Canadian Chiropractic Association

When it comes to your health, your family and your income, why take unnecessary risks?

We all need protection …
for our health, our families, our finances. But finding an insurance program that’s adjustable and affordable can be time consuming and frustrating. That’s why the Canadian Chiropractic Association is pleased to offer you a Personal Benefits Insurance Plan.

This program is offered through HUB International and Manulife Financial, two leaders in the field of group insurance and related services. And it’s specially designed for members, their employees and families!

Life Insurance

Some people look at Life Insurance as a way to leave money to loved ones. But it’s much more than that. It’s a way to protect your loved ones from a financial crisis if you should die prematurely.

What you need to know before applying …

The Life Insurance plan is available to members of the Canadian Chiropractic Association (CCA), their spouses, as well as employees of members and their spouses. Members and their employees must apply for or have coverage before their spouses can apply. To apply, you must be under age 65 and residing in Canada. Medical evidence of your good health is required when applying for benefits. You must therefore complete the Health Declaration section on the Application Form. If further information is required, you will be notified.

Life Coverage Options

CCA Members
Available in units of $20,000 up to $760,000

Spouse of CCA Member
Available in units of $20,000 up to $500,000

Employee of CCA Member
Available in units of $20,000 up to $500,000

Spouse of Employee
Available in units of $20,000 up to $500,000

Dependent Child(ren)
$5,000

Benefit Details

Coverage becomes effective on the first of the month following the approval of your application.

Coverage reduces ...

• for CCA members and their spouses at age 66 by $2,000 per $20,000 unit, per year, until coverage terminates at age 75;
• for employees and their spouses at age 66 by $2,000 per $20,000 unit, per year, until coverage terminates at age 70.

Coverage ends when …

• you cease to be a member of the CCA or an employee of a member;
• you reach age 75 (CCA members & spouses) or age 70 (employees & spouses);
• premiums are not paid;
• this plan is cancelled.

Plan Features

• Smoker/Non-smoker rates
• Monthly Payment Options
• Premium Waiver. If you are totally disabled for six consecutive months prior to age 65, your life premiums will be waived while you remain totally disabled up to age 65.

Optional Rider

• A Dependent Life Rider which will insure all your children for $5,000 each, for one low premium. Dependent children are covered until age 21, or age 25 if in school full time.

Accidental Death & Dismemberment

The CCA Accidental Death & Dismemberment (AD&D) plan provides additional financial protection if you die or are seriously injured due to an accident. The coverage provides you with protection anywhere in the world, 24 hours a day.

What you need to know before applying …

The AD&D plan is available to members of the Canadian Chiropractic Association (CCA), their spouses, as well as employees of members and their spouses. Members and their employees must apply for or have coverage before their spouses can apply. To apply, you must be under age 65 and residing in Canada.

AD&D Coverage Options

CCA Members
Available in units of $20,000 up to $760,000

Spouse of CCA Member
Available in units of $20,000 up to $500,000

Employee of CCA Member
Available in units of $20,000 up to $500,000

Spouse of Employee
Available in units of $20,000 up to $500,000

Benefit Details

Coverage becomes effective … on the first of the month following the approval of your application.

Coverage reduces ...

• for CCA members and their spouses at age 66 by $2,000 per $20,000 unit, per year, until coverage terminates at age 75;
• for employees and their spouses at age 66 by $2,000 per $20,000 unit, per year, until coverage terminates at age 70.

Coverage ends when …

• you cease to be a member of the CCA or an employee of a member;
• you reach age 75 (CCA members & spouses) or age 70 (employees & spouses);
• premiums are not paid;
• this plan is cancelled.

Plan Features

• Premium Waiver. If you are totally disabled for six consecutive months prior to age 65, your AD&D premiums will be waived while you remain totally disabled up to age 65.

Note: Any loss must be the result of an accident and occur within 365 days of the accident, and must be total and irrecoverable.

Additional Information

The Cost

MonthlyLife Insurance rates vary based on age and smoker/non-smoker status. They are subject to change as you enter a new age bracket. Accidental Death & Dismemberment rates do not increase with age.

Premiums are payable in advance on a monthly basis. You may pay using pre-authorized bank deduction, by credit card or by cheque. Rates shown do not include provincial sales tax, where applicable. Rates are reviewed on a yearly basis. You will be advised in advance of any necessary rate changes.

Next Steps

• Decide the amount of protection you require.

• Complete the Application for Insurance. Remember to include dependent information if you require dependent life insurance coverage.

• Indicate whether you want pre-authorized bank deduction, credit card payment or payment by cheque. If you select pre-authorized bank deduction, please include a blank cheque marked “VOID”.

• Return your application and VOID cheque (do not send money)

Once your application is approved you will receive a Certificate of Insurance detailing the coverage and the main policy provisions. Once you receive this document, you have 10 days to review your certificate. If you are not satisfied, simply return the certificate and any paid premiums will be returned to you.

Designating a beneficiary

In the event of your death, benefits will be paid to your beneficiary. You may appoint your beneficiary on the Application Form, or change your beneficiary at any time by completing a Change of Beneficiary Form, subject to the law in your province of residence. If you do not appoint a beneficiary, or your named beneficiary predeceases you, benefits will be paid to your estate.

When it comes to your health, your family and your income, why take unnecessary risks?

We all need protection...
for our health, our families, our finances. But finding an insurance program that’s adjustable and affordable can be time consuming and frustrating. That’s why the Canadian Chiropractic Association – is pleased to offer you a Personal Benefits Insurance Plan.

