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All Posts by Health Plus

winter wellness - healthy holiday

Prescription for a Healthy Holiday Season

Prescription for a Healthy Holiday Season ... expect side effects

Favourite time of year? Or just want the fuss to finish? No matter how you experience the holidays, there’s extra wear and tear on body and soul. For some, it’s an overload of social commitments and non-stop to-do’s while others feel more alone, anxious or sad. Every one of us could use a boost to our health. Fortunately, there are remedies for seasonal stress…no pharmacy required. Here’s the prescription for a healthy holiday season. Best taken daily.

Say No.

Take yourself off autopilot that leads to overwhelm. Send regrets for occasions that don’t appeal and let go of tasks that involve more stress than joy. Set boundaries. That may mean a change in traditions or routines that no longer work, or a commitment to yourself to avoid issues, arguments or drama that can ruin your mood if you let it. Say no to overspending. The ‘perfect’ gift is rarely the overpriced splurge. In fact, let go of ‘perfect’ anything. Simple is almost always much more fun.

Say Yes.

Speaking of fun, make time for more of it. Make a date with people you love, or with yourself for a good book or hobby you enjoy. Sing your heart out, carols or classics. Say yes to work….yes really! Sometimes. A sense of accomplishment is healthy and it can feel great to focus and get a project off your mind.  Just be sure work doesn’t keep you from saying yes to the essence of what matters … the people you care for who count on you. Oh, and make time for the mistletoe. 

Give. 

You don’t have to give like Gates or channel Mother Teresa. Small acts of kindness for a neighbour, supporting the food drive or donating whatever your budget allows to a cause you believe in all contribute to your own good health. Studies from Harvard to happiness professionals confirm ‘giving’ activates regions in the brain associated with pleasure, social connection and trust. Scientists have actually labelled the related release of endorphins. It’s called the “helpers high”. Get your dose.

Laugh. 

It will give you a serious lift. Reminisce about hilarious moments with friends, enjoy a favourite movie or stand-up act, or simply listen and treasure the cute comments from a child in your life. Studies abound on how laughter heals. It nourishes you by helping to relieve stress and elevate immune response. 

Repeat. 

Take these remedies as often as you can. Expect immediate relief and lasting benefits.

The Health Plus team wishes you and your family a happy, healthy holiday season. If you're looking for more support this holiday season make sure to check out our Wellness Resources. 

best value health insurance

How to get the best value health insurance

How to get the best value when you shop for health insurance

Shopping for health insurance isn't anyone's idea of a good time but it is part of a smart financial plan. It allows for one monthly budgetable bill that covers both routine health expenses and protection in case of unforeseen expenses from illness or injury. Because as much as we like to think we're invincible, we're probably not. But, how do you choose a plan that offers the best bang for your buck? When it comes to insurance, it's not just the sticker price (or overall monthly premium) that you should look at. You also want to know what you're getting for your money. Here are 4 factors to help evaluate a plan when shopping around to get the best value health insurance. 

Overall Maximums

This is the most straightforward. It refers to the maximum coverage amount for each type of service. Pay attention to whether a plan offers a separate maximum for each service or a combined maximum for a group of services. Maximums are often on an annual basis, but can be longer or shorter depending on the service. Some plans also include overall lifetime maximums or the total amount you can claim the entire time you are on the plan.  

I'm sure you've already figured out that in general, higher maximums are better. But, remember to consider not only maximums for services you may already be using (e.g. your dental visits) but all maximums weighed against real world costs. Most of us hope to never need expensive medication but a high prescription drug maximum is still a good idea. With the development of new groundbreaking medication, drug prices are on the rise. More than 1 in 100 Canadians will require prescription medication costing more than $10 000 per year, not something you want to pay out-of-pocket. 

Per-visit Maximums

A lot of insurance companies also choose to limit the amount covered for one visit to a practitioner, even before you reach you reach your overall maximum. They do this so they can control claims expenditures. Low per-visit maximums can mean you end up paying a lot of out pocket for a covered service. For example, if your plan has an overall maximum of $500 for paramedical services such as massage therapy or chiropractors but a $25 per-visit limit you'll pay the difference every time you go. Obviously most professional services don't cost just $25, so this isn't too great of a deal. 

