Understanding all the terms and acronyms within the benefits space can feel like learning a new language, so we’ve put together a quick reference chart for you containing all the essential glossary of group benefits terminology and acronyms, in alphabetical order. You can also skip ahead with the alphabet below to the term you are looking for.
Accidental Death Benefit
A benefit in a life insurance policy providing for the payment of an additional amount equal to the face amount of the policy in case of death by accident.
Accidental Death and Dismemberment Insurance (AD&D)
A form of health insurance that provides payment in the event of death or loss of one or more bodily members (such as hands or feet) or the sight of one or both eyes as a result of an accident.
Actively at Work or Active at Work
The employee is performing the normal duties of their occupation and working the number of hours set forth in the application.
A person professionally trained in calculating the risks and costs of insurance.
A type of insurance policy that allows the insurance company to make changes to the policy under certain conditions. Changes can include the amount of insurance, the premiums charged and the cash value.
Administrative Services Only (ASO) Plan
An arrangement under which an insurance carrier or an independent organization will, for a fee, administer a health benefit plan and settle claims but not guarantee payments because the plan is uninsured.
A person licensed by a provincial or territorial regulator to sell life insurance, accident and sickness insurance, group insurance and annuities including segregated funds. Also called an agent or a broker.
Aggregate Stop Loss
Provides a ceiling on the dollar amount of eligible expenses that an employer would pay, in total, during a contract period.
Anniversary Date or Renewal Date Flexible Benefits Plan
The anniversary of your flexible benefits plan issue date or another date on which the plan renews.
Annual Plan Reviews
A yearly study of a company’s coverage and claims history. This is completed to ensure that the plan is functioning efficiently.
The person who receives payments from an annuity. It can also refer to the person on whose life the payments are based or the policyholder.
A contract that pays out income at regular intervals, typically monthly, in exchange for an upfront payment. The income can start right away, or in the future. Annuities are often used to provide retirement income. When offered by an insurer, annuity contracts can be registered as RRSPs, RRIFs, TFSAs, etc., as well as offered through group retirement and savings plans.
A statement of information made by a person applying for insurance. It identifies the plan and the amount applied for, the life insured and the beneficiary, and provides other data useful in evaluating risk.
In the context of health or dental claims, this is an arrangement for the employee to assign reimbursement payments to another. For example, a patient can assign payment to the dentist so that the dentist can bill the insurer directly and the patient does not have to pay the dentist upfront.
Association Group Plans
Insurance plans designed for members of a professional association or trade association. Members may be protected under a group policy or by individual franchise policies.
Automatic Premium Loan
A feature in a permanent life insurance policy that allows the insurance company to pay for overdue premiums by taking a loan against the policy (as long as it has a cash value). Paying for overdue premiums in this way prevents your policy from being cancelled (or lapsing).
Base Annual Salary
The gross annual compensation prior to before-tax payroll deductions, if any, which an insured earns from their occupation with the policyholder and which was used in the calculation and remittance of premiums.
The person who is to receive the insurance proceeds at the death of the insured.
Cash Surrender Value
The amount your insurance company pays you when you cancel a permanent life insurance policy that has built up a cash value. The insurance company deducts any policy loans or overdue premiums from the cash surrender value before paying you.
The cash amount that builds up in a permanent life insurance policy. You can take a loan against the cash value of your policy. If you cancel your policy, you get the cash value. Whole life, variable life and universal life are types of life insurance that have cash value.
Certificate of Insurance
A document that sets out the key features of the insurance under a group insurance plan. It lists things like the type and amount of coverage, categories of dependents, deductibles and coinsurance, limits and exclusions, and instructions for making a claim.
A demand to the insurer by the insured person for the payment of benefits under a policy.
The person who makes a claim.
A provision in a health insurance contract by which the insurer and insured share, in a specific ratio, the covered expenses under a policy. For example, the insurer may reimburse the insured for 80 percent of covered expenses, the insured paying the remaining 20 percent of such expenses.