This program is offered through HUB International and The Manufacturers Life Insurance Company (Manulife Financial), two leaders in the field of group insurance and related services. And it’s specially designed for members, their employees and families!

Critical Illness Insurance

Critical Illness insurance is a product that provides a lump sum, tax-free payment when you are diagnosed with a covered condition. There are 18 covered conditions, including cancer, heart attack, multiple sclerosis and stroke. Thanks to medical advances, the chances of surviving from one of these serious illnesses continue to improve. But the diagnosis of a serious illness can leave individuals, families and businesses with a lack of financial resources.

The lump sum payment can fund the immediate costs associated with a serious illness, such as, alternative medical treatment, home care or private nursing costs and other costs not covered under our current health care system. Critical Illness Insurance can also provide the financial resources to pay off your mortgage or other existing debts, cover a reduction or permanent loss of income and fund early retirement.

What you need to know before applying… This plan is available to The Canadian Chiropractic Association members and their spouses as well as employees and their spouses. To apply, you must be under age 65, and residing in Canada.

Medical evidence of good health is required when applying for benefits. You must therefore complete the medical questions section on the Application Form. If more information is needed, you will be notified.

Note: Members and their employees must apply for or have coverage before their spouse can apply for coverage.

Coverage

Coverage is available from $25,000 up to $1,000,000 in units of $1,000. The benefit pays a lump sum benefit on diagnosis of one of the covered conditions. You must survive for a period of 30 days following the first diagnosis of one of the covered conditions. Benefits are tax-free provided you are paying the premium.

Benefit Details

Covered Conditions:

• Life Threatening Cancer
• Heart Attack
• Stroke
• Coronary Artery Bypass Surgery
• Kidney Failure
• Major Organ Transplant
• Paralysis
• Multiple Sclerosis
• Motor Neuron Disease
• Coma
• Major Burns
• Loss of Limbs
• Blindness
• Deafness
• Loss of Speech
• Occupational HIV
• Parkinson’s and
• Alzheimer’s Disease

No benefit is payable for cancer if the diagnosis was made or the symptoms leading to the diagnosis were present during the first 90 days of coverage.

Return of Premium on Death

The plan includes a built in return of premium on death benefit. Should death occur within the 30- day survival period or from a cause other than one of the covered conditions, and no Critical Illness benefit has been paid, all premiums will be returned and paid to your named beneficiary.

Waiver of Premium Rider (Optional)

If you choose the Waiver of Premium Rider and you become totally disabled, and remain totally and permanently disabled for at least 6 continuous months, premiums will be waived. Premiums will continue to be waived until you are no longer totally disabled.

This rider is available to employed individuals only.

Coverage ends when...

• you cease to be a member of the CCA;
• you cease to be an employee of a member of the CCA;
• you reach age 70;
• a Critical Illness payment is made;
• on death;
• premiums are not paid or;
• this plan is terminated.

Exclusions & Limitations

This insurance does not cover any loss, or expenses caused or contributed to by:

• intentionally self-inflicted injury or illness while sane or insane;
• attempt at suicide, while sane or insane;
• committing or attempting to commit an assault, battery or criminal offense;
• operating a motorized vehicle while the concentration of alcohol in 100 ml. of bodily fluid exceeds 80 mg.;
• the use of any drug, poisonous substance, intoxicant, or narcotic, unless prescribed by a licensed Physician and taken in accordance with directions given by the Physician or in the case of a nonprescribed medication, as directed by the manufacturer;
• war and any hazard arising from war or hostile action of the armed forces of any country, whether such war is declared or undeclared and/or;
• the use of any alcohol
• any act of terrorism, bioterrorism, the use of force or violence and/or threat thereof of any person(s) or group(s), weather acting alone or on behalf of or in connection with any organization(s) or government(s) and/or any medical or surgical treatment or complications from such treatment

Note: Some conditions apply if a critical illness occurs or is diagnosed outside of Canada.

No Critical Illness Benefit will be payable if you do not survive for a period of 30 days following the first diagnosis of a covered condition. When death occurs during this period, a return of premium is paid.

Additional Information

The Cost

Monthly rates vary based on age and are subject to change as you enter a new age bracket.

Premiums are payable in advance on a monthly basis. You may pay using pre-authorized bank deductions by credit card or by cheque. Rates are reviewed on a yearly basis. You will be advised in advance of any necessary rate changes.

Next Steps

• Decide the amount of protection you require
• Complete the Application for Insurance
• Indicate whether you want pre-authorized bank deduction or if you will be paying by cheque. If you select pre-authorized bank deduction, please include a blank cheque marked “VOID”
• Return your application and VOID cheque (do not send money)
• Coverage becomes effective on the first day of the month following approval of your application

Once your application is approved you will receive a Certificate of Insurance detailing the coverage and the main policy provisions. Once you receive this document, you have 10 days to review your certificate. If you are not satisfied, simply return the certificate and any paid premiums will be returned to you.

Long Term Disability (LTD) and Professional Overhead Expense (POE)

When it comes to your health, your family and your income, why take unnecessary risks?

We all need protection …
for our families, our finances. But finding an insurance program that’s adjustable and affordable can be time consuming and frustrating. That’s why the Canadian Chiropractic Association is pleased to offer you a Personal Benefits Insurance Plan.

This program is offered through HUB International and Manulife Financial, two leaders in the field of group insurance and related services. And it’s specially designed for members, their employees and families!