You may see the words "reasonable and customary" in a policy instead. This is just the insurance company's way of saying they'll cover your treatment up to a set amount, meant to reflect the typical cost of a service. Some plans, like Health Plus plans, require an approval step for services beyond a dollar limit instead of placing a low per-visit limit. While the initial step of getting approval may seem annoying, ultimately it means if you need it you're covered. Our advice is to avoid plans with low per-visit maximums. When you're already paying high premiums they aren't good value. 

best value health insurance
best value health insurance
best value health insurance

Reimbursement Levels

Just because something is included in the plan doesn't mean the insurance company is covering 100%. The reimbursement level, also known as co-pay is the percentage of a claim, up to the maximum, the insurance company will pay. Plans vary widely. While some pay 50%, others pay 90%. This consideration goes hand in hand with maximums. A plan that pays 100% isn't worth much if low per-visit limits mean you'll be paying out-of-pocket regardless. 

Rate Increases

This is an important one and not usually highlighted in the brochures. Plan rates may increase over time due to factors such as increasing healthcare costs or an increase may be written into your terms. For example, most plans have an automatic increase with age (Health Plus plans don't). This means every 5 years, after age 40 or 45, your monthly premium will automatically go up, something you'll definitely want to budget for. While no plan can guarantee its rates will never rise, you can try to choose a plan with relatively stable rates. And as you work health insurance into your budget it's a good idea to gauge how much of an increase you might be facing. Don't be afraid to ask whether premiums were recently increased and whether another increase is expected.

Health insurance is not an insignificant purchase. Making sure you get a plan where your money goes the farthest and you have the security you need is important. A little extra research beyond the basics and marketing slogans can go a long way. Whether you're working with a broker to help navigate the options available to you or going to companies directly, asking questions and knowing exactly what you're getting for your money will help you feel more confident in your decision. 

Workplace wellness

4 Workplace Wellness Tips for Small Business

4 Workplace Wellness Tips for Small Business

Running a small business is tough. You’re often taking on the tasks of more than one person, which can mean taking on the extra stress as well. This makes a workplace wellness plan all the more important. Whether it’s just you or you have a team, investing in wellness can lead to increased productivity and positively impact employee satisfaction. Ultimately, healthy people lead to healthier business.   

 So, what exactly is “workplace wellness” anyway? The term workplace wellness usually refers to a number of programs aimed to improve employee physical and mental health. These might include stress management, fitness and nutrition, or smoking cessation programs, and can be educational or activity-oriented.   

 Workplace wellness programs don’t have to be expensive or complicated, two things you definitely don’t need in a small business. Here are 4 tips to implement a workplace wellness initiative that works for you.   

1.   Identify what type of "wellness" you actually want or need

There’s no one-size-fits-all approach to fitness and health in life or in the workplace. The first step to planning a wellness initiative is figuring out what issues you and your team are facing. This doesn't need to be complicated or intrusive. Get input from your team about their biggest stressors and health concerns and ideas for how to improve. If it’s just you, think of a wellness challenge you’re facing or what helps you relax or feel physically or mentally energized. Then choose an activity or initiative that fits you and your team. Not everyone wants lunchtime goat yoga, no matter how trendy it might be. Is a running group, meditation break, or healthy snack sharing more your speed? 

2.  It starts with your workspace

Where you work matters. Our workspace is often where we spend the majority of our waking hours, which means it can have a big influence on both our mental and physical health. Good news, small changes can have a big impact. Research has shown that sitting at a desk for too long is incredibly detrimental to our health. Try standing meetings, or use reminders to take a walk break. If poor air quality or low light are an issue, it may be as simple as a lamp, air filter, or diffuser. Check whether your workspace has secure bike storage if you'd like to encourage alternate transportation. Revamp your lounge or break space to encourage your team to take a mental break throughout the day and make connections with one another. Implement a healthy snacks only rule for shared food if you’re trying to encourage healthier eating.  