If you choose to name more than one person to receive a benefit, you can name some to be primary and others to be secondary (also called contingent). Primary beneficiaries are first in line to receive benefits. Secondary beneficiaries receive a benefit if the primary beneficiary for that specific share has already died when the benefit becomes payable.
An insurance contract is the legal agreement with your insurance company that sets out the terms of your coverage. The contract usually includes your application, the policy, and any changes made later to the policy.
A right that a policyholder has to exchange their policy for another one, without giving proof of good health. A common example is term insurance that can be exchanged for a permanent insurance policy. Another example is a group insurance plan where an employee plan member who leaves the plan can convert their group insurance to an individual insurance policy.
Coordination of Benefits
Families with two working adults may be covered by more than one health or dental plan. If your primary plan doesn't pay the full amount of an expense, you can submit a claim to the other plan for the balance. In this way, you can receive up to 100% of your expense.
Covered Expenses (also called eligible expenses)
Specified hospital, medical and miscellaneous health care expenses that will be considered in the calculation of benefits due under a health insurance policy.
A living benefit product that provides a lump-sum cash payment on the first diagnosis of one of several contractually specified critical illnesses or events.
Creditor’s Group Insurance
A type of insurance that helps to pay down or pay off your loan or credit card or cover your payments in certain situations, such as if you die or become disabled. It can be offered through financial institutions, auto dealers, mortgage brokers, retailers, or credit card companies when you take on debt.
If you have unpaid debts, the people you owe the money to (your creditors) may legally have access to your assets such as property, investments, or valuables to pay off the debt. This may happen through your bankruptcy or other legal proceedings.
Critical Illness Insurance
A type of insurance that pays you a lump sum if you are diagnosed with a life-altering illness such as cancer, heart attack, stroke, multiple sclerosis or Parkinson's disease. The exact illnesses covered are listed in your policy. You can buy this type of insurance on its own or may be able to add it to a life insurance policy or group plan.
A statement, signed by the insured, warranting that the information given by them is true.
The amount of covered expenses that must be incurred and paid by the insured before benefits become payable by the insurer.
A contract that pays out income at regular intervals, starting at a future date (e.g. a certain number of years or at a specific age).
Defined Benefit Pension Plan
A workplace pension plan that pays you a set benefit amount when you retire. Benefits are based on a formula that takes into account things like your salary, how long you were a member of the plan, and how much you and your employer contributed to the pension plan.
Deferred Contribution Pension Plan
A workplace pension plan where the amount you contribute is fixed but the benefit amount you receive on retirement is not. Your benefits are based on the amount you and your employer have contributed, plus investment earnings.
A type of insurance that provides coverage for dental expenses. It's usually provided as part of a group plan, but you can also buy it on its own.
Dependent Life Insurance
Life insurance for an employee’s spouse or children.
A physical or mental condition that makes an insured person incapable of performing one or more duties of their occupation.
A benefit added to some life insurance policies providing for waiver of premium and sometimes payment of a monthly income if the insured becomes totally and permanently disabled.
Disability Income Insurance
A form of health insurance that provides periodic payments when the insured is unable to work as a result of illness or injury.
The length of time you must be a member of a group before qualifying for coverage under the group plan. For example, an organization whose health and dental plan has a 90-day eligibility period would require 90 days of qualified employment before coverage could begin.
The waiting period an employee must be disabled before disability benefits become payable.
An acute, unexpected, or unforeseen illness or accidental injury which results in a sickness or accidental bodily injury of the insured.
Employee Assistance Plan (EAP), Employee and Family Assistance Plan (EFAP)
A benefit that provides confidential counselling or resources to employees and their family members.
A type of life insurance that pays you a set amount if you live to the maturity date of your policy. If you die before that date, your insurance company pays the set amount to your beneficiary.
Evidence of Insurability, or evidence of good health
A medical questionnaire an employee must complete to disclose medical history.
Things that are not covered by an insurance policy. They can include certain medical conditions you had before you applied for the insurance or high-risk activities such as skydiving. You can sometimes buy extra insurance to pay for risks that wouldn't otherwise be covered.
