C
Child
Your natural or adopted child or stepchild who is: unmarried, under age 21, or under age 25 if a full-time student not eligible for coverage as an employee under this or any other group benefit program. A stepchild must be living with you to be eligible. A child who is incapacitated on the date he or she reaches the age when coverage would normally terminate will continue to be an eligible dependent. However, the child must have been covered under this benefit program immediately prior to that date. A child is considered incapacitated if he or she is incapable of engaging in any substantially gainful activity and is dependent on the employee for support, maintenance and care, due to a mental or physical disability. For dependent life insurance, a child must be at least one day old to be eligible.
Coinsurance
The percentage you must pay after the yearly deductible has been met until out-of-pocket maximum is reached.
D
Dependents
Your spouse or child(ren) who are covered under the provincial group plan.
Deductible
The deductible is the amount you pay each year before the plan begins to pay for expenses.
L
Late Application
An application is considered late when you apply for coverage on any person after having been eligible for more than 31 days; or reapply for coverage on any person whose coverage had earlier been cancelled. If you apply for benefits that were previously waived because you were covered for similar benefits under your spouse’s plan, your application is considered late when you apply for benefits more than 31 days after the date benefits terminated under your spouse’s plan; or apply for benefits, and benefits under your spouse’s plan have not terminated. Medical evidence can be submitted by completing the Evidence of Insurability form, available from your employer. Further medical evidence may be requested by Manulife Financial.
Late Dental Application
If you apply for dental coverage for dental for yourself or your dependents who were previously waived because you were covered for dental under your spouse’s plan, your application is considered late, the benefit will be limited to $125 for each covered person for the first 12 months of coverage.
Lifetime Maximum
The maximum amount the plan will pay per covered member in his or her lifetime.
M
Medical Evidence
Medical evidence is required for all benefits, except dental, when you make a late application for coverage on any person. Coverage for late applicants is not guaranteed and Manulife Financial has the right to approve or decline coverage, based on the evidence submitted, as well as request additional evidence of insurability information. The late applicant will bear the cost of extra medical information required to assess his or her insurability. Manulife Financial’s decision will be communicated to you in writing. Coverage is effective when the application is approved by Manulife Financial.
S
Spouse
Your legal spouse, or a person continuously living with you in a role like that of a marriage partner for at least 12 months.