Definitions

  • Single – one employee, without a spouse or dependents
  • Family – one employee including a spouse or dependents
  • Spouse – a person who is legally married to the employee, or who is not legally married to the employee but has cohabited with the employee for not less than 12 consecutive months and having been represented as husband and wife (common-law)
  • Dependent – the employee’s eligible spouse and children residing in Canada or the United States of America
  • Participant – both employees and dependents are defined as ‘participants’
  • Direct bill – employees pay only their portion of the prescription cost and the remainder is billed directly to Alberta Blue Cross
  • Maximum – a dollar-amount coverage limit. Maximums may apply per visit, per year or per lifetime coverage. Once the maximum for the service or product has been reached, Alberta Blue Cross will stop paying and the covered individual must pay all remaining costs.
  • Dental coverage – can be basic, periodontic or extensive.
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