A life insurance policy where the savings growth doesn't exceed limits set under income tax law. In an exempt policy, the savings growth isn't subject to annual taxation.
Benefits such as health, dental, and vision. Premiums increase with use.
Extended Health Insurance (EHC)
A form of health insurance that provides, in one policy, protection for hospital and medical expenses not covered by government programs and usually other health care expenses, such as prescription drugs, medical appliances, ambulance, private duty nursing, etc.. The policy may contain a deductible amount, coinsurance, and high maximum benefits. Also called extended health benefits (EHB).
Extended Term Insurance
An option in a permanent life insurance policy that allows you to extend the period you're covered without having to pay additional premiums. It uses the cash value in your policy but your insurance coverage stays the same. How long the policy continues depends on how much cash value is available.
Also called the "sum insured", the face amount is the amount stated in your policy that your insurance company guarantees to pay when the insured person dies. It doesn't include amounts payable under accidental death coverage or other special provisions.
Financial Needs Analysis
When you buy insurance, an advisor may help you decide how much insurance you need by completing a financial needs analysis. This looks at your current financial and personal situation and goals to help decide how much insurance you need. It can include things like taking care of dependents and paying off loans.
Flexible Premium Policy or Annuity
A type of life insurance policy or annuity contract where you can vary the amount of your premium payments and when you make them. For example, you can pay premiums for six months and then stop paying them for the next six months. There may be minimums and maximums that apply to your payments.
Fraternal Benefit Society
A period in which an insurance policy is effective even though the premium is past due.
A workplace savings plan that provides a regular income, typically at retirement. Pension plans and group registered retirement savings plans often use group annuities to fund the plan.
Group Benefits, Group Insurance
A benefit plan developed for an employer that could include coverage for life, disability, extended medical and prescription drugs, dental, and critical illness.
An organization (for example an employer or association) that enters into a group insurance contract with an insurance company.
Guaranteed Death Benefit
The minimum amount an insurance company pays to the beneficiary when the insured person dies.
Guaranteed Insurability Benefit
An option in a life insurance policy. It gives you the right to buy additional insurance coverage at set future ages without having to give proof of good health. It's also called "Guaranteed Insurability Option" (GIO).
Guaranteed Maturity Benefit
The amount that your insurance company guarantees to pay you on the policy maturity date. This benefit is most common with segregated fund contracts.
Guaranteed Minimum Withdrawal Benefit
An option within a segregated fund contract that guarantees to pay you a stated income as long as you live, or for a specified period, even if the market value of the contract drops. If the market value grows, then the income paid to you can increase.
Guaranteed Renewable Policies
A feature of an individual insurance policy where the insurance company guarantees to renew the insurance at the end of a certain period, regardless of any changes in your health. Premiums may increase at renewal times.
Health Spending Account (HSA)
A benefit that covers an employee’s health care expenses. Claims are made against this account to pay for health and dental expenses that are not covered under the terms of the regular benefit plan.
A type of insurance that covers medical expenses (such as prescription drugs, dental expenses, vision expenses, and paramedical expenses) or loss of income if you're sick or injured.
Hospital Expense Insurance
A feature of extended health care insurance that covers hospital expenses not covered by your provincial health plan during your stay in the hospital. It can include the cost of private or semi-private hospital rooms and other prescribed hospital services.
A health insurance benefit that pays a flat amount for each day a covered person is in the hospital. The number of days covered is set and the daily amount paid doesn't vary, regardless of the medical expenses the covered person incurs. Also called "hospital cash plans".
A document you may get from your advisor when you are thinking about buying insurance. It explains how the policy would work and shows the costs and values of the policy under different conditions. It also should clearly show what's guaranteed and what's not. A policy illustration is for your information only and isn't part of a legal contract.
An annuity product you buy with a single lump-sum payment and that starts paying a guaranteed amount almost immediately.
Someone who has a serious medical condition may qualify for an impaired life annuity. This means they may receive a higher payment amount because their life expectancy is shorter than that of a healthy person.