Long Term Disability

This program is designed to protect your single most valuable asset – your ability to earn an income. And if you pay for this coverage with after-tax dollars, any benefits you receive are tax free!

What you need to know before applying …

This plan is available to Canadian Chiropractic Association (CCA) members and their employees. To apply, you must be under age 60, working full time (at least 25 hours per week) and residing in Canada.

Medical evidence of good health is required when applying for benefits. You must therefore complete the Evidence of Good Health section on the Application Form. If more information is needed, you will be notified.

Plan Features

• Total Disability & Rehabilitation Benefits
• Premium Waiver
• Quarterly or Monthly Payment Options

Additional Features for CCA Members

• Partial Disability Benefit for income losses of 20% or more.
• Four Elimination Periods (also known as waiting periods) from which to choose: 30, 60, 90 or 120 days.

Optional Riders for CCA Members

• Own Occupation Rider to provide Total Disability Benefits if you can’t work at your regular occupation even if you’re working elsewhere.
• Cost of Living Adjustment Rider to protect your disability benefits from inflation.

Coverage Options

CCA Members can purchase units of $100 up to a monthly benefit of $7,500, depending on your income(Please refer to the CCA Income Ratio Guide ). There is a minimum purchase requirement of $500.

Note: The maximum coverage for which you are eligible will be reduced by any disability insurance in force or applied for under this plan or elsewhere. At the time of claim, the total monthly benefit you receive, when added to other disability benefits, may not exceed 100% of your taxable, or 80% of your nontaxable, pre-disability average monthly earned income.

Employees of CCA Members can purchase up to a monthly benefit of $2,500 , depending on your income.

Note: At the time of claim, your monthly benefit under this plan will be integrated with the Workplace Safety and Insurance Board (WSIB), Canada/Quebec Pension Plan, and any other government benefits for which you may be eligible. Your disability benefit, when added to other disability benefits, may not exceed 100% of your taxable or 80% of your non-taxable, pre-disability average monthly earned income.

Benefit Details

Coverage becomes effective ... on the first of the month following the approval of your application.

Benefit payments begin for CCA members ... after your chosen elimination period (or waiting period) has expired. You have four elimination periods from which to choose: 30, 60, 90 or 120 days. If you choose, for example, a 30-day elimination period, no benefits will be paid until you have been Totally Disabled for 30 consecutive days.

Benefits are payable to age 65 for accident and sickness. For disabilities beginning after age 63 but before age 68, benefits are payable for a maximum of 24 months. For disabilities occurring after age 68, benefits are payable for a maximum of 12 months or to age 70, whichever is longer.

Benefit payments begin for employees of members ... after your 120-day elimination period has expired (you must be Totally Disabled for 120 consecutive days before benefits will be paid). Benefits would then be payable for the lesser of 60 months or to age 65 for accident or sickness.

Coverage ends when ...

• you cease to be a member of the CCA or an employee of a member;
• you are no longer working at least 25 hours per week;
• you reach age 70 (CCA Members) or age 65 (employees), or earlier retirement;
• premiums are not paid;
• this plan is cancelled.

Rehabilitation Benefit. If you participate in a rehabilitation program, Total or Partial Disability benefits may be continued for the duration of the program.

Premium Waiver. Your disability premiums, including rider premiums, will be waived while you are receiving Total or Partial Disability benefit payments.

Definition of Total Disability

CCA Members will be considered Totally Disabled prior to age 65 if, as a result of an accident or sickness, you are unable to perform the essential duties of your regular occupation, are not working elsewhere (except as noted under the Own Occupational Rider) and are under the regular care of a physician. After age 65, Totally Disabled means you are unable to engage in any gainful employment and are under the regular care of a physician.

Employees of Members will be considered Totally Disabled for the first 24 months if, as the result of an accident or sickness, you are unable to perform the essential duties of your regular occupation, are not working elsewhere, and are under the care of a physician. After the first 24 months, Totally Disabled means you are unable to engage in any gainful employment for which you are reasonably suited by way of education, training or experience, and are under the regular care of a physician.

Definition of Partial Disability

Applies to CCA Members Only

You will be considered Partially Disabled prior to age 70 if, as the result of an accident or sickness, you are not Totally Disabled but have a loss of income of at least 20% and are either:

• unable to perform one or more of the important duties of your regular occupation; or
• engaged in another occupation.

Benefit payments begin after your chosen elimination period has expired. Benefits are payable to age 70. For disabilities beginning after age 63 but before age 65, benefits are payable for a maximum of 24 months (combined Partial and Total Disability benefits).

During Partial Disability, your monthly benefit is paid in the same proportion as your loss of income. For example, a 50% loss of income provides a monthly benefit payable of 50%.

Optional Riders

Available to CCA Members only

Own Occupation Rider. This rider provides you with Total Disability benefits if you are unable to perform the essential duties of your regular occupation as the result of an accident or illness even if you are working in another occupation. This rider terminates at age 65.

Cost of Living Adjustment (COLA) Rider. This rider increases your benefit payments once you have been Totally and/or Partially disabled for 12 consecutive months. Each year on the anniversary of your disability, your benefits are increased according to the Consumer Price Index (CPI) to a maximum of 5%. These annual inflation adjustments continue until you reach age 65 or recover.

Note: If the Own Occupation Rider is elected, COLA benefits will not be paid if you are Totally Disabled from your regular occupation but working elsewhere.