3.  Communicate & write it down

For any new wellness activity or initiative, small or large, you’ll need to communicate it to your team. Get them involved and engaged in the process. Put up affirmations or reminders in the office of what your goals are. Create a team board, online or in the office, that is your place for all things wellness. Even if it’s just you in your business, writing down your wellness goals will help keep you accountable.   

4.  Learn what resources are available to you

While you may not have the budget to hire an outside company to curate an entire wellness program just for you or administer additional health and fitness benefits, you can utilize resources already available to you to help inspire a new wellness idea, or provide educational tools.  If you already have health benefits, look into what wellness resources are included. Many health plans, including Health Plus, include wellness tools to help their members kickstart a healthier lifestyle. Other online resources, such as those from Canada's Healthy Workplaces Month, give great ideas for wellness activities for a variety of goals.   

Wellness isn't a one-and-done activity but a lifelong process. However, getting started can be a lot easier than you might think. And, if you find the right activity for you, it can end up being a lot of fun with huge rewards, both personally and professionally. 

​

health plus plan upgrades

New Health Plus Plan Upgrades

Exciting Upgrades to Your Health Plus Plan

At Health Plus we’re always working hard to make sure our members have the best benefit plans available. This year we’ve made big improvements to both our Optimum and Priority plans. First, we brought in 3 great Wellness Resources, available to all members at no extra cost. Now, we’re working with new partners to help us make your insurance even better.  

NEW  SINGLE PARENT PRICING

Being a parent is tough, especially if you're building a business, which is why we're committed to offering the best rates for families and we've added a new reduced rate for single parents. 

Header

HEALTH PLUS OPTIMUM*

HEALTH PLUS PRIORITY*

Parent + 1 child 

$181.00

$144.00

Parent + 2 children

$246.00

$199.00

For parents with 3 children existing Family rates apply. *Rates per month including tax.

VIEW ALL RATES

PLAN UPGRADES

We've extended existing coverage and added completely new coverage.  So whether you run your own business, freelance or work on contract you can be sure you're getting the best value available. 

  • NEW  Major Restorative Dental Coverage, including Crowns, Bridges, and Dentures. Optimum plan maximum $600 / person / year.  Priority plan $400 / person / year. *Eligibility after 18 months of plan membership  
  • Extended Travel Coverage. Out-of-country emergency health coverage extended to 60 days (from 30 days) so you can enjoy peace of mind on longer trips without having to buy any more travel health insurance.  
  • Higher Vision maximum (Optimum plan). Coverage for glasses and contact lenses increased to $200 from $150 every 2 years.  
VIEW ALL COVERAGE

NEW PARTNERS

As a small business ourselves, we understand the demands and look at things from your point of view. We  want to make sure we work with companies with the same commitment to meeting your needs. To help bring you these latest plan improvements, we've partnered with MDM Insurance Services and The Cooperators, two companies who, combined, have been serving Canadians for over 100 years.

Have questions? Contact Us
Ready to get covered?
APPLY NOW
summer health and safety

Summer Health & Safety Tips

Essential Summer Health & Safety Tips
to Make the Most of the Season  

Summer is finally in full swing. Whether you're headed to the cottage, planning a vacation, or just trying to enjoy activities or events in your hometown, it's good to keep a few summer health and safety tips in mind. 

Take care of yourself   

Of course you already know you should use sunscreen. But it's not only the SPF factor you should pay attention to.  Make sure your sunscreen protects against both UVA and UVB rays and is water resistant. Apply evenly to all exposed skin and reapply regularly. If you want to try natural or mineral sunscreen look for the ingredients titanium dioxide or zinc oxide. 

Use insect repellant. Bug bites can lead to much worse than an annoying itch. This year, there are warnings about the increased risk of Lyme disease, which is carried by ticks. Learn more about how to recognize ticks and prevent infection here. And while mosquitos at the cottage might be legendary, remember there's just as big a risk from mosquitos in small amounts of standing water and from ticks in the park or on the beach. Cover up, spray well before going out and check your body and clothes when you come inside. 