In life and health insurance, a person is known as an impaired risk if they either have physical/health problems or a risky occupation/hobby. A person who presents an impaired risk may not qualify for coverage. If they do qualify, they may pay higher premiums for their coverage. For example, someone with a history of strokes would be an impaired risk.
Insurance purchased on an individual basis, covering only one person or, in some cases, family members as well.
Individual Variable Insurance Contract
An annuity contract where your premiums are invested in segregated funds managed by the life insurance company. The value of the plan will vary over time, based on the value of those investments. You are guaranteed to receive at least 75% of what you've paid into the plan on death or maturity, even if the investments have dropped in value.
The party to the insurance contract who promises to pay losses or benefits. Also, any corporation licensed to furnish insurance to the public.
A type of benefits plan that looks after injured or sick employees by continuing to pay a portion of their regular income while they are unable to work.
Key Person Insurance
A type of insurance on the life of a key employee in a business. If the key employee dies, this insurance is designed to provide cash to hire and train a replacement and replace lost revenues and profits.
An insurance policy that has ended because you stopped paying premiums and there was not enough money in the policy (cash value) to keep the payments up to date.
Level Premium Life Insurance
A type of life insurance where the premium you pay stays the same through the life of the policy.
The official certification a provincial or territorial regulator gives an individual to show the individual is authorized to sell insurance.
Insurance providing for the payment of benefits upon the death, whether by accident or otherwise, of the life insured.
Life Income Fund (LIF)
A type of retirement plan containing funds transferred from a pension plan. If you leave a pension plan, you may transfer the value of your pension to a LIF. At retirement, income payments from a LIF are subject to upper and lower limits each year, based on the amount in the account and the pension laws that apply to the LIF.
Life Income Option
An option available to beneficiaries to receive their life insurance payout. With this option, the insurance company pays the beneficiary regular and equal payments for as long as they live.
A restriction applied to a Registered Retirement Savings Plan or Registered Retirement Income Fund if amounts are transferred to that plan from a pension plan. It prevents withdrawals from the plan so that the plan can be expected to provide a retirement income.
Locked-in Retirement Account
A type of Registered Retirement Savings Plan (RRSP) containing funds transferred from a pension plan and where the money is locked-in.
Locked-In Retirement Income Fund
A type of retirement plan similar to a Life Income Fund. LRIFs are governed by pension laws and aren't available in all provinces.
Long Term Care Insurance
A type of insurance that provides financial support for people who become unable to care for themselves because of a debilitating, severe, or chronic illness.
Long Term Disability (LTD)
Management Expenses Ratio (MER)
The MER is a measure of how much it costs to operate and manage a fund. For a segregated fund, the MER often includes the basic guarantee cost. The MER is expressed as a percentage of the fund's value.
A review of a company’s current benefits package in comparison to benefits offered in the insurance marketplace.
Information or a fact you're aware of that could affect an insurance company's decision about whether to insure you and at what cost. For example, if you're being checked for a medical condition when you're applying for insurance, you must tell the insurance company. If you don't, the company could cancel your policy and refuse to pay any claims.
The date on which the insurance company pays a maturity benefit and the policy ends. For an endowment policy or annuity contract, including segregated fund contracts, the maturity date is a predetermined age or date.
Medical Information Bureau
A non-profit association of Canadian life and health insurance companies established to provide for the confidential sharing of information among its members. Member insurance companies use MIB's services to help assess an individual's risk and eligibility during the underwriting of life, health, disability income, critical illness, and long-term care insurance policies. Reports from MIB may alert insurance companies to applicants who have provided incomplete or false information, helping to prevent insurance fraud.
Medical Services Plan (MSP)
The provincial health plan for British Columbia.
A false or misleading statement an applicant makes when applying for insurance. An insurance company can cancel the policy if they find someone gave them false or misleading information in the application.
Misstatement of Age
This happens when an insurance company is given the wrong age for the person insured. In some situations, the insurance company can cancel the coverage when the wrong age is given. However, in many cases, they adjust the coverage or premiums to take the correct age into account.