Income Ratio Guide

Applies to CCA Members Only The following chart indicates the amount of disability coverage you may apply for, based on income. Actual coverage is to be selected in multiples of $100 (minimum $500/maximum $7,500). Use chart for reference only.

 

*Net Income is gross income after expenses but before income tax.

Professional Overhead Expense Insurance

Electricity, rent, employee salaries, telephone. Who will pay your office expenses if you are sick or injured? Professional Overhead Expense Insurance is advantageous for anyone running a business with regular monthly expenses.

What you need to know before applying …

This plan is available to members of the Canadian Chiropractic Association (CCA). To apply, you must be under age 60, working full time (at least 25 hours per week) and residing in Canada. Medical evidence of good health is required when applying for benefits. You must therefore complete the Health Declaration section on the Application Form. If more information is needed, you will be notified.

You can purchase units of $100 up to a monthly benefit of $8,000. There is a minimum purchase requirement of $500.

Plan Features

• Covers monthly overhead expenses including rent, electricity, telephone, heat, water, laundry, depreciation, your employees’ wages or salaries, and other normal office expenses.
• Two Elimination Periods from which to choose: 14 days or 30 days.
• Premium Waiver.

Benefit Details

Coverage becomes effective … on the first of the month following the approval of your application.

Benefit payments begin ... after your chosen elimination period (or waiting period) has expired. You have two elimination periods from which to choose: 14 or 30 days. If you choose, for example, a 30-day elimination period, no benefits will be paid until you have been Totally Disabled for 30 consecutive days. Benefits would then be payable for a maximum of 18 months so long as you remain Totally Disabled.

Coverage ends when …

• you cease to be a member of the CCA;
• you are no longer working at least 25 hours per week;
• when you reach age 65, or earlier retirement;
• premiums are not paid;
• this plan is cancelled.

Premium Waiver. Your Professional Overhead Expense premiums will be waived while you are receiving disability benefit payments.

Expenses Not Covered

Your salary, fees, drawing account, or any other remuneration for yourself, any member of your profession or any person employed to perform the duties of your profession or occupation, and the cost of goods, merchandise of any nature, automobiles or implements.

Definition of Disability

You must be Totally Disabled to receive Professional Overhead Expense benefits. The definition of Total Disability is the same as for Long Term Disability under age 65. See page 4.

Additional Information

The Cost

Monthly Rates vary based on age and are subject to change as you enter a new age bracket.

Premiums are payable in advance on a monthly basis. You may pay using pre-authorized bank deduction, by credit card or by cheque. Rates shown do not include provincial sales tax, where applicable. Rates are reviewed on a yearly basis. You will be advised in advance of any necessary rate changes.

Next Steps

• Decide the amount of protection you require.
• Complete the Application for Insurance
• Indicate whether you want pre-authorized bank deduction or if you will be paying by cheque. If you select pre-authorized bank deduction, please include a blank cheque marked “VOID”.
• Return your application and VOID cheque (do not send money)

Once your application is approved you will receive a Certificate of Insurance detailing the coverage and the main policy provisions. Once you receive this document, you have 10 days to review your certificate. If you are not satisfied, simply return the certificate and any paid premiums will be returned to you.

As a new member of the CCA, you are eligible for a guaranteed issue insurance benefit. You can only apply for the CCA Graduate Plan up to 12 months after you graduate from Chiropractic College.

Under the plan, applicants are usually required to complete a medical questionnaire and undergo medical testing (i.e., blood tests). Disability insurance and overhead expense insurance also requires income and expense information. However, under the CCA Graduate Plan, you can purchase the following benefits at member rates with no medical or financial questions asked:

• Either $20,000 or $40,000 of life insurance
• Up to $1,500 of monthly long term disability benefit in units of $100 (minimum of $500); the optional riders may be added by completing a medical questionnaire
• Up to $1,500 of overhead expense insurance in units of $100 (minimum of $500)
• Click here for more information on Life insurance
• Click here for more information on Long Term Disability (LTD) & Professional Overhead Expense (POE) insurance
• Click here to apply for the Graduate Plan

Note: This summary is intended to provide a brief description of the benefits available under the CCA group insurance program. This material does not create or confer any rights. The exact terms and conditions of your benefits are outlined in the applicable benefit’s policy provision. Some restrictions and/or limitations may apply to all benefits mentioned above. Please contact HUB International for full details.

Eligibility Rules: who qualifies and when?

To be eligible, a plan member must:

• Be a CCA member or an employee of a CCA member;
• Work a minimum of 25 hours per week;
• Be "actively at work" when he or she becomes eligible for coverage;
• Be medically approved by the insurer;
• Be a resident of Canada; and
• Not have attained the age of 65 on the date Manulife Financial Affinity Markets receives his/her application for insurance.

Coverage begins the first day of the month following the date of the approval. Premiums become payable on the first of the month coincident with or next following the effective date. For example, if the plan member’s coverage is effective February 10, premiums for the new coverage start on March 1. If the plan member’s coverage was effective February 1, then both the eligibility date and premium payments would begin on February 1.

Additional Provisions

A plan member may cover only one spouse at a time:

• A legal spouse
• A common-law spouse: a common law spouse is eligible for coverage under this agreement when living together in a conjugal relationship with the plan member continuously for a period of not less than one year

 Eligibility of Dependent Children

Dependent children are eligible for coverage as defined in master policy up to the attainment of their 21st birthday or to the attainment of their 25th birthday if enrolled and in full-time attendance at an accredited college or university.