When it comes to repellants, conventional chemical skin repellants DEET and Picaridin are both highly effective at repelling mosquitos, ticks and flies for up to 12 hours. If you’d prefer to use a natural formula, lemon eucalyptus oil and IR3535, a plant-based compound, have both been found to be almost as effective against mosquitos. Other natural oils such as citronella, tea tree, rosemary, eucalyptus, geranium, cedarwood, and lemongrass can be used to make a DIY repellant. But be aware, these are less effective and require reapplication every 30-60 minutes. 

Stay hydrated … and not just with beer or cocktails, as refreshing as they might be.  Drinking water and plenty of it, is especially important in hot, sticky weather.  Dehydration, heat stress and stroke can be deadly.  Make sure you get your 8 glasses (2 litres) every day.  Experts recommend water every 20 minutes when it’s extremely hot or you’re engaged in sports or other physical activity.  And make sure the people around you, especially children and the elderly, are drinking enough water too.  If you are relaxing with a cocktail try alternating a glass of water with a top up. 

Take care of others ... on the road and in the water

Take extra care when you're driving. There are often more distractions this time of year - more people on the roads, biking and playing, more tourists and more construction. If you're biking, running, or walking remember the rules of the road apply to you too. Pay attention to signals, signs and use lights at night. 

If you're heading to the cottage, pool or beach follow water-safety precautions and be smart when you swim, surf and boat. Don't get behind the wheel or in the water impaired. Don't assume your guests have the same skills or good habits as you and your family. Take time to make sure everyone is comfortable and equipped. 

Run Away

We’re not kidding.  Find time to step back, slow down and relax.  Research shows people who take vacations have fewer heart attacks, headaches and backaches. They go back to work more energized and productive with a positive attitude that rubs off on the people around them, including clients.  ​

Whether you're simply taking a weekend staycation or a longer trip make sure you actually "unplug", take yourself off "on call" and escape work for a little while. And if you are travelling out of the country, make sure you have travel insurance. Nothing ruins a vacation like an unexpected injury or illness, followed by a whopping bill. If you have Health Plus you have 30 days emergency health coverage included in your plan. If you have any questions about your coverage or want to sign up give us a call. 

From our team to yours have a fun and safe rest of your summer! 

wellness moment comfort food guide

Wellness Moment: Comfort Food

The food group that Health Canada forgot ...

Kudos to Health Canada for our new Food Guide for what to eat, what to avoid and the reminder it's not only what we eat, but how that matters. Food fosters connection with friends and family and between cultures and generations. And we know connections help keep us healthy. It's very sound advice. But with all due respect to the professionals, we think there's a food group missing: Comfort Food. 

Now before you automatically think calories, cholesterol and guilt, let's take a closer look. Webster's defines comfort food as "food prepared in a traditional way ... with nostalgic or sentimental appeal". Psychologists tell us it can be any food we associate with happy occasions, fond memories, and feeling cared for and connected. And those positive feelings cheer us up and ward off stress. 

So here’s a recipe for winter wellness. Take a moment to let your mind wander. What’s your favourite comfort food, meal or memory? Fresh peaches that remind you of summer holidays, your mom’s roast chicken, or the cookies you bake with your kids. Maybe it’s not home-cooking. It could be tapas in a café with friends or take-out that lets you trade kitchen time for downtime. It’s the food with a positive association, from last weekend or long ago, a celebration or a simple tradition. And if your food of choice conflicts with your regular eating goals, not a problem. The magic is that you don’t have to actually eat comfort food (although why not?). You can enjoy the memories without taking a bite. 

If this Moment leads you to host a spontaneous pot-luck, make soup or make reservations, that’s great. If not, that’s fine too. You’ll have taken a healthy step just by savouring positive thoughts. 

Health Plus New Services

New Wellness Services

We've just added even more benefits. For everyone. 

You know Health Plus already offers great coverage for health bills, routine and unexpected.   Now there are even more advantages that come with your plan. 