Mutual Insurance Company
Non-Contributory Pension Plan
A pension plan where the employee makes no contributions. The employer funds the entire cost of the plan.
A feature of some permanent life insurance policies that provides the policyholder with choices if they stop paying premiums on a policy.
Optional Life Insurance
Life insurance on which all the required premiums have been paid and coverage continues.
Partial Disability Benefit
A disability benefit that pays a monthly amount that's less than a total disability benefit. In this situation, the insured person can't work full time or is prevented from performing one or more important daily duties of their occupation, but isn't considered totally disabled under the policy.
A savings plan intended to provide you with a monthly income in retirement. It can include a workplace plan, government plan, or your own individual plan. For workplace plans, depending on the specific plan, you and your employer may contribute to it.
Permanent Life Insurance
A type of life insurance that provides coverage for the lifetime of the person insured provided the required premiums are paid. Permanent life insurance usually has a cash value. Whole Life, Term to 100, and Universal Life are examples of this type of insurance.
The daily management and implementation of a benefits plan. This might include handling claims, adjusting coverage, adding and removing employees, or any number of other procedures.
The employer, association, or union which holds the group insurance contract.
Policy or Contract
The legal document issued by the insurer to the policyholder that outlines the conditions and terms of the insurance.
The person who owns an insurance policy. Also called the "insured".
If you have a participating insurance policy, a policyholder dividend is a payment your insurance company makes to you when the company performs well. Dividends are not guaranteed—they depend on things like the total amount of claims the company pays, how the company's investments perform and its level of expenses.
A loan made by a life insurance company to a policyholder based on the policy's cash value. A policy loan reduces the cash value and the insurance company usually charges interest.
The pool of funds that an insurance company keeps specifically to meet its policy obligations. The law requires insurance companies to keep sufficient reserves to pay all future claims.
Pooled Registered Pension Plan
A defined contribution pension plan designed for smaller workplaces and the self-employed. The funds in your account are pooled with other employers' funds in the plan to achieve lower investment management and administrative costs. The plans are run by licensed organizations such as insurance companies. In Quebec, this type of plan is called a Voluntary Retirement Savings Plan (VRSP).
Predetermination of Benefits
A claim procedure required by many group plans before you incur large expenses. For example, if you need major dental work, your plan may require you to obtain and submit an estimate of the costs so your insurer can determine what portion of the costs your plan will cover (called a predetermination of benefits) before you receive treatment. You can then budget for the expense knowing how much your plan will pay and how much you'll have to pay. You may be able to cover some of your costs under your spouse's/partner's plan.
A medical condition for which you've had symptoms, consulted a medical professional, or received treatment before you apply for insurance or before your coverage takes effect.
The payment, or one of the periodic payments, a policyholder is required to make for an insurance policy.
A payment arrangement where the insurance company uses policy dividends or cash value to pay your premiums.
Provincial Health Insurance Plan
Canada's health care program is made up of provincial and territorial health insurance plans, all of which share certain common features and standards and are designed to ensure all residents of Canada have reasonable access to health care from doctors and hospitals.
An insurance policy where the insured person does not meet the company's standard insurance requirements (for example, because of a risky occupation). The policy has higher risks and higher premiums.
Reduced Paid-up Insurance
A form of paid-up life insurance available as a nonforfeiture option. The policy continues, but for a reduced amount.
Registered Education Savings Plan (RESP)
A type of savings plan for your child's or grandchild's post-secondary education. No tax deduction is provided for contributions. Payouts from the plan to the student, for qualified education programs, are not taxed.
Registered Pension Plan (RPP)
Pension plans are subject to regulation by the Canada Revenue Agency, and such plans are called "registered pension plans".
Registered Retirement Income Fund (RRIF)
A type of payout plan that provides a minimum—but not guaranteed—retirement income. Registered Retirement Savings Plans (RRSPs) can be moved into RRIFs, or annuities, at or before their maturity date.