Children over 21 years of age may qualify for coverage if they are dependent upon the covered plan member by reason of a mental or physical disability. If a dependent becomes mentally or physical disabled at a later date, please contact HUB International for more information.

Eligibility of Unmarried Dependent Children

Dependent children are eligible for benefits up to the age restrictions noted on the provision, provided they are not married (or living in a common law relationship) and they are financially dependent on the plan member or the plan member’s spouse. Dependent children are automatically terminated upon reaching the age restrictions outlined in the benefit summary pages of the provision.

Eligibility of Over-Age Dependent Children - Student

Over-age dependent children are eligible for benefits provided he or she is attending a recognized school, college or university on a full-time basis. Full-time attendance means more than ten hours of classroom instruction per week. Manulife Financial Affinity Markets will require that the plan member submit a proof of tuition payment along with the first claim for the over-aged dependent after September 1 of each calendar year that the dependent is eligible for coverage.

Survivor Benefits

The plan allows for the Spouse and Dependents already covered to maintain the protection after the death of the plan member. This coverage will be continued without payment of premium but terminates on the earliest of the following circumstances:

• Upon the termination of the Master Policy; or
• Upon the completion of 24 months from the date of the plan member’s death; or
• Upon ceasing to be an eligible Dependent for any reason other than there not being an eligible Insured Member or Insured Employee living.

Note: Request for Survivorship should be indicated at the time of death.

Billing Process

The billing administration is performed by LifeWorks.

Each group will receive an invoice for the benefits during the month prior to the coverage month. For example, invoices for July’s coverage will be mailed in late June. Payment is due on the 1st of the month for that coverage month.

All cheques for monthly premiums must be made payable to
“Morneau Shepell Ltd., In Trust”.

All additions, changes, and terminations must be made on the Plan Member Enrolment Form or the Notice of Change Form, as applicable. To ensure that Plan Member changes are reflected on your next monthly premium statement, please provide notification to LifeWorks prior to the 12th of the month. The forms may either be emailed or faxed to your nearest LifeWorks office. Changes received after the 12th of the month will be reflected on the following month’s premium statement.

Premiums become payable on the first of the month coincident with or next following the eligibility date. For example, if the Plan Member’s effective date is February 10th, the Plan Member becomes eligible to submit claims on the 10th but premium payments do not start until March 1st. If the Plan Member’s effective date is February 1st (rather than February 10th) then the eligibility date would be February 1st and premium payments would also start on February 1st.

Adding or Deleting Dependents

1. Plan Administrator completes the “Reason for Completion” box and Part 1 of the Notice of Change Form by indicating the Plan Member's identification number, name, effective date of change etc.
2. Plan Member completes applicable information in Section B of the Notice of Change Form
3. Fax a copy of this form to your nearest LifeWorks office
4. Retain the original for your files

Terminating Employment

1. Plan Administrator completes Section 1 of the Notice of Change Form
2. Fax a copy of this form to your nearest LifeWorks office
3. Retain the original for your files. We recommend that you keep the application for a period of one year following the termination date
4. Ensure the Plan Member's pay-direct drug/id card is returned and destroyed on the effective date of termination (if applicable)

Disability Claims

Long Term Disability

In case of a disability due to sickness or injury, Manulife Financial Affinity Markets must be notified within 30 days of the commencement of the disability, and you should complete all required sections of the Disability Claim package. Please contact LifeWorks to obtain a disability claim package. To ensure timely claim processing, all forms/sections contained in the package must be completed.

If the plan member is eligible for WSIB benefits, the plan member will receive a Worker's Compensation claim form from their physician

Once completed by the appropriate individuals, mail all sections of the Disability Claim package to Manulife Financial Affinity Markets directly.

Life Accidental Death Insurance Claims

In the event of the death of an insured plan member or spouse, the claimant should call LifeWorks at 1-866-432-8427.

Note: Upon approval of a claim, the claim settlement cheque is sent directly to the beneficiary – the services of a lawyer are not usually required in submitting a claim for death benefits. If the beneficiary is the estate, Manulife Financial Affinity Markets will require a notarized copy of the Will and the certificate of appointment of Estate Trustee.

Accidental Dismemberment Claims

In the event of the accidental dismemberment claim for an insured plan member or spouse, the claimant should call LifeWorks at 1-866-432-8427.

Note: Settlement of accidental dismemberment claims will be sent directly to the claimant.

For further assistance regarding any aspect of a claim, please contact LifeWorks Shepell.

Billing

Q: When is my premium payment due?
A: Payment is due the first business day of the billing month (i.e. January 1 for January). Most invoices are mailed weeks prior to the due date..

Q: How and when do the rates change?
A: During an annual renewal of the plan, the insurance company examines the entire pool’s claims experience and other external factors such as inflation. They then determine the rate changes needed to support the claims in the coming year. We do negotiate these renewals on your behalf to ensure that they are remaining as competitive as possible. Rates also factor in age, family status, smoking status, and province of residence.

Q: When are notices of changes due?
A: To ensure that coverage changes (e.g., new hires, terminations, etc…) are added to your next premium statement, notify LifeWorks, using the Group Insurance Change Form, prior to the 12th of the month.

Q: Is it required that I adjust my monthly premium payment to reflect the changes I am submitting?
A: No. You can submit changes without adjusting the premium amount due. Your next invoice will indicate the credit or the back charges for the changes submitted.