The new benefits we’ve added are not what you might expect. In fact, they’re not usually available if you work in small business or on your own (unless of course you search and pay).  We think that’s just not right.  That’s why we chose these new services for you. 

​Health Plus now includes three professional Health and Wellness Resources.  No added cost, no claims required, customized to your needs.  Designed to help you, your family and business thrive, the new services are simply here when you need them.  

Answers, information, someone to listen, professional advice ...

Life, work and relationships can present challenges and questions.  Now with Health Plus you have access to the Employee and Family Assistance Program (EFAP) from Shepell.  For the times you simply want a sounding board or professional view on a health, financial or relationship matter, from day care options to career moves.  Or the times you’re facing a serious situation that's causing anxiety or poses​ a risk to you or someone close.   
 
Your EFAP is available 24/ 7 by phone, email or text, in many languages.  The on-line library alone has hundreds of resources on dozens of topics. Experienced Shepell professionals can help connect you with more specialized and longer term services if needed. Used to be only people in a big employer plan had an EFAP.  Health Plus is the only plan that includes it for you ... even when you’re on your own.  With your Health Plus plan, now you can count on Confidential Counselling and Resources.

Fewer side effects, faster route to wellness when you take prescription drugs ... 

A personal pharmacogenetic test is new science that helps your doctor prescribe the right drug in the right dose for your unique DNA.  A simple test you do yourself at home can help reduce adverse / allergic reactions and avoid the ‘trial and error’ process it sometimes takes to find the right meds for physical or mental health concerns.  In some cases, it can be life-saving.  Test results are interpreted by the Health Plus consulting pharmacist who reviews them with you (and your doctor if you agree) and even suggests non-pharma treatment too.  You’re on your way to wellness more quickly with a Personalized Prescribing Plan.   

A professional HR department even when you're a company of one ...

Whether you’re solo, employ staff, or work for someone else, you may have questions about contracts, compensation, policies, or other workplace concerns. Now, you can call the experienced HR professional at our partner, Beneplan for answers, suggestions on best practice, even policy templates. Without the cost of hiring a consultant, when you're a Health Plus client, you can call on Custom HR Advice.  

You can see why we're excited to say Health Plus benefits just got better. 

​We’ll be posting details very soon on how to access this toolkit of services.  In the meantime, visit ​workhealthlife.com, click 'browse as a guest' below the sign in, for a sample of the extensive EFAP support.  If you want to explore any of the three new services further before our next post, please contact us at Health Plus.  416-498-6944, 877-218-0394 or info@healthplusinsurance.ca.   We’ll be happy to connect you directly.   

  • 416-498-6944
  • 877-218-0394
Coworking Guest Blog

Feeling Healthier – and Happier – with Coworking

Just as insurance must change to fit the new world of work, where we work is changing too. We know it can be hard to find good benefits when you’re on your own.  Our friends, the Rostie Group recognize it can also be a challenge to find the right work space. In our first guest blog, the Rostie team explains why co-working might just be the answer and why it’s good for your business and your health.  

Feeling Healthier - and Happier - with Coworking 

In a rapidly changing world, your options for where you shop, live, and even work are broader than they’ve ever been. Entire enterprises can be started and run out of a mobile phone and a laptop.

If you’ve started your own business, you’re a freelancer or do gig work, it can be tempting to set up a home office and call it a day. But you’ll quickly find out that staying in and doing all your work from home may start affecting your creativity, discipline and social skills.

A coworking space can not only help alleviate those symptoms, but may even boost your well-being, and provide new opportunities for business.

Coworking Boosts Creativity

Surrounding yourself with familiar sights may make you comfortable, but true creativity does not come from comfort. It instead comes from the diversity in people and in the places around you. In a coworking space, there is diversity and inspiration. You will meet people who you may have never come across in your neighbourhood, and their own stories and ideas will excite and engage you.

Coworking helps with discipline

Anyone can enjoy a day working from home. Sometimes we all need a moment away from the office. But just as above, the same surroundings that make us comfortable, may also lead to lower productivity. If you can take a nap during the day in your own bed, why wouldn’t you? A nap turns into a longer lunch, which can turn into entire days off.