Registered Retirement Savings Plan
A type of retirement savings plan. The amount you can contribute to an RRSP is based on your income and is set by the federal government. The amount you contribute reduces the income tax you pay at the time, but you typically pay tax on any money you withdraw from the account.
Reinstating a Policy
You may apply to restart your insurance coverage if it ended because you did not pay your premiums. This process is called reinstating your policy. To do so, you must apply within two years of the date the required premiums were not paid. You must also provide evidence of insurability and pay any outstanding costs, plus interest.
An agreement between insurance companies to share insurance risk. One company transfers some of its insurance risk to another company, known as the reinsurer. Reinsurance is one way your insurance company manages the risks it takes on.
Renewable Term Insurance
A type of term life insurance that can be renewed at the end of the term, either automatically or at the policyholder's option, without evidence of insurability. The amount you pay for the insurance (the premium) is usually fixed and guaranteed not to change for the length of the term. When the insurance renews, the premium increases based on your age.
The act of replacing an existing insurance policy with another policy. Since this means that the first policy is cancelled, the insurance company usually requires a written statement showing you understand the seriousness of making this change.
The policyholder's right to cancel a policy within a set period of time and get a refund of any premiums paid. This "free look" period allows you to review the policy and ensure it meets your needs.
A type of beneficiary designation. You can change a revocable beneficiary at any time.
A change or addition to an insurance policy that either expands or limits the coverage and benefits.
The likelihood that an insured event will happen while the policy is in place. For example, in life and health insurance, risk is typically the likelihood that the person insured will die, be injured, or get sick.
A pool of investments held by the life insurance company and managed separately (i.e. segregated) from its other investments. If you buy a variable insurance contract, sometimes called a segregated fund policy, the value of your policy varies according to the market value of the assets in the segregated funds. Segregated funds may also be part of a group savings plan.
The choices a beneficiary or policyholder may have for receiving payment of life insurance benefits, other than an immediate cash payment. For example, the beneficiary may choose to receive the benefit in the form of an annuity.
Short-term disability (STD)
A benefit plan that pays an employee an income while they are unable to work due to non-work related illness or injury.
A benefits plan that only addresses one area of coverage. A dental plan is an example of a specific plan.
Standard or Statutory Provisions
The provisions in an insurance policy setting out certain rights and obligations that you and the insurance company have. These are required by provincial insurance laws.
A provision in a life insurance policy stating that benefits will not be paid if the person insured commits suicide or dies as a result of self-inflicted injuries.
Tax-Free Savings Account (TFSA)
A registered account you use to save money for any purpose. You don't get a tax deduction when you contribute to the plan. Investment earnings in the account are tax-free and you don't pay taxes when you withdraw money.
Employer-provided non-cash compensation that is subject to income tax.
Term Life Insurance
A type of life insurance that provides coverage for a set period of time. The period (or term) of the coverage can be either a fixed number of years (e.g., 10 years) or to a set age (e.g., age 65). The policy has no cash value.
Term to 100
A type of permanent life insurance that provides coverage for your lifetime, as long as you pay the required premiums. The premium amount stays the same and you stop paying premiums after age 100. The policy has little or no cash value.
Third Party Administrator
A company other than an insurance company who manages businesses’ benefit plans.
The process by which an insurer determines whether it will accept an application for insurance.
A type of permanent life insurance with flexible premium payments. It consists of two parts: life insurance and an investment account. You pay money into the investment account. The insurer takes premiums and other expenses from the account. Any investment growth accumulates in the account. You can increase or decrease your premiums and your death benefit within certain limitations. Investment growth may not be guaranteed depending on the type of investment chosen.
Weekly Indemnity (WI)
See Short Term Disability.
Waiver of Premium
A feature of some insurance policies that allows you to stop paying the premiums if you become disabled.
Whole Life Insurance
A type of permanent life insurance that provides coverage for your lifetime. It has fixed premiums, builds up a cash value, and has features that help keep your coverage in place if you can't pay the premiums.