Atlantic Federation of Agriculture

Health Care

We are proud to provide you health care through Medavie Blue Cross. This plan covers what your provincial health plan does not. Enrollment in a provincial health plan is a requirement to be eligible for reimbursement of supplemental medical expenses under this plan. The chart below provides an overview of the plan.

Coordination of Benefits

If your spouse also has coverage, submit your own claims through your plan first and have your spouse submit claims through his or her plan first. You can submit any leftover amounts to each other’s plan to maximize your coverage. You must wait for the Explanation of Benefits (EOB) to be produced prior to coordinating your benefits. For any children on the plan, submit their claims through the plan of the parent whose birth date comes first in the calendar year

For further details, consult the plan booklet.

Dental Care

Keeping those pearly whites healthy is easy with your Medavie Blue Cross dental benefit.

Life insurance provides your named beneficiary/ies with a benefit in the event of your death.

Accidental death and dismemberment (AD&D) insurance provides specified benefits to you in the event of a covered accidental bodily injury that directly causes dismemberment.

Remember to make sure your beneficiary information is accurate, and update it through Morneau Shepell if you have any life changes. If you do not have a designated beneficiary, your life insurance and AD&D benefit will be paid to your estate. 

Basic Life Insurance/AD&D

This benefit is provided to you through Morneau Shepell. 

Optional Life/AD&D

You may purchase additional coverage through Medavie Blue Cross for yourself and your eligible family members.

Farm Family Support Center

We are proud to provide a confidential Farm Family Support Center. This is a short-term counselling and advisory service that connects farmers and their immediate family members to a network of dedicated professionals who are available to provide assistance 24 hours a day. This offers up to 3 hours per case of assistance for no cost. If you require more specialized or longer-term support they will connect you with the appropriate support. This services offers access to lawyers, financial advisors, dieticians, counselors, and more.

Critical Illness

Critical Illness insurance provides a lump sum benefit if you or your spouse or child suffer a condition that is covered and meet the survival period, and use the money in any way – there are no restrictions on how the money is spent. Some of the critical conditions that are covered are: cancer, heart attack, stroke, kidney failure, major organ failure requiring transplant, coma, blindness, deafness, Multiple Sclerosis (MS), Parkinson’s Disease, etc. For more details, see the plan booklet. Critical illness coverage, provided through Medavie Blue Cross, is available to you at an affordable group rate. Coverage is also available for your dependents.

For information on the cost of the benefits program, please click here for the rate sheet outlining your contributions.

You are eligible for benefits if you work 20 or more hours per week. You must have provincial plan coverage (or special temporary replacement coverage) in place to be eligible for the benefit plan. You must also enroll your eligible family members under the plan.

If you do not enroll your family members within 31 days, they will be subject to medical underwriting (which can result in restricted or declined coverage).

• Eligible family members include:
• Your legally married spouse
• Your common-law partner (must be common law partner for at least 1 year)
• Your children who are your biological children, stepchildren, adopted children or children for whom you have legal custody (age restrictions may apply)
• Disabled children who reach the age limit and who meet certain criteria may continue on your health coverage

If you are enrolled in a spouse’s plan and decide to waive health and dental benefits, you must still be enrolled in pooled benefits, including life and disability insurance.

To enroll in the plan, complete the information below and return to the third party administrator (Morneau Shepell). Once enrolled, you will receive your benefits card and information to sign up to the carriers benefit portal.

Please complete the following forms to enroll in the plan:

Click here for an example of a completed Section 1.
Click here to complete the Enrolment Form.
Click here to complete the Pre-Authorized Debit Agreement.

If you are applying for Optional Benefits or require Statement of Health Forms, please complete the following forms: Click here to complete the Medavie Blue Cross Statement of Health. Click here to complete the Medavie Blue Cross Statement of Health for Dependents. (if applicable)

If you are applying for Optional Benefits or require Statement of Health Forms, please complete the following forms:

Click here to complete the Medavie Blue Cross Statement of Health.
Click here to complete the Medavie Blue Cross Statement of Health for Dependents. (if applicable)

If you experience a qualified life event, please contact Morneau Shepell within 31 days. If you do not, your dependent(s) will be subject to medical underwriting, which may result in restricted coverage under the plan. Following are examples of the most common qualified life events:

• Marriage or divorce
• Reaching co-habitation period for common-law status
• Birth or adoption of a child
• Child reaching the maximum age limit
• Death of a spouse, common-law partner or child
• Spouse losing coverage under external benefits plan

Be prepared to show documentation of the event, such as a marriage license, birth certificate or divorce decree. 

It's as easy as a click. The following forms are available to print, fill out, and fax or mail in. They are provided in Adobe Acrobat PDF format. If you do not have Acrobat Reader, download it free of charge from Adobe's web site.

Forms for Enrolment:
Enrolment Form
Pre-Authorized Debit Agreement

If you are applying for Optional Benefits or require Statement of Health Forms, please complete the following forms:
Medavie Blue Cross Statement of Health
Medavie Blue Cross Statement of Health for Dependents

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