Q: Is there a waiting period that must be satisfied before new employees can be added to the group plan?
A: CCA program’s waiting period is three months from the date of permanent full-time (at least 20 hours per week) employment for Health and Dental coverage.  For Life, Accidental Death & Dismemberment, Long Term Disability and Critical Illness, the employee is not required to fulfill a waiting period.

Eligibility

Q: What are the eligibility requirements?
A: You must have a CCA membership in good standing, be a resident of Canada and be under the age of 65 to apply.

Q: When does my coverage become effective?
A: It can take up to 4-6 weeks in total from beginning to end. This depends on your application and if the insurance company requires any additional information from you. We can keep you posted on the status of your application. The effective date of coverage is usually the 1st of the month following your approval date.

General Questions

Q: What is HUB International's role in all of this?
A: We are consultants who locate the best products to suit your needs as well as ensure the financial competitiveness of your programs. We do not, however, insure the program (pay the claims) but rather work with various insurance companies on your behalf. LifeWorks is the Third-Party Administrator (TPA) who manages and runs all of the administration required of a group insurance program

Q: Is there a penalty to cancel my coverage at any time?
A: No, there is no penalty as long as we receive a written notification requesting cancellation of coverage at least 31 days in advance of a premium due date.

Q: Does my coverage continue once I retire? If not, what do I do?
A: Your contract defines the termination date of your benefits. If you require further information, please do not hesitate to contact HUB International.

Q: If I get disabled due to a car accident for example, am I covered?
A: Your disability claims are adjudicated on a case by case basis. You must meet the definition of disability (as per the contract) and remain under the care of a physician.

In an effort to continually improve the glossary, we welcome all suggestions. If you need help with a particular word and cannot find it in the glossary, please let us know

A

• Accidental Death & Dismemberment - A lump sum payment if the insured dies as a result of an accident or loses eyesight, hearing, or appendages (i.e. arms, legs, feet and hands).
• Acupuncture - Services provided within their specialty by acupuncturists authorized to practice acupuncture in Canada or in the province where the services are provided.
• Administrator - Individual or company responsible for administering the group insurance contract including the accounting and enrollment.
• Adverse Selection - Persons poorer-than-average health (or health expectations) tend to apply for greater insurance coverage than do persons in average or better health.
• Age Reduction - A reduction in the amount of insurance when a person reaches a certain age. See Termination age
• Aggregate - When referring to a family deductible or out-of-pocket maximum, aggregate implies that the family charges may total up to the maximum, as long as one member-  meets the individual amount.
• Allowable Expense - Any claims that meet the criteria of the insurance policy which you are covered by.
• Annual Maximum - The maximum amount any one individual may receive, per year, under an insurance contract.
• Anti-selection - The selection of coverage beneficial to the employee but not beneficial to the plan itself.
• Association Group Plans Health - plans designed for members of an association.
• Audiology - Services provided within their specialty by audiologists authorized to practice audiology in Canada or in the province where the services are provided.

B

• Basic Life Coverage The base (core) life insurance plan, offered either as a lump sum or in multiples of salary. If desired, additional life coverage can be added to Basic Life to increase the coverage: see Optional Life Coverage.
• Beneficiary The person designated by the insured to receive Group Life and/or Accidental Death Benefits upon the death of the insured.
• Benefit The amount payable by the insurance company to the holder, assignee or beneficiary of the insurance policy when a loss covered by the policy occurs.

C

• Canada Pension Plan (CPP) - Government plan that pays a monthly pension to eligible individuals. See Offsets.
• Carrier - The insurer who agrees to underwrite the group contract and provide certain types of coverage and service.
• Child, Handicapped - Specific provision in contract for the continuing coverage of dependent child regardless of age, if handicapped and unable to provide for themselves.
• Chiropractic - Services provided by a member the Canadian Chiropractic Association or an affiliated provincial association.
• Claim - A demand by the insured person to the insurer for the payment of benefits. See Notice and Proof of Claim.
• Claimant - A plan beneficiary exercising his/her right to receive benefits.
• Claims Paid - Cheques paid out to claimants by the insurance company. The checks are considered Paid Claims if they either are dated within the policy year or are cleared by the banks within the policy year.
• Class - A categorical listing of insurance coverage which an individual is placed into to determine eligible coverage under the policy.
• Co-ordination of Benefits - A policy which will determine how benefits will be calculated if the claimant is insured under several group contracts insuring the same event.
• Coinsurance - 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 expense. The amount paid by the Insurer is the Coinsurance, and the amount paid by the Insured is the co-pay.
• Common-Law Marriage - Two persons who have been cohabiting and residing with each other for a continuous period of at least one year, and who’s spousal relationship has been publicly recognized.
• Consumer Price Index - Price index produced by Statistics Canada that measures the percentage variation over time of the cost of purchasing a specific list of goods.
• Consultant - A person or firm specializing in the design, sale and service of employee benefit plans.
• Contributory - A portion of the premium paid by the employee is required.
• Contributory Plan - A plan which requires employees to pay part of the cost for the benefit plan.
• Convalescent Hospital - Facility that provides rehabilitative care and is eligible under the provincial hospital insurance legislation.
• Conversion - The individual has the right to convert group insurance coverage to an individual plan without presenting evidence of insurability if converted within 31 days of termination.
• Coverage - 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.

D

• Deductible - An amount of expenses that must be paid by the insured before any benefits become payable.
• Definition of Disability - See Permanent and Total Disability and Two Year Own Occupation.
• Dependent - The employee's spouse or children.
• Dependent Life - Life Insurance issued for the spouse and children with the employee as the beneficiary.