Having a place to go everyday, to set up and work, and then return home can help with your discipline – to have a clear line between home and work.

Coworking grows your social skills

Humans are social animals. We require company and others around us to develop social cues and learn from each other. While there is nothing wrong with some alone time, historically work has been the place where social relationships have developed. 

A coworking space allows you to still have that camaraderie and interaction with other people that is necessary. Even if you don’t all work for the same company.

Coworking allows you to expand your business via networking

The key to expanding your business is networking. Getting to know other entrepreneurs and workers who have either started their own businesses, or are part of a small team. As entrepreneurs working in the same space, they understand the value and product, and will be your easiest sales.

Additionally, they can help you by telling you what services are helping their business, strategies for growth, and what’s worked for their own business. It’s the sense of community that you can’t get anywhere else.

If you are ready to give coworking a try, either temporarily or permanently, take a look at The Rostie Group in Toronto. They offer daily and monthly coworking options, that all include the following:

  • 24/7 access to 20 Bay Street, WaterPark Place, 11th floor Coworking Room
  • 20 Bay St. business address with mail handling and Reception Services
  • Hi-speed wireless Internet connection
  • 30% Off Meeting Room rates, including 8 free hours of small Meeting Room usage per month
  • Access to a phone at your dedicated desk with a locked filing cabinet upon request
  • Use of business services (printer/fax/copier/admin) (additional charges apply)
  • Use of the Rostie Group Lounge and Kitchen
  • Invitations to all social gatherings, events and networking activities
  • Discounted TriFit gym membership for WaterPark Place tenants only
  • And complimentary coffee

www.rostiegroup.com

416-214-1840

info@rostiegroup.com

Wellness Moments Friendship

Wellness Moment: A Little Help From Our Friends

Wellness Moment

"I get by with a little help from my friends"

The Beatles are right. Friends matter. Not to argue with the icons but actually, friendship does more than help us “get by”. There’s growing scientific evidence it helps us thrive. Our social connections (note that’s social, not social media connections) boost wellbeing, happiness and resilience. In fact, studies show that people with a solid network of friends live longer.

This may not be news to you. So why this “Moment” on this theme? Because we know what happens. When life gets hectic, what most often slides is time with friends. Even with the best of intentions, between our schedule and theirs, you know how it goes. This week is Mental Illness Awareness Week, not to mention the lead-up to Thanksgiving. It feels like the perfect time to check-in on those we love and take a little time for ourselves. 

So, take a moment. Think of the people you truly enjoy – old and new friends, a favourite neighbour, kindred spirit colleague, or the family member you’d love even if you weren’t related. Set a date ... for coffee, the market, to watch the game or go for a walk. If that’s not possible, plan a phone call. Although it turns out in-person is the best tonic, just hearing each other’s voice will do you both good. 

Wellness Moments Friends

Photo by Ivana Cajina

If you’re wondering how you’ll find the time, remember this. It’s good for the immune system, and everything on your to-do list will go better. We promise. The Beatles would agree. For more on the link between friendship and health: Washington Post, New York Times, The Village Effect: How Face-to-Face Contact can make us Healthier and Happier.

Insurance Jargon

Insurance Jargon in Plain Language

Insurance Jargon in Plain Language ... it's not you, it's them

 Here’s a pitch we hear too often. “I have just the plan for you.  Guaranteed issue, no deductibles, high maximums and good co-pay. Great coverage at a great premium because it includes generic substitutions. Underwritten by Befuddle Insurance Co.”     

Ready to sign?  Probably not.  Confused?  You’re not alone.  The insurance world often forgets we’re mere mortals, not insurance bots, and gets carried way using industry jargon instead of plain language.    
 
Insurance is an important financial decision, especially if you’re self-employed or own a business, and choosing the best option takes effort.  Deciphering dense terms should not be part of the chore, so we’ve decoded some common insurance jargon to help clear the fog.    

Insurance Jargon
Premium

Premium may sound like something insurers are pitching as the “best” but actually, premium refers to what you pay your insurer. In other words, the monthly rate for your coverage.   Be careful taking the number at face value though.  Low premiums often mean the plan covers much less.   

