Plan Member Guide
Insurance Terms & FAQ
Group benefits come with a lot of jargon. This guide explains the terms you're most likely to encounter on a claim statement, an enrolment form, or a call with your insurer — in plain language. Reach out to your Plan Administrator or Benefits Plus Inc. any time something isn't clear.
Part 1: Frequently Asked Questions
Part 2: Key Terms & Definitions
Quick Reminders
- Keep your certificate number and policy number handy — you'll need both for every claim.
- Review your beneficiary designation at least once a year and after any major life event.
- Request a predetermination before major dental or high-cost treatment.
- Ask about a Prior Authorization Form before filling a specialty or high-cost prescription.
- Submit claims promptly; most plans have a 12-month deadline.
- Your benefits booklet governs. If this guide and your booklet differ, the booklet and the insurance contract apply.
This page is a plain-language reference only. Coverage, limits, and exclusions are governed by your group benefits booklet and the master insurance contract.