Coverage varies by plan, insurer, and employer. Employees can confirm their coverage by reviewing the Employee Benefits Booklet provided by the insurer or provider, or by contacting them directly for specific eligibility, limits, and claim details. If we are your Group Benefits Consultant, employees should also have access to the Employee Benefits Summary designed to make the plan easier to understand. It highlights the benefits employees typically ask about most, summarizes key coverage information, and provides important links, contact details, and access information in one convenient resource. As a summary resource, the insurer’s booklet and policy remain the governing sources for coverage details. Should you wish to access this resource, please contact your employer directly.

The first step in understanding whether you have enough insurance coverage is knowing what you already have. Group benefit plans provide valuable protection, but they may not address every personal financial risk or obligation. Some individuals therefore maintain personal insurance alongside the coverage available through work. Coverage needs can change over time. Changes in income, employment, family circumstances, dependants, debt, or other financial responsibilities may affect the amount and type of protection you need. Your group benefits coverage may also change when you change jobs, your earnings change, or your employer modifies its plan. Keeping a clear record of both group and personal coverage makes it easier to see what protection is in place and when a review may be appropriate.INSURANCE TRACKERDOWNLOAD A simple tool to help you organize and track your life & living benefits coverage in one place.Once completed, consider keeping: an electronic copy that can be easily updated whenever coverage changes; anda printed copy with your insurance documents so the information is readily available if required. Once your tracker is complete, you can visit our Individual Insurance page to learn more about the services we provide and how we can help review your personal circumstances and existing coverage for potential gaps. Contact us if you would like to discuss your coverage. Disclaimer: This resource is provided for organizational purposes only. It does not constitute insurance, investment, financial, legal, tax, or other professional advice, and no result or outcome is guaranteed. EBC’s downloadable resources are intended to be saved and used on your own device; information you enter into them is not submitted to or stored by EBC. Please verify information and seek appropriate professional advice before making any decisions.

The person, people, or entity (“Beneficiary”) you designate to receive an eligible death benefit under your group benefits plan. You may name more than one Beneficiary and assign a percentage to each, provided the total allocation equals 100%. Beneficiary designations should be reviewed periodically, particularly after major life events. Primary: The Beneficiary first entitled to receive the death benefit. Contingent: The Beneficiary that receives the death benefit if no Primary Beneficiary survives you. This helps avoid delays or complications in directing the proceeds. Minor Beneficiary: A child under the age of majority, but special rules apply to how the proceeds are paid.Trustee: A person appointed to receive and manage the proceeds on behalf of a minor beneficiary. They are not a beneficiary.Entity Beneficiary: A non-individual beneficiary, such as a charity, trust, corporation, institution, or estate.Estate Beneficiary: If designated or no eligible beneficiary remains, the death benefit may be payable to your estate.Revocable Beneficiary: A designation you can generally change without obtaining the beneficiary’s permission.Irrevocable Beneficiary: A designation that generally cannot be changed without the beneficiary’s written consent. Important: Beneficiary designations do not necessarily update automatically after marriage, separation, divorce, or other life changes. Review and update your designation directly with the insurer when circumstances change. Employees can use the insurer’s beneficiary designation form or online portal and should seek appropriate professional advice where needed.

Coordination of benefits applies when you or your eligible dependants are covered under more than one benefits plan. It determines the order in which claims should be submitted so each plan can assess its portion of the eligible expense. The claim is submitted to the primary plan first. Any remaining eligible balance can then be submitted to the secondary plan, together with the first plan’s Explanation of Benefits (EOB). Total reimbursement cannot exceed the eligible expense. If a Health Care Spending Account is available, any remaining eligible balance may be submitted after all insured coverage has been coordinated.COORDINATION OF BENEFITS SEQUENCE: Alberta Government-Sponsored Programs: This chart applies to employees without coverage under Alberta’s Non-Group Coverage or Coverage for Seniors programs. Effective October 1, 2026, employees with either program should submit eligible EHC expenses to all applicable private insurance plans first, then submit any remaining eligible balance to their government program before claiming through their HCSA.

Your claim may not be fully reimbursed for several possible reasons: Eligibility & Timing: Waiting periods, benefit years, or claim submission deadlines may affect payment.Coverage Exclusions: The service, treatment, drug, supply, or procedure may not be covered or may be specifically excluded.Coverage Limits: The plan may only reimburse a percentage, apply a deductible, or limit coverage by frequency.Charge Limits: Fee guides, R&C & dispensing limits, generic pricing, or alternate-benefit provisions may reduce reimbursement.Approval Requirements: Referrals, prior or special authorization, medical necessity, or step therapy may be required.Coordination of Benefits: Another plan may need to pay first, with the remaining eligible balance submitted afterward.Documentation: Missing receipts or information, incorrect details, or insufficient documentation may affect processing.Processing Issues: Duplicate claims, billing errors, or insurer processing errors may require review or resubmission. Start by reviewing the insurer’s Explanation of Benefits (EOB) or the provider's Claim Statement, which should show what was paid and why any portion was declined or reduced. If the reason is unclear, contact the insurer or provider directly - they can explain how the claim was assessed and whether additional information or a resubmission is required. If we are your Group Benefits Consultant and you are having difficulty resolving the issue with the insurer or provider, you are welcome to contact us directly. With your written consent, we can escalate the matter with the insurer or provider and keep you informed. To protect the confidentiality of your personal health information, we recommend contacting us directly. Claim details are handled confidentially and are not shared with your employer as part of our assistance, unless you provide prior written consent.