Deductible

You're probably somewhat familiar with this piece of insurance jargon.  Commonly tossed around as a plan feature, deductible is the dollar amount you must pay out of pocket before the insurer will begin to pay any portion of your bill.  Deductibles are good for the insurance company because in theory they help mitigate risk.  The idea is that if we’re paying the first bill ourselves we might think twice before incurring an unnecessary expense because “it doesn’t matter, my insurance will cover it”.  The insurer wants to avoid a deluge of minor claims which can really add up.  

Not all plans have deductibles, and amounts can vary, so you’ll want to look into plan details to make sure you’re getting the coverage level that’s important to you. 

Co-insurance / Co-pay

These terms simply refer to what percentage of the bill you’re responsible for paying, after any deductible is taken off the top, and what the insurance company pays. For example, Health Plus Optimum Plan covers 90% of health services such as prescription drugs.  That means if you have a $100 bill, Health Plus would pay $90 and you would pay $10.  (With Health Plus, there’s no deductible).   

Maximum

Even the best benefit plans have limits on what’s covered.  Maximums refer to the maximum dollar amount a plan pays for claims during a specific time period.  Maximums may apply for a specific type of service (e.g. massage or physiotherapy) or for all services combined (e.g. an overall dental maximum). The time period in which a maximum is applied may differ as well. It is common to see per year or per visit maximums.    

Maximums are important to look at when comparing plans because they can affect how you'll actually be able to use your coverage and how much of your bills are paid. For example, even if your plan has a high overall maximum for the year, if there is a very low per visit maximum for a service, such as physiotherapy, you will end up having to pay out of pocket for treatment.  

Underwriter

Although this term sounds rather ominous (it’s a little too close to undertaker) it actually refers to the money guys,​ the people who pay your claims, usually a large insurance company. The underwriter reviews your application and assesses risk based on factors such as current health, age, previous health history, or sometimes lifestyle if you happen to be a stunt sky-diver to try to determine how likely it is you will have expensive claims. The underwriter then decides to take you on or denies coverage because they think you pose too big a risk to the plan. They may also approve your insurance coverage but adjust the monthly premium to account for higher risk.  
 
The bottom line, look for a plan that's underwritten by established, reputable insurers. And it's best to apply when you’re healthy.   

Guaranteed Issue

No doubt you’ve heard the ads  “acceptance guaranteed, no medical info required”.  Sounds easy, doesn’t it.  And in fact it is straightforward, on the surface. It refers to coverage that is guaranteed to be issued to you regardless of your age or the state of your health. That’s the upside.  The downside is that because these plans don’t involve health questionnaires, the underwriters can’t assess the risk involved in insuring you. So they set the rates high.  You should assume that guaranteed issue plans offer significantly less coverage and tend to be more expensive than plans that require information about your health.     
 
Guaranteed issue plans can be a good option if you don’t qualify for anything else due to a chronic or serious medical condition. But make sure you do your homework so you know exactly what you’re getting.  You don’t want to lose out on coverage you’re counting on.   
 
And if you’re currently healthy, don’t rely on guaranteed issue as a fallback for future.  If you become ill or injured, there’s a good chance these plans won’t offer the coverage you need.  We’ll say it again: the time to buy insurance is when you’re healthy.  

Generic Substitution

Think of this simply as brand-name and non-brand.   Generic drugs have the same active ingredients as their brand name counterparts so they carry the same health benefits.  But they’re sold under a generic label at a significantly lower price.  Substituting a lower cost generic alternative for a brand name drug is a way to keep claims costs lower for the insurance company.  And since your rates are based on the cost of claims made by everyone in your plan, generic substitution saves you money too. But if the generic drug doesn't work for you good plans, such as Health Plus, will substitute the brand name drug.   

So here’s to simplicity.  If you come across terms you don’t understand, don’t be shy.  The problem’s not you.  It’s up to your insurance company and advisor to translate insurance jargon and make things clear.   Don’t hesitate to ask.   

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