E

• Effective Date - The date a policy becomes effective. If the hour is not specified, the effective time is 12:01 a.m. on the appropriate date.
• Eligible Employees - Employees who have met the requirements under the group policy for insurance.
• Employee Benefit Program - A program through which various benefits are offered to employees by their employer to cover such contingencies as medical expenses, disability income, retirement and death; usually paid for wholly or in part by the employer. Such benefits frequently are referred to as "fringe benefits" because they are separate from wages and salaries.
• Evidence of Insurability - Proof presented through written statements on an application form, and/or through a medical examination, that an individual is eligible for a certain type of insurance coverage.
• EOB - Once a claim has been processed, the subscriber will receive an Explanation Of Benefits statement. The following information is detailed on the EOB actual charges, allowed charges, deductible and coinsurance amounts, total benefits payable and the claimant responsibility

F

• Family - Two spouses who are legally married or living common-law, or one or two adults (legally married or living common-law) and their dependent children.

G

• Group Insurance - Insurance issued, usually without medical examination, on a group of people under a master contract. It is usually issued to an employer for the benefit of employees. The individual members of the group hold certificates as evidence of their insurance.
• Group Insurance Change Form - A form used to submit additions, changes and terminations for processing by the premium administrators.
• Group Life - Insurance covering a group of employees under one life insurance policy.
• Guaranteed Issue - Maximum amount of benefit that will be provided without the need for evidence of insurability.

H

I

• Insured - The member who is covered by the policy.
• Insurer - The insurance carrier who agrees to underwrite the group contract and provide certain types of coverage and service.
• Indemnity Plan - Plan which restores or reimburses one to the extent of their loss.

J

K

L

• LTD - Long Term Disability insurance provides income protection in the event of time lost due to sickness or accident of long term nature. Generally monthly payments commence after a specified waiting period and continue while the employee remains disabled usually up to a specified age. See Definition of Disability, Permanent and Total Disability, Period of Disability, Two Year Own Occupation and Offsets.

M

• Massage Therapy - Services provided within their specialty by individuals authorized by a recognized provincial association to practice massage therapy. (Where such an association does not exist, individuals who, in the insurer’s opinion, have similar qualifications.)
• Maximum Benefit - The maximum amount any one individual may receive under an insurance contract. See Annual Maximum.

N

• Naturopathy - Services provided within their specialty by members of the Canadian Naturopathic Association or an affiliated provincial association.
• Non-Evidence Maximum (NEM) - The maximum amount of insurance coverage one may receive before Evidence of Insurability is required.
• Notice and Proof of Claim - The policy will specify time limits for giving notice, and then proof of claim. It also specifies the manner in which the proof of loss must be submitted.
• Nursing Home - Facility housing (elderly) individuals who, due to a reduction in their physical or psychological autonomy, must live in a sheltered environment.

O

• Occupational Therapy - Services provided within their specialty by occupational therapists authorized to practice occupational therapy in Canada or in the province where the services are provided.
• Offsets - Reductions to one’s Long Term Disability benefit in order to offset other sources of income such as Worker’s Compensation, CPP, QPP, etc.
• Old Age Security (OAS) - A federal retirement income program providing pension benefits to those 65 or older, with residence in Canada for at least 10 years.
• Optional Life Coverage - Option to purchase additional life insurance over and above Basic or core life insurance coverage. Optional Life frequently requires applicants to provide additional personal information. See Evidence of Insurability.
• Orthotherapy- Services provided within their specialty by orthotherapists authorized to practice orthotherapy in Canada or in the province where the services are provided.
• Osteopathy - Services provided within their specialty by holders of a doctorate in osteopathy conferred by a college of osteopathy approved by the Canadian Osteopathic Association.
• Out-of-Country Expenses - Expenses incurred by an insured or insured dependent for emergency services and treatment of bodily injury or disease while travelling outside Canada.
• Out-of-Pocket Expenses - Those medical expenses which an insured is required to pay because they are not covered under the group contract.
• Out-of-Pocket Maximum - The maximum amount of coinsurance an insured is required to pay before the plan will pay 100% .
• Over-the-Counter Drug - Drug that can be purchased without a prescription.

P

• Payroll Deduction - The amount taken from the employee's earnings with their consent, as contribution toward the cost of the group insurance plan.
• Period of Disability - The period during which an employee is prevented from performing the usual duties of his/her occupation or employment or during which a dependent is prevented from performing the normal activities of a healthy person of the same age or sex. More than one cause (accident or sickness) may be present during or contribute to a single period of disability. See Two Year Own Occupation.
• Permanent and Total Disability - A disability that will presumably last for the insured's lifetime and prevents engagement in any occupation for which the insured is reasonably fitted. See Offsets.
• Physiotherapy - Services provided within their specialty by members of the Canadian Physiotherapy Association or an affiliated provincial association..
• Podiatry - Services provided for foot health by individuals authorized to practice.
• Pooling - The combination of all premiums, claims, expenses for certain size cases, types of coverage or excess classes in order to spread the risk.
• Pre-Existing Condition - Any physical and/or mental condition or conditions that existed prior to the effective date of coverage under a contract.
• Premium - The amount paid to the insurer for the insurance protection.
• Prescription Drug - Drug that cannot be obtained without a prescription from a physician or dentist.
• Provision - A part of a group insurance contract that explains or describes a feature, benefit, condition, requirement, etc., of the insurance protection afforded by the contract.
• Psychology - Services provided within their specialty by permanently recognized psychologists whose names appear in the registry of psychologists of the province where the services are provided.

