes eligible for insurance.
Weekly Indemnity - A benefit that pays a percentage of your pre-disability earnings for a defined length of time if you are unable to work due to sickness or accident.
UNIGROUP - The benefits of understanding. 1-800-292-9066
