is not always easy to read and understand the jargon used in group insurance brochures.
That’s why today I offer you a few explanations on the most commonly used words, in order to make your life a little easier …even if, I agree with you, reading a group insurance leaflet is, by no means, no one favourite bedside reading!
COORDINATION OF BENEFITS
If 2 members (married or common-law couples) have 2 separate family group insurance contracts, they can claim their medical expense with their insurance, and then claim the expense balance with their partner’s insurance. But beware! Both participants must have family contracts to coordinate their benefits.
OUT OF POCKET
Portion of medical claim not covered by the group insurance that remain at your charge.
ELIMINATION PERIOD
Waiting period before being able to get your benefits. This term is often used in salary insurance. Indeed, in this case, a 7-day standstill period is registered in the contract before entitlement to benefits.
WAIVER
The right not to join the health insurance if you can provide proof of insurance with your spouse or partner’s insurance or via another job.
EXEMPTION
Guarantee provided in the contract in case of sick leave that allows you to keep your health coverage without contribution payments.
PROOF OF INSURABILITY
Form to be filled in to validate your health situation and thus to determine acceptance or not by an insurance company.
This glossary is far from being exhaustive but is a good summary of the terms most often used in group insurance jargon. There are, of course, other expressions or words not explained in this document. If in doubt, do not hesitate to refer to your group insurance administrator.
You can also write to us and ask us any questions. We are here to help and serve you.