Q

• QPP Québec Pension Plan. See Offsets.
• Québec Pension Plan - Government plan that pays a monthly pension to eligible individuals.

R

• Reasonable and Customary - This term refers to limiting benefit payments to fees which are reasonable and representative for the service rendered, under the circumstances rendered, by the physician rendered.
• Recurring Disability - A case where if a second disability occurs related to the first disability within a specified period of time, the second disability will be a continuation of the first disability claim.
• Rehabilitation - Refers to a provision in many long-term disability (LTD) plans that enables the insured claimant to receive at least partial benefits while undergoing retraining and seeking new employment.
• Rehabilitative Employment - Any occupation or work for compensation or profit approved by the Insurer and undertaken by the insured while unable to work on a full-time basis usually in conjunction with a LTD plan.
• Renewal Date - The date when the insurance policy is to be reviewed for experience and the rates are adjusted.
• Retention - The portion of the premium retained by the insurance company to cover expenses and provide profits.
• Retirement - Permanent withdrawal from the labor force.

S

• Salary - Base salary, excluding bonuses.
• Secondary Payer - The plan that pays second when you have coverage through two benefit plans (yours and your spouse's plan). This is known as co-ordination of benefits where you can be reimbursed up to 100% (but not more) when you submit your claim to both benefit plans.
• STD - Short-Term Disability benefit provided to employees who are absent from work due to illness or disability. Short Term Disability (also known as Weekly Indemnity or Sick Leave) usually has a maximum amount of time the benefit will last.
• Sickness - Illness not arising from accident or injury. Usually the sickness causing disability must be contracted by the insured while the policy is in effect. Some policies require that the sickness need only manifest itself while the policy is in effect.
• Single - An unmarried person with no dependent children.
• Smoker - A smoker is defined as someone who has smoked cigarettes at least once in the last 12 months.
• Speech Therapy - Services provided within their specialty by holders of a master’s degree in speech therapy who are a member of the Canadian Association of Speech-Language Pathologists and Audiologists or an affiliated provincial association or who satisfies the conditions for membership in this association.
• Spouse - The person to whom you are lawfully married; or a person who has been cohabiting and residing with you for a continuous period of at least one year, and has been publicly represented by you as your spouse.
• Subject to Insurability - A statement of proof of a person's physical condition, occupation or other factor affecting his or her acceptance for insurance is required.
• Survivor Benefits - Allows dependent family members of a deceased employee to have continued coverage for a specified period; premiums are often waived during this period. See Waiver of Premium.

T

• Term Life Insurance - Life insurance plan that terminates when employment ceases. Conversion policies are available.
• Termination - An employee who terminates employment with the employer or withdraws from a group plan offered by the employer.
• Termination Age - Specified age when an employee loses insurance coverage. See Age reduction.
• Total Disability - Inability to perform all of the duties of one's regular occupation or the duties of any occupation for which the individual may become fitted due to education, training or experience.
• Twenty-Four Hour Coverage - Insurance providing benefits for an accident or sickness incurred either on the job or off the job.
• Two-Year Own Occupation - Common disability definition stating that the employee is disabled for his or her own occupation during the first two years of disability and thereafter is disabled for any occupation that is suitable by virtue of past training, education or experience.

U

• Underwriting - The process by which an insurance company determines whether or not it will accept an application for insurance.

V

• Voluntary - Chosen by one's own consent. Often refers to lack of minimum enrollment requirements.

W

• Waiting Period - A period of time that must pass in order for an individual to become eligible for benefits under a group insurance policy.
• Waiver - An agreement attached to a policy which exempts from coverage certain disabilities normally covered by the policy.
• Waiver of Premium - A provision that under certain conditions a person's insurance will be kept in full force by the insured without further payment or premiums. It is used most often in the event of permanent and total disability.
• Worker's Compensation Act - A statute imposing liability on employers to pay benefits and furnish care to employees injured and to pay benefits to dependents of employees killed, in the course of and because of their employment. See Offsets.

X

Y

Z

As a client of HUB International, we are excited to announce a new offering for your employees who are losing coverage – whether through retirement or not.

Key features:

• Fully online experience with Green Shield Canada (GSC) – quotes and application
• is available to anyone between the ages of 18 – 79 who are losing their group coverage – for any reason
• there is no termination age, not even for the travel benefit
• allows plan members to choose between a number of different individual plans
• options are available without medical evidence (i.e., a typical conversion product) as long as they apply within 90 days of coverage termination

Into the details:

Coverage is available on the 1^st of the month following approval. Applicants can choose their coverage effective date for any guaranteed issue plan with some options up to 3 months in advance (ie, approval today – you could choose a June 1^st, July 1^st or August 1^st effective date).

Quotes and applications for the Health Assist ZONE and LINK products are easy and can be done online for all provinces, except Quebec. In Quebec, quotes can be done online; however, any applications would need to be printed off and mailed in.

Here is the link for plan details, quotes and application https://mygscadvantage.ca/ha/Quote/AllProducts?mgaid=5567&oid=HA466&aid=N8024. The online portal will allow you to compare 3 plans at a time to assist with your decision.  An offering with “+” means that medical underwriting is required. If you prefer to use your own branding, you can copy and paste the link from the communications attached.

Future rate changes for employees signed up on this program will be effective on the 12-month anniversary of their policy. GSC will advise members of any rate changes directly.

Should employees have any questions, please email